Get em In - Get em Out

Session
Patient Throughput

Author
Pauline Hogan
Systems and Process Consultant
Franciscan Skemp-Mayo Health System

Description
Attend this session to hear how a small community hospital system in the midwest is streamlining patient throughput by focusing efforts at both ends of the cycle: Streamlining Admissions and Expediting Discharges. You'll learn of the resources used, strategies employed - both successful and unsuccessful - outcomes being measured and next steps. Walk away with some ideas, templates and strategies you can use to make positive changes in your own patient flow projects.

Abstract
Throughout the past two years, Fransciscan Skemp has been working on streamlining patient throughput. A recent effort to convert to a more private room model has reduced the overall number of beds available for patient care and the difficulties to fill open nursing positions further strains the system. We focused our efforts first at streamlining patient placement. These efforts included developing a One Call system for physician referrals and patient transfers; creating a nursing operations coordinator who manages the placement of patients; developing an electronic bed board that reflects more than just open beds, but also reflects staffed bed capacity; and many others.

Then the group focused at expediting discharges. To jump-start this effort, 2 units (both med/surg floors), participated in a 6 week IHI web and action series. Before starting the program, we analyzed the admission and discharge patterns. Both transactions were peaking at the same time of day. The IHI program focused on scheduling discharges similar to airline departures. The goal is to schedule 80% of all discharges and of those scheduled 80% leave within 15 minutes of discharge. These units have moved their average discharge time up by 15 minutes. Given the volume of discharges, this represents a statistically significant improvement.

For the presentation, I will share templates and resources used - including IHI, HCAB, and others. We have also recently developed a scorecard for patient throughput, so I will be able to share the results of that at the time of the conference. I will also be able to speak to our future efforts to incorporate more provider involvement and recent CMS regulations that will impact all hospitals as it pertains to discharge notifications.