Late Discharges, Cold Bed Times, ED Diversions…Reduce Costly Delays with 3 Patient Flow Steps
Nothing spells poor patient care (and bad business) better than delays. When the patient flow process has clogged—and you can’t get people to the appropriate care level—your satisfaction ratings and margins will take a hit. ED diverts, procedure delays, admitting bottlenecks, late discharge times, these are all 4th Alarm fires that will foul the temper of even the nicest hospital CEO. Not only is this bad patient care, but it also means lost revenue, costly inefficiencies, and cranky doctors and nurses.
So, let’s talk numbers. Here are some national averages that indicate lost contribution margin (yes, lost profit). All these result from delays:
Can anything be done, or do we just have to keep a box of chocolates (or a Valium) around for the CEO on those days? We need to reduce patient care delays by enhancing patient flow and care coordination. Here are three steps:These are direct losses in reimbursement, and do not include the costs for additional nursing staff, billing inquiries, or any complications or legal issues that arise from these situations.
Step One: Recognize
With impending reforms, we can’t ignore this problem and hope it will go away. Consider, does your hospital experience any of these typical care delay scenarios?
- Late discharges due to late or non-prioritized rounding
- Unacceptably lengthy “cold bed” time, often caused by failure to report when discharged patients actually leave (“bed hiding”)
- Barriers to timely acceptance of transfers: poor bed visibility, or slow physician response
- Failure to “plan ahead” for potential AM discharges and for patient load from “scheduled” points of entry such as Cath lab, GI suite, same-day surgery, etc…
- Lack of planning expected LOS and expected discharge dates/times, especially around observation patients
- Little or late attention paid to “moveable” patients where level of care exceeds need
Our challenge is to recognize when these delays and patient flow barriers are happening in our institution, and resolve that we actually CAN change them. Here’s how…
Step Two: Plan Process
Once we’ve accepted the need for change, we need to plan out the processes to reduce delays by evaluating patient flow best practices and current workflows.
Many emerging best practices differ from the traditional way things are handled. Strong leadership, relationship building, and a commitment to the vision must be present to engage in some of these cultural and process changes.
Some of the “scarier” fixes that significantly impact patient flow:
- Telling physicians that they have to take a patient even if they aren’t part of their practice
- Taking bed turnover out of the hands of nursing, even if it means nurses get patients close to shift change
- Have hospitalists round on potential discharges earlier, or even the night before
- Updating LOS and expected discharge dates based on changing issues
Everything above can be planned, agreed upon, designed on Visio diagrams, in-serviced, and placed in reference binders on every shelf throughout the hospital. However, two immutable truths exist:
- Old habits don’t die.
- Out of sight is literally out of mind–those new instruction binders will remain on the shelf, and traditional workarounds will replace them.
Step three: Execute
To stay on track, the tools used in the trenches must support your desired processes. This is where we look at technology and ask, “Do my tools only display information, or does this software really help me get my job done right?”
To reduce delays and enhance margins, the workflows designed in Step Two need to become a living, breathing part of the technology in use. Literally, the system must think, move, alert, and report just like a person who is following the instruction binder.
This is where Central Logic’s patient flow ‘secret sauce’ sets it apart from the rest of the field. With Core™ Bed Management, you have the ability to design custom workflows and processes into your patient flow software system.
The ability to take into account the needs of specific units, various physicians, the different ways we communicate, escalate, and look at issues… All of these can be factored and accounted for within Core. With technology that supports your staff, and reminds and guides them through best practices, you will reduce delays leading to increased patient satisfaction, boosted margins, and a happier C-Level.
Click here to get a free one-hour consulting session and discuss patient flow solutions.