Proper capacity management is especially critical for hospitals with a mission to provide essential care to marginalized and underserved populations. Essential hospitals often have a trauma center designation and provide teaching services. Many are run by large hospitalist groups, have a large number of attending physicians, and deliver a multitude of service lines. In other words, they are complex in a unique way.
The same complexity that enables them to provide this array of critical services also can cause unique challenges. Unfortunately, challenges with alignment across service lines, physician groups, and other parts of the organization can cause confusion and lead to capacity management problems, as well as patient and physician satisfaction issues.
To avoid these issues, all physicians should be aware of barriers to patient discharge. If you implement a process through which all physicians communicate upcoming discharges to nursing staff at least 48 hours in advance, nurses can anticipate and resolve potential barriers to the discharge. With discharge planning in place, there is a much higher likelihood that patients will go home on time, freeing a bed for an incoming patient in need.
Imagine planning a trip with your family. You would likely start planning well in advance to know where you were going, what route you would take, and when you would need to leave. Just as important, you would use a navigation system that alerts you to upcoming barriers or road blocks so that you can change your course if necessary. Similarly, a proactive discharge barrier forecast program can help hospitals avoid “traffic jams” before it is too late. A barrier identification process anticipates delays and enables mitigation before the problem is out of control.
Avoiding Hospital ‘Traffic Jams’
One place hospitals frequently see “traffic jams” is in the emergency department, where patients often are waiting for inpatient beds. If a patient needs to go to the telemetry unit, but there are no beds, how can the patient receive the most appropriate and highest quality care? A forecasting process using real-time information on the telemetry unit would allow quicker movement of patients to a lower level of care in a more proactive way.
Another example could occur during the discharge process. If a physician can communicate a day before discharge that the patient requires a walker or oxygen, other members of the care team can ensure an order is placed in time for those items to arrive before the patient’s planned discharge time. If this need is not communicated before the discharge orders are written, the care team might not have time to get the required supplies and equipment in order, and the patient might need to stay an extra night in the hospital. Not only does this affect capacity, but it also could end up costing the hospital several thousand dollars as the patient takes up a bed for an additional, avoidable night.
There are a lot of scenarios that can lead to “traffic jams” in your hospital. Implementing a real-time barrier identification and escalation process will give your patients a smooth ride to their destinations.