Why did they close all those beds in the 1990's?

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Tools, Techniques & Strategies for Change

Amy Diane Short
Six Sigma Black Belt
The University Hospital of Cincinnati

Terry Dunn
Six Sigma Black Belt
Health Alliance of Greater Cincinnati

Lee Ann Liska
VP, The University Hospital of Cincinnati

Overcrowded ED's, patients boarding in the PACU, incoming transfers delayed or refused-Demand for inpatient beds across the country seems to grow daily, while nursing staffing shrinks! Hear how one urban teaching hospital routinely at 90%+ occupancy is leaping forward to meet the ever-increasing needs of its patients and workforce.

More and more patients want to get in, but staff are so busy they can hardly keep up with routine care, let alone ready patients for discharge! The University Hospital operates as a teaching hospital, a regional referral and trauma center, and as the de facto public hospital serving the poorer areas of Cincinnati. Following the closing of an adjacent community hospital, demand for services has been nearly overwhelming. Complete leadership turnover brought fresh ideas and renewed interest in using the assistance available from internal consultants, and created an opportunity to start fresh in addressing the mismatch between supply and demand. What they've learned can help others.Effectively managing for inpatient throughput in a capacity constrained environment requires a different mindset than most managers have. One of the biggest challenges is aligning the sometimes conflicting goals of managers from seeking local optimization to achieving system success. The next hurdle is knowing where to look for improvements and how to make them happen. Finally, the right strategies "not just people!" to maintain flow have to be in place.