Capacity management is fundamentally a multidisciplinary team endeavor. Hospitals need to forge partnerships with providers both within and outside the organization to ensure efficient care delivery from admission through discharge. Darin M. Vercillo, MD, a co-founder and CEO of patient flow software firm Central Logic, shares six tips for leveraging hospital-provider relationships to improve patient flow.
1. Break down silos. The first step to optimize patient flow in any setting is to remove the barriers between departments and people. "Break down the silos of these different organizational units," Dr. Vercillo says. "Bring in combination things like bed management and case management under one organizational unit to function jointly. Traditionally, we've seen a lot of these function separately and their crossover has been minimal. Best practice is to bring transfer centers, bed management and case management together."
2. Do bed huddles. After eliminating silos, hospitals can establish daily bed huddles so a multidisciplinary team can discuss the progression and plans for patient flow. In bed huddles, physicians, nurses, case managers, social workers and other providers regularly meet to predict patient volumes and prepare for patient flow challenges. The same approach can be used for discharge planning, in which physicians and staff determine when and how to discharge patients.
3. Partner on room discharge. To shorten the time between a patient's discharge and hospital notification that a bed is open, some hospitals have given the notification responsibility to transport staff. Once a patient leaves a room, a transporter communicates to the appropriate people that a room is ready to be cleaned. "In the past, it was left up to the nursing staff or another staff member with multiple responsibilities." Dr. Vercillo says. "The last thing on their list is to tell someone the room is free. By using technology to automate the process and turning it over to the transporter, you can reduce turnover from eight hours to half an hour."
4. Communicate the in-system transfer process. A hospital that needs to transfer patients due to capacity limits can minimize revenue losses by establishing processes to easily transfer patients to an affiliated hospital. Hospitals should also communicate the availability of in-system facilities to physicians. "The most effective hospitals have provided tools for their own affiliated physicians to keep the patient in the hospital or if the patient has to leave, to provide a path of least resistance to go to a sister hospital when it makes sense from a business and patient care standpoint," Dr. Vercillo says.
He suggests hospitals that are part of a larger system take advantage of the system's different facilities to prevent patients from going to competitors. "Hospital systems need to look at themselves with a system-ness approach and not pit individual [facilities] against each other. [They need to] come up with a more cooperative approach to provide services where they funnel patients into the system and then utilize their battery of resources across hospitals more efficiently."
5. Build relationships with specialists. Hospitals should build relationships with specialty care physicians both within and outside the hospital to encourage referrals and prevent delays in transfers. Having a connection with specialists ensures easy, safe and fast transfer of care to the hospital and to the specialist, which improves patient flow.
6. Work with post-acute care providers. To improve patient flow to post-discharge care, hospitals should also form relationships with nursing facilities, rehabilitation centers and other post-acute care providers to create a safe transition for patients. "We see patient flow as being a fundamentally connected process — around the inpatient world, but growing now to touch even the outpatient world," Dr. Vercillo says.
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1. Break down silos. The first step to optimize patient flow in any setting is to remove the barriers between departments and people. "Break down the silos of these different organizational units," Dr. Vercillo says. "Bring in combination things like bed management and case management under one organizational unit to function jointly. Traditionally, we've seen a lot of these function separately and their crossover has been minimal. Best practice is to bring transfer centers, bed management and case management together."
2. Do bed huddles. After eliminating silos, hospitals can establish daily bed huddles so a multidisciplinary team can discuss the progression and plans for patient flow. In bed huddles, physicians, nurses, case managers, social workers and other providers regularly meet to predict patient volumes and prepare for patient flow challenges. The same approach can be used for discharge planning, in which physicians and staff determine when and how to discharge patients.
3. Partner on room discharge. To shorten the time between a patient's discharge and hospital notification that a bed is open, some hospitals have given the notification responsibility to transport staff. Once a patient leaves a room, a transporter communicates to the appropriate people that a room is ready to be cleaned. "In the past, it was left up to the nursing staff or another staff member with multiple responsibilities." Dr. Vercillo says. "The last thing on their list is to tell someone the room is free. By using technology to automate the process and turning it over to the transporter, you can reduce turnover from eight hours to half an hour."
4. Communicate the in-system transfer process. A hospital that needs to transfer patients due to capacity limits can minimize revenue losses by establishing processes to easily transfer patients to an affiliated hospital. Hospitals should also communicate the availability of in-system facilities to physicians. "The most effective hospitals have provided tools for their own affiliated physicians to keep the patient in the hospital or if the patient has to leave, to provide a path of least resistance to go to a sister hospital when it makes sense from a business and patient care standpoint," Dr. Vercillo says.
He suggests hospitals that are part of a larger system take advantage of the system's different facilities to prevent patients from going to competitors. "Hospital systems need to look at themselves with a system-ness approach and not pit individual [facilities] against each other. [They need to] come up with a more cooperative approach to provide services where they funnel patients into the system and then utilize their battery of resources across hospitals more efficiently."
5. Build relationships with specialists. Hospitals should build relationships with specialty care physicians both within and outside the hospital to encourage referrals and prevent delays in transfers. Having a connection with specialists ensures easy, safe and fast transfer of care to the hospital and to the specialist, which improves patient flow.
6. Work with post-acute care providers. To improve patient flow to post-discharge care, hospitals should also form relationships with nursing facilities, rehabilitation centers and other post-acute care providers to create a safe transition for patients. "We see patient flow as being a fundamentally connected process — around the inpatient world, but growing now to touch even the outpatient world," Dr. Vercillo says.
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