1. Automate patient flow. One example of this trend is the growing use of logistic control technology in patient flow, says Lisa Romano, RN, MSN, Chief Nursing Officer, TeleTracking Technologies. Addressing overcrowding exclusively as an ED problem was treating the symptom and not the disease. Without available beds for ED admissions, emergency personnel must split their time between emergent cases and patients who should be moved to the units. Automated patient flow squeezes wasted time out of the bed turnover process, converting that time into space — as much as 20 percent more space without adding a single new bed. By speeding bed turns and transports, patient flow automation can make many more beds available.
2. Review overhead departments. Departments such as accounting, human resources, IT and education do not directly earn money for the hospital, making it difficult to determine how much they need to be cut back when revenues are down. This hurdle makes it all too easy for hospital budget-cutting to sidestep these departments and focus on areas where financial performance can be more easily measured, says John Johnston, vice president of QHR Consulting.
One way to establish a budgetary target for overhead departments is to look up their percentage of operating revenue five years ago, when hospitals were still ramping up services, and compare it to the percentage now. The 2005 data would have to weighed against other considerations. For example, cuts in the IT department might have to be laid aside because a new CPOE system is being installed.
3. Tag movable equipment for inventory management. It's important for hospitals and healthcare providers to keep track of where the movable equipment is located to make sure the books are set up appropriately and are complying with financial reporting requirements, according to a report from Principle Valuation. Principle Valuation helps its clients with inventory management by tagging assets with a bar code. Appropriately detailing the existing assets will assist in determining whether they are over insured or underinsured, and knowing their remaining life will help determine depreciation expense for financial reporting and tax purposes, according to the report.
The inventory reports can be organized to show the assets by type and department, and placing bar codes on the movable equipment can help track them as they move from one floor to another.
4. Continuously assess workflow. The business office and other staff should get together and review the center's workflow process every three or four months. "Staff may be working hard but they're not always working smart," says Jeff Blankinship, CEO of Surgical Notes in Dallas. If they brainstorm, staff could come up with many areas ripe for improvement. Staff identifies the inefficiency and then suggests ways to address them.
Many issues seem minor at first glance. In a facility that relies on scanning a large number of documents, for example, staff have to remove staples from documents each time they scan. One answer is to use paper clips instead. When downloading dozens of reports, an employee might be pushing the button for each report, instead of pushing the button to download all of the reports at once. Instead of coming up with its own solutions, an ASC might decide following a general list of best practices, but Mr. Blankinship says this not enough because each ASC has its own set of problems that have to be identified.