Healthcare capacity is a hot issue. As Baby Boomers age in droves and the relative number of healthcare providers dwindles, the flow of patients through a hospital can have a significant impact on operating margins.
Accordingly, there is plenty of buzz around optimizing patient flow and troubleshooting throughput issues. At the root of the issue is the desire to provide excellent patient care. However, other concerns, such as patient satisfaction and patient loyalty, may also be at play.
"In a world of HCAHPS and pay for performance, there is more and more demand each year for hospital administrators to improve quality, reduce cost and prepare for the future of healthcare. Hospitals can't stand still. They have to continuously improve efficiencies and effectiveness of systems and processes," says Diane McCullough, vice president for patient transportation and observation with ABM Healthcare Support Services. "What happens is some administrators may rely on modifying their current structure and may overlook addressing non-clinical staff, systems and processes that must be put into place to facilitate throughput efficiency," she says.
Indeed, departments operating as silos can cause serious problems. When each service line is considered only in relation to itself, capacity gets messy. Hospitals can miss efficiencies because of decentralized flows of both people and information, which can add on to waiting times for ED patients, as well as for other departments like surgery.
As a result, hospitals may consider building out their EDs; however, adding space is not always the best option.
The ED as a piece of the capacity puzzle
ED capacity and patient throughput are intimately connected for several reasons. First, basic inefficient movement of patients within the ED can increase wait times. Second, the percentage of patients being admitted to hospitals from the ED has increased significantly. In just a few decades, the figures have ballooned to more than 50 percent, and they can be much higher.
"I just interviewed a hospital ED director at a hospital where 94 percent of their admissions came through the ED," says Ms. McCullough. This astonishing statistic highlights the stark truth: Assessing hospital capacity is no easy feat.
For hospitals leaders who suspect their services may be siloed, Ms. McCullough suggests examining nonclinical support services capabilities— such as patient transport and environmental service processing — that have the potential to reduce holding times.
She also suggests considering investing in a real-time patient flow technology solution, which shows promise for both tracking current bed demand and predicting future bed demand, given certain parameters.
Finally she suggests factoring in communication and measuring wait times across service lines and among caregivers as another potential avenue for finding capacity efficiency. "After all, resolving system-wide issues depend on the little things," she adds.
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