Summer 2005
Raising Efficiency. Raising Capacity. Raising the Bar.
Time is Muscle
"That's saving an hour of time, an hour of muscle," says James Blakenship, M.D., cardiologist and director of cardiac catheterization laboratories. To streamline procedures, ED physicians, not cardiologists, decide when the cath lab team should be called in. They use a 9-question checklist with items such as "Does the EKG show definite STEMI" to guide decision-making.
Performance Improvement Advisor – Volume 9, No. 4, pp. 40-42
Ask the Expert
The Institute for Healthcare Improvement asked Flow faculty expert Kirk Jenson to explain why flow is such a great challenge for hospitals and what they can do to make improvements. Jensen stated that significant variation in flow and utilization of services within hospital microsystems (e.g., ED, ICU, OR) is a key contributor. What can hospitals do? According to Jensen, push information out to the people who really need it so they can make the best informed decision.
Institute for Healthcare Improvement
Improved Flow = More Peace
"Our waiting room environment has changed significantly since implementing patient flow technology," exclaims Mary Kay Thalken, Interim COO of Bergan Mercy Medical Center, part of Alegent Health System. Thalken says that a sense of peace has replaced tension, with a setting that's much more relaxed. Why? "Our patients' loved ones are better informed. At a glance, they know what's happening in real-time - and therefore have greater peace of mind." Alegent implemented StatCom in its new $58 million Procedure Center, using the software to improve patient flow from arrival to discharge. By consulting a plasma display or asking a "concierge," or volunteer to consult his or her tablet PC, friends and family can learn the patient's status and receive updates. Loved ones also receive a pager notifying them of updates, enabling them to leave the waiting area and enjoy the Healing Garden or walk around at their leisure.
Is there a Hospitalist in the House?
In a study of twelve representative communities, 107 plan and hospital respondents discussed competitive strategies to address market and cost pressures, patient flow problems, and patient safety. The overarching sentiment: Hospitalists are an attractive solution to patient flow problems, rising malpractice costs and the growing focus on patient safety. Local market forces resulted in new hospitalist roles and program structures - a growing trend to improve efficiency and care.
Pham, Hoangmai H., Devers, Kelly J., Kuo, Sylvia & Berenson, Robert (2005) "Health Care Market Trends and the Evolution of Hospitalist Use and Roles," Journal of General Internal Medicine, 20 (2), 101-107
Healthcare IT Takes Front Seat
On July 14, the Senate Appropriations Committee approved $95.2 million for healthcare information technology as part of a $146 billion fiscal year 2006 spending bill, falling short of the $125 million the House had granted. The House bill allocated $75 million for the Office of the National Coordinator for Health Information Technology (ONCHIT), led by David J. Brailer, M.D., and provided $50 million to fund the Agency for Health Research and Quality's healthcare technology demonstration projects. The Senate version provides $45.2 million for ONCHIT and $50 million for AHRQ. HIMSS and other healthcare IT groups said they would continue to lobby Congress for the full funding.
HealthcareITNews.com – July 15, 2005
JCAHO Steps Up Flow Education
JCAHO will hold three conferences this fall on managing patient flow and
patient safety. Information is at www.jcrinc.com in the Education section of the Web site.
OR Manager – Vol. 21, No. 7, p.5
Do "Safety Net Providers" Alleviate Overcrowding?
According to a national study by the Center for Studying Health System Change (HSC), less than half of uninsured Americans typically use or know about a safety net provider that offers free or reduced-cost care to low-income and uninsured patients. Among the uninsured, those with lower incomes, racial/ethnic minorities and people living near safety net providers have the highest awareness. Hospital emergency departments were not frequently cited as affordable sources for medical care; however, the study's findings suggest that many uninsured people do not know of an affordable source of care to turn to when they need medical attention.
May, Jessica H., Cunningham, Peter J., Hadley, Jack, "Safety Net Awareness Low Among Uninsured," HSC (hschange.org), Nov. 2004
The Waiting Game
A typical goal is to remove waiting times in admissions, ED and other areas. But while you make patient flow improvements that reduce waiting, consider this: David McMahon, PhD, of Pepperdine University cites "distraction, information and compensation" as successful strategies to keep waiting people content (www.pepperdine.edu). The second strategy, information, is a key factor for patients and loved ones in hospital waiting areas. Providing patient status and expected wait times can potentially lessen tension and reduce "people managing" by hospital staff.