Patient throughput, also called patient flow, is often a source of headaches for hospital administrators and department leaders. Bottlenecks or breakdowns at any point in the process can cause unnecessary inefficiency and significant wait times for patients and placement staff.
In order for patient throughput to truly “flow,” discharge processes, transportation processes, housekeeping processes, and placement processes all need to work seamlessly together, which can be a monumental challenge, especially for larger facilities. It’s impossible to know how well all these processes work together without concrete data on each individual point in the process – after all, you can’t manage what you don’t measure.
With technology tools like BedWatch Bed Control, BedWatch Transport Control, and BedWatch Admit Control (coming late 2014), hospital administrators and department managers can easily track and monitor throughput processes on the go, from any mobile device or other internet-capable computer. The comprehensive, time-and-date-stamped data BedWatch captures, along with dynamic, built-in reports, make it easy for users to objectively asses performance by department, by unit, or by individual team member.
This data is the key to identifying chronic bottlenecks and breakdowns in your throughput processes, and can ultimately help you drive lasting improvement. A good benchmark goal is for the entire process to average under 240 minutes, ED Door to Patient In Bed, per the Centers for Medicare and Medicaid Services.
At BedWatch, we highly recommend that all of each of our partner hospitals create a Throughput Committee to help ensure that throughput process improvement is an ongoing, constant effort.
The single most important component of any throughput committee – and any innovation or improvement effort – is active engagement and support from the administrative team. Top-down leadership is the most effective way to drive change of any kind, and creating a culture of performance improvement is no different.
Once the executive team is fully on board, it’s time to assemble the Throughput Committee. We recommend including the following roles, however, each hospital is different, so this is just a guideline from one of our own hospital partners:
- EVS Director
- Nurse Managers / Directors
- Site Administrators / House Supervisors
- ED Director
- Lab Director
- Pharmacy Director
- Radiology Director
- Project Manager
- Bed Board Personnel
- Case Management
- Admitting Personnel
- Any Applicable Physician Leadership (CMO, ED Chief, etc.)
We recommend meeting once a month to review performance data for the entire patient throughput process, start to finish, looking for chronic bottlenecks and brainstorming strategies for improvement. It is imperative that the Throughput Committee be a “safe space,” free of accusations and finger pointing – the purpose of this effort is not to blame the person whose department is the source of a bottleneck, but to work together to improve throughput for each and every patient that comes through the hospital doors.
Map the entire patient throughput process, and track the following month-to-month (again, these examples come from a BedWatch partner hospital — this should be tailored to each specific facility):
- ED Door to ED Seen
- ED Seen to Care Complete
- Care Complete to Patient in Bed
- Bed Turnover Times
- Time Ahead of ADT Discharge (if possible)
- STAT Turnaround Times
- Length of Stay
Review each of these measurements monthly, and put process improvement efforts in place to drive improvement where needed. Review the effects of those efforts and either continue with them if they are successful, or go back to the drawing board and try something new if they are not. Continue to follow up and review these metrics and efforts each month.