Patient flow model helps independent community hospital improve length of stay, culture

One independent community hospital in Illinois adopted a new patient-flow model that reduced length of stay, bolstered hospital culture and improved patient flow, according to an article in Hospitals & Health Networks.

The Aims for Excellence at Northwest Community Healthcare is designed to help staff, improve scheduling of tests and treatments, decrease time between interventions, reduce infections rates, minimize patients' lengths of stay and better anticipate needs of services, writes author Pat Stack, R.N., the vice president of performance improvement at the hospital.

Using the latest technology and a central control center operated by specially trained staff, patients receive a daily schedule that alerts them to procedures, testing, potential discharges or transfers, which the hospital hopes will reduce anxiety. The more than 60 newly trained clinical care coordinators, from case management and nursing leadership roles, will oversee schedules from admission to discharge, Stack writes.

The program trumps patient-centeredness and performance focus by implementing leadership rounding, according to the article, and unit leaders work with senior leaders during the biweekly sessions. Though early in the process, the move has already increased visibility and engagement of leaders in solving patient-flow challenges, Stack says.

Northwest Community identified eight aspects to improve overall length of stay, including time from:

  1. Bed request to bed assigned

  2. Bed assigned to patient in bed

  3. Test ordered to test completed

  4. Test completed to results available

  5. Transport request to transport completed

  6. Room cleaning request to room available

  7. Pending transfer order to transfer completed

  8. Discharge order to room available

The hospital has already seen cycle-time improvements in four of the eight milestones, and expects to see improvements in the remaining four as the program grows and improves. Length of stay dropped from 4.2 days to 3.93 days immediately post-implementation, but has since returned to previous levels, Stack writes. However, hospital officials expect the number to continue to decrease over the next six to 12 months.

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