Rapid response teams reflect hospital disorganization

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While rapid response teams are an absolute necessity for any hospital--seeing as they save countless lives each year--their existence points to an alarming trend that has only grown worse in recent years: poor patient flow. More lives and dollars could be saved if hospitals simply would take the time to organize their schedules, as opposed to trying to fix their problems on the back end, writes Dr. Eugene Litvak of the Institute for Healthcare Optimization in Newton, Mass., in the most recent issue of the Journal of the American Medical Association.

Oddly enough, elective surgery scheduling is the chief cause of such disorganization, according to Litvak and renowned Johns Hopkins anesthesiologist Dr. Peter Pronovost. "The way we schedule our elective admissions is less predictable than when patients break their legs and come into the emergency department," Litvak tells MedPage Today.

Litvak calls the scheduling process a "holdover" from yesteryear, when hospitals typically had no problems covering peak load times. Even a few years ago, doctors were able to schedule procedures around their own individual workloads, rather than based on the needs of the facility.

Now, however, with hospitals laying off staff left and right to cut costs, such unpredictability causes major shifts in patient flow--sometimes by as much as 30 percent in one day--reports MedPage.

Litvak believes there is hope, however, citing Cincinnati Children's Hospital as a facility that was able to change for the better. There, elective surgery scheduling is now the job of hospital administrators, who make it a point to keep a few operating rooms empty at all times, just in case. Bed occupancy rates now hover in the 90 percent range, rather than around 76 percent which, along with some other streamlining measures, has helped the hospital to increase revenue by nearly $140 million annually.

Over a 10 year span, $1 trillion could be saved, Litvak maintains, if all hospitals followed the lead of Cincinnati Children's.

To learn more:
- read this MedPage Today piece
- here's the abstract in JAMA (registration required)

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