It’s no secret that patient flow is complex. Hospitals must simultaneously address several interdependent processes to guide patients through care and create efficiency for them, their family members, and staff. It’s easy to get caught up in the details before seeing the big picture. But, however complicated managing patient flow may seem, there are approaches that can create strategic alignment and improve efficiency in any health system.
Here are a few key tactics to help smooth the patient flow process:
1. Assign a Patient Flow Leader
Many organizations have someone responsible for bed management and call that person their patient flow leader. Too often, this person’s accomplishments fall short of creating a seamless patient flow experience. Many of these people are great organizational leaders. But to be successful, they must be empowered and fully supported by senior leadership. Patient flow must be a strategic priority for hospitals and leaders must set expectations for everyone involved in the process. When effectively implemented, a patient flow leader will be:
- A senior leader that reports to CNO, COO or another executive.
Responsible for managing the external transfer process, internal bed management and patient flow across all inpatient units within a health system.
- Empowered to implement processes with case management, inpatient units, physicians and various support services to improve patient flow.
- An active leader within cross-functional bed huddles to identify daily issues and mitigation strategies.
With this empowered leader in place, they will not only impact daily activities, but also the hospital’s bottom line over time.
2. Implement Standard Scorecards
Measurement is necessary to improve any process. How else would you know if you’re improving? Standard scorecards must be implemented to set and review performance expectations. Good scorecards should include the following:
- Goals – The organization must align on goals for each of the key metrics in the patient flow process. Goals can change over time, but they require cross-functional alignment to make them effective.
- Standard Definitions – Metrics must be well-defined and understood across all stakeholders. This ensures that everyone is measuring performance in the same way.
- Actual Performance – Once standards are well understood, the organization can begin to review how they have performed over a given time. Recurring review is important, so depending on your audience, it is important to set a consistent distribution cadence for your scorecards. This may be as frequent as daily for people close to the process, but may be monthly or quarterly for executives. A consistent review cadence keeps everyone well informed.
- Trend – Point-in-time analysis is never enough. Improvement does not happen overnight. The organization must see that things are trending in the right, or wrong, direction.
3. Have a Meaningful Morning Huddle
While there will be many processes to improve, a daily huddle is a ritual that can create action and improve performance over time. Many organizations use a bed huddle as nothing more than a meeting where everyone reports the status of their areas. The key to an effective huddle is to have a structured, action-oriented agenda that focuses on specific problems and potential solutions. Here are a few simple questions that can lead to action.
- What areas of the hospital are going to have issues today?
- What can we do to mitigate the issues?
- Which specific patients do we need to focus on to facilitate better flow?
- Do we need broader support across the hospital to mitigate an issue, or can the issue be handled at the unit level?
This kind of meeting shifts the conversation to talking about individual patients or small patient populations that may be able to improve patient flow. The most common focus is early discharges, but there are many other opportunities for improvement, including internal transfers, observation patients, elective surgeries, and even outpatients currently occupying inpatient beds that can be addressed to improve throughput.
Technology is playing a new role in helping hospitals and health systems move away from a reactive approach to patient flow and take actions to mitigate bottlenecks before they happen. Data and analytics, combined with these sorts of human process improvements, go a long way towards helping organizations make critical patient flow decisions that not only support better patient care, but create happier staff and more profitable operations.