At Baptist Health Louisville, we had been working on patient flow for years. We had a dedicated inpatient flow team, multidisciplinary rounds, daily huddles, performance improvement resources, dashboards and reporting. Because emergency department (ED) boarding remained a significant challenge, we had also created surge areas to use when needed.
We had a strong foundation. We had also reached the point where we had gotten much of the low-hanging fruit.
The next opportunity was not another isolated initiative or more physical space. We needed to make our established operating model more consistent, connected and proactive. That shift helped us reduce ED boarding hours by 48%, lower operational length of stay by 9.6 hours and give precious time back to leaders each day.
When a strong process still creates too much work
Our existing workflows required leaders to gather information manually from multiple places. The preparation took time, the information was fragmented and multidisciplinary rounds varied by unit, physician or leader. In many meetings, we spent more time reporting what had already happened than solving problems. Even when we addressed barriers, we often did so reactively.
We wanted one place where teams could see patient progression, barriers and priorities. We also wanted a partner, not simply another application. We selected LeanTaaS and its iQueue for Inpatient Flow solution to support that evolution.
The technology mattered because it put the right information in front of the right people at the right time. The goal was operational: less manual preparation, a more consistent workflow and more time to make decisions.
Turning daily huddles into decision-making time
Every morning, we begin with an 8:30 a.m. safety huddle for leaders at the director level and above. At 9 a.m., nursing leaders meet with departments across the hospital, including radiology, physical therapy, cardiology and environmental services.
That cross-functional participation has been a huge part of our success. Together, we look at the census, demand across the organization, staffing needs, expected discharges and barriers we can address that day. If the emergency department is holding 10 patients, several patients need MRIs or a high surgical volume is headed to one area, everyone understands the pressure and the plan.
This discussion once took 30 to 40 minutes. Now it takes about 10 because the information is already available in one shared view. Leaders no longer report unit by unit or spend significant time assembling updates. We can focus on the operational decisions that matter.
We also moved our afternoon huddle earlier, to 2 p.m., and changed its purpose. Instead of revisiting patients expected to leave that day, we spend a minute or two resolving any remaining barriers and then prepare for tomorrow. We look ahead to tests, procedures, transportation and other needs that could delay the next day’s discharges.
That shift from reacting today to preparing for tomorrow has been one of our biggest wins.
Results that patients and teams can feel
From January through July 2026, compared with the same period in 2025, ED boarding hours declined from 23,489 to 12,314, a 48% reduction. Operational length of stay fell from 6.1 to 5.7 days, or 9.6 hours. Expected discharge date compliance reached 91%, and discharge processing time improved by 14 minutes.
The operating model also returned about 40 minutes each day to nurse managers, with additional time savings for directors and other leaders. That matters. I often say the nurse manager role is the hardest job in the hospital. Time that leaders no longer spend digging through applications or sitting through repetitive reports can go back to patients, staff and operational priorities.
The improvement did not come from one department. Standardized multidisciplinary rounds created a consistent process for physicians, nurses, case managers and other teams. Ancillary departments gained earlier visibility into what patients needed. Clear task ownership after huddles helped ensure that actions did not get dropped.
Change management made the operating model stick
We did not create entirely new workflows. We built on what teams were already doing and made those routines work better. That distinction is important in healthcare, where teams are already experiencing change fatigue.
Even so, standardization required a significant investment in change management. We explained why the work mattered, listened to barriers and worked alongside teams. Our chief medical officer and I continued to attend multidisciplinary rounds. We met regularly with hospitalist and nursing leaders to understand who was adapting well, who needed help and what needed to change.
Sometimes the barrier was basic. We learned that case managers needed laptops to participate fully in the new workflow. At other times, nurse managers told us the information on screen was too busy or did not fit their workflow. Responding quickly helped them feel heard and increased engagement.
For health system leaders, the lesson is straightforward: build on existing workflows, commit the leadership time and social capital required for change management, and choose a technology partner willing to adapt around frontline needs. The platform can create the opportunity, but frontline involvement and leadership reinforcement make the change sustainable.
Patient flow is never finished
Every improvement reveals the next constraint. We continue to refine our huddles, improve discharge performance and reduce administrative work. We are now using next-day discharge information to coordinate patient movement with physicians, admission and discharge nurses, transportation and overnight follow-through by house managers.
Patient flow can feel like boiling the ocean because so many pieces affect it. A shared, data-driven operating model makes the work more manageable. It helps teams see where the barriers are, decide who will act and keep improving without starting over.
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Michelle presented this work at Transform Inpatient Flow Virtual Summit on September 1, 2026. Watch Baptist Health Louisville’s story and others on demand.
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