Healthcare News & Insights

How one hospital system improved patient flow

Keeping patient flow efficient should be at the forefront of every hospital executive’s mind. The quicker patients are evaluated and triaged for treatment, the more patients your hospital can see – which improves your facility’s bottom line. 

200314225-001Recently, a large hospital system in Philadelphia — Thomas Jefferson University Hospitals — did a serious overhaul of its patient flow processes. The results of its efforts were detailed in a study from the American Journal of Medical Quality.

According to an article from Medscape about the transition, using quality improvement tactics popularized by GE, Jefferson decided to take active steps to streamline patient flow five years ago. At the time, issues with patient flow were negatively affecting emergency department wait times and patient care.

The goal of the program was to improve the facilities’ bed management so patients wouldn’t have to wait as long to be admitted and treated.

Key improvement steps

By adapting GE’s famous “WorkOut” process, which encourages collaboration between employees in different roles and departments in a company, Jefferson came up with several ideas to improve patient flow.

The biggest idea was creating the Patient Flow Management Center (PFMC), a facility with an open floor plan designed as a central hub for the three hospitals in the system.

The PFMC controlled a variety of services relating to patient flow, including bed management, patient case management, patient transport, and ambulance and helicopter dispatch. Even the cleaning staff used for patient rooms at each hospital was headquartered at the center.

Hospitals could communicate with one another through a single, standardized technology platform that relayed details about the status of these functions in each building. Because each hospital could easily find out about bed capacity and wait times at the other facilities, patients could be quickly transported to another hospital for faster treatment if necessary.

Building upon GE’s WorkOut principles, Jefferson also created a patient flow team with representatives from various roles within the hospital, including doctors, nurses and case managers.

Communication was encouraged through daily bed meetings with nursing staff, which helped the patient flow team receive regular updates about what was working and what needed to be changed. Physicians were also encouraged to rethink their discharge protocol, altering times of patient discharge to maximize the available number of beds in each facility (within reason).

Other processes were implemented to improve efficiency at Jefferson’s hospitals as well. Staff members at PFMC were trained on best practices to maximize workflow.

They were also encouraged to follow evidence-based protocol for identifying and treating patients with critical conditions such as congestive heart failure, strokes and pneumonia. Using tools such as checklists, clinicians were able to quickly determine how patients should be triaged, and could direct them through the PFMC accordingly.

Favorable results

By centralizing and streamlining processes related to patient flow, Jefferson experienced a turnaround.

Before implementing these changes, the wait time for a patient to see a provider after arriving at the emergency department was 74 minutes. Afterward, the time dropped to 41 minutes. There were also marked improvements with completed patient transports, monthly admissions and ambulance diversion to competing hospitals (which decreased from 87 hours each month to 7).

Even without having a patient flow center like Jefferson’s, hospitals can still do the legwork to root out inefficiencies in care processes or communication protocol that have a negative impact on patient flow. Consider creating an interdepartmental patient flow team of your own to get the ball rolling.

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