UMass Memorial president on tackling patient flow issues

 Emergency department boarding remains at crisis levels even as the pandemic dwindles — and capacity problems will likely persist for hospitals through the next decade. 

Worcester, Mass.-based UMass Memorial Medical Center is one such hospital where staffing issues and low capacity in other care settings such as skilled nursing homes and long-term care facilities have caused discharge delays — one of the factors that has driven a rise in the facility's average daily patient census, hospital President Michael Gustafson, MD, wrote in a July 13 blog post for LinkedIn. 

In June, UMass Memorial's average midnight patient count was 813, up from 636 for the same month in 2019, according to a graph shared by Dr. Gustafson. To target these challenges, UMass Memorial has undertaken the following initiatives: 

  • Started reporting kew flow and access metrics on a weekly basis
  • Launched a daily discharge report so operational leadership can track performance in all inpatient units
  • Increased focus on multidisciplinary rounds and dyad RN, MD leadership

"Over my tenures at UMass Memorial we have seen a staggering increase in patient demand across the community. While much of it cannot be controlled, we are managing where we can" through efforts such as expanding the hospital-at-home program, Dr. Gustafson said. 

The testing of a predictive model to identify patients likely to be discharged within 24 to 48 hours was among other efforts the hospital is undertaking to address capacity challenges. 

"Solving our capacity challenges will not happen overnight. This work takes time, careful analysis, innovation, patience and persistence — and comprehensive input and collaboration from all areas of the hospital," Dr. Gustafson said. "But I am confident that by sticking on the trajectory detailed above, no matter how challenging the external environment gets, we will experience more 'good days' with smoother operations than 'frustrating days' with persistent patient backlogs." 

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