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.