As hospitals and healthcare systems pinch pennies and look for ways to operate more efficiently, a new report reveals six simple steps they can take to reduce length of stay and increase on-time discharge.
Experts from leading hospitals around the country shared ideas with CentralLogic on how to improve patient care, even with limited resources:
- Emphasize accurate patient placement following the 5 Rs: Place the patient in the appropriate sector of care using five guidelines--right level of care, right service, right nursing unit, right bed and right time period.
- Initiate daily multidisciplinary rounding and daily bed huddles: Track patient progress daily so you can complete ancillary tasks on time, such as teaching, patient evaluations, payer authorizations, post-acute service setup and rides home, says Catherine Morris, director of case management at St. Joseph's Hospital, New York City.
- Discharge patients as soon as possible: The entire healthcare team should help patients reach discharge as quickly as is clinically feasible. Some hospital staffs keep patients hospitalized longer than necessary because traditional models call for discharges early in the day, according to the report. "Hospitals are 24-7 operations," Laura Ostrowsky, R.N., director of case management at Memorial Sloan-Kettering Cancer Center, New York, N.Y., says. "Limiting yourself to morning discharge is not focusing on timely discharge, nor is it in the best interest of the hospital or the patient."
- Review your patient census: Manage elective admissions to stablize peaks in the patient census and balance them out with the emergency department admissions, says Eugene Litvak, Ph.D., president of the Institute for Health Optimization and a committee member of the Institute of Medicine.
- Communicate with staff and patients: Case management can help play a huge role in streamlining communications between patients and hospital staff and ensuring that patients progress as quickly as possible through care milestones, the article states.
- Measure and distribute the correct metrics: Know the average daily admissions, both scheduled and unplanned, in order to appropriately manage capacity, says Kathy Pecenka-Johnson, access center director at Children's Hospital of Los Angeles (CHLA). She also suggests reviewing data on the number of boarders, diverted patients and denied patients. The report also recommends that staff look at the number of hours admitted patients wait in the ED, bed-cleaning turnaround time and avoidable days.
"Capacity optimization is everyone's responsibility," Morris says. "There is no quick fix; each issue needs to be broken down and addressed. Work on throughput is continuous, so don't give up. If you stop addressing it, things will backslide."
Shorter hospitals stays can actually improve readmission or death rates, according to research from the Annals of Internal Medicine, FierceHealthcare previously reported.
To learn more:
- here's the report (.pdf)