Ways to Improve Patient Flow

Patient flow is the movement of patients through a healthcare facility. It involves the medical care, physical resources, and internal systems needed to get patients from the point of admission to the point of discharge while maintaining quality and patient/provider satisfaction. Improving patient flow is a critical component of process management in hospitals and other healthcare facilities.

Optimizing patient flow encompasses quickly, efficiently, and effectively meeting the demand for care by moving patients through care pathways while improving coordination of care, patient safety, and health outcomes.? To optimize patient flow, providers seek to successfully match the appropriate amount of resources to each of their admission

Patient Flow Problems in Hospitals

Patient flow is primarily associated with hospitals, especially with back-ups and overcrowding in emergency departments and inefficient scheduling in surgical departments. Poorly managed patient flow in hospitals can lead to?adverse health outcomes, including increased re-admissions and mortality rates. Even?hospitals that are expanding their facilities?and hiring additional staff are not immune to issues of overcrowding and poor orchestration of patient admissions, transfers, and discharges.

Inefficient scheduling leads to some patient flow problems. For example, surgical services may schedule the bulk of their elective surgeries earlier in the week, so patients can recover when resources are more readily available. This strategy causes post-operative units to become overcrowded, and staff and support services to become stretched.

Disorganized handoffs?— between referring physicians and hospitals, as well as between departments within a hospital — also lead to patient flow problems. Hospitals, therefore, are taking a critical look at their admissions and referral processes in an effort to make improvements.

Several hospitals and health systems are pursuing strategies to improve patient flow. An efficient patient flow will increase your healthcare facilities' revenue and, more importantly, keep your patients satisfied and safer.

Ways to Improve Patient Flow

#1:?Share Capacity Data with Surrounding Hospitals

By building partnerships with hospitals in your area, you can become more efficient at getting patients the care they need in a timely manner. In addition, sharing capacity data will ensure that patients arrive at or are transferred to healthcare facilities with sufficient room.? In the thick of the pandemic, Boston hospitals shared data and agreed to mutual aid across their systems.

#2. Coordinate the Arrival and Discharge of Patients Undergoing Elective Procedures

The pandemic's immediate impact on the medical industry was the slowdown of elective procedures/care and even procedures conventionally considered non-elective.?

With elective procedures on a slight uptick, orchestrating the arrival and discharge of patients undergoing elective procedures (the timing of which is often under institutional control) could be a more effective and lasting solution. Spacing elective surgeries throughout the week will help alleviate strain on post-operative units instead of block scheduling, leading to capacity crunches.

#3. Establish?Timely Discharge?in the Morning Hours

Another way hospitals can relieve congestion is by discharging patients earlier in the day when appropriate. Leaving the hospital early in the day gives "patients time to get home, get their prescriptions filled, and have a visiting nurse come in

#4. Improve Hospital Layout for Easy Navigation

One way an emergency department can increase patient throughput is to consider the layout. The layout should make it as easy as possible for staff and patients to navigate the facility and complete tasks.

#5. Form a Patient Flow Team for Quality Improvement

One of the benefits of a multidisciplinary team is that members will bring different perspectives and knowledge about problems, underlying causes, and potential solutions. "Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals."

?#6: Align Reporting with Your Department Heads for Optimization

When you create a consistent reporting framework between your department heads, the patient flow will become optimized with your patients in mind.

As in many healthcare facilities, care is given from one department to the next. This could be from admissions, radiology, surgery, and more. As a patient moves from one area to the next, it's imperative all activities are documented from each department.

Clinicians can become frustrated when they have no insight or control over the actions taken outside of their immediate department.

?#7: Create a Culture of Accountability

Hospital culture can impact patient care. A hospital’s values, mission, and practices must be understood and consistent with all employees. Data reflects there is an interrelationship between safety culture and?patient safety?improvement.?

#8: Gain Executive Support and Direction for Improving Patient Flow

Keeping in line with the findings above, the approach taken by senior managers and leaders matters.?It can increase the risk of harm when department heads do not support staff and hospital culture.

#9: Explore Different Staffing Models

"Nurse leaders?can, to some degree,?control the flow of patients?and staff accordingly, if they harness unit-level data to find trends and identify how they change staffing and routines to accommodate those trends."

?Match capacity and demand.

When your organization knows its capacity constraints and demand patterns, it can make changes to align with demand. When both are matched, delays in care can be reduced. For example, examine average and peak daily emergency department admissions.?

"Examining historical data on average and peak daily emergency department (ED) admissions helps predict the demand and allows for planning for the capacity needed to meet the demand. Predictions can be used to make system adjustments to meet the conditions." [source:?Institute for Healthcare Improvement]

?#10: Use Technology to Improve Patient Care and Safety

Patient flow is attainable when healthcare facilities have the right tools for collaboration and measurement.

Care Command Center?gives healthcare institutions a much-needed operational tool. It quickly "integrates with your existing systems to facilitate a collaborative environment focused on efficiency, experience, and quality. Care Command Center gives everyone in the care continuum the information they need to orient and act."

#11: Set Goals with Attention to Patient Acuity

The "patient flow standard" (Standard LD.04.03.11) was published by the Joint Commission to help healthcare facilities manage their patients' flow throughout the hospital.

The 4-hour time frame referenced in the Standard is a guideline for hospitals to use as a?reasonable goal in their boarding time?- when a patient is held in the emergency department to the time they are admitted or transferred.??

Using data will help hospitals manage any issues affecting their emergency department, i.e., patient boarding, leading to patient harm, and quality of care.

#12: Provide an Automated Bed Board Tool?

University of Utah Hospitals & Clinics was "experiencing long patient wait times before admission and patients being held in the ED or PACU for extended periods before admission." They wanted to improve the patient experience and remove inefficiencies.

Tele tracking?helps improve access to quality care. Tele tracking assisted the University of Utah Hospital (UUHC) by providing an automated tool to revise its patient flow system. This helped increase customer and employee satisfaction and discharge rate. The system created transparency in bed availability, the status of discharges or transfers, and incoming patients.?

#13: Highly-Trained Staff on Time Management

One of the most effective skills to have for healthcare professionals is time management. Understanding how to plan and control your time spent on daily tasks is crucial to patient safety.

#14: Invest in Mobile Technology

"90% of hospitals surveyed have made or are planning significant investments in smartphones and secure unified communications platforms."

"The survey found nearly half (48 percent) of hospitals have identified or were identifying return on investment models to justify mobile investments demonstrate cost reductions,?outcome improvements, and staff/patient satisfaction."

Tablets can also be used for a better patient experience. Paperwork could be eliminated, which will expedite the process.

#15: Connect Maintenance and Operations to the Patient Experience

Patient satisfaction is a top priority for healthcare facilities.

According to Dude Solutions, "The maintenance department influences your patient experience, and how you can create a better experience for everyone with an awareness and the right tools."

Communicate more effectively between your departments - from maintenance to housekeeping and more. A patient's experience and satisfaction can depend mainly on a task from the maintenance department. Think lighting, doors, or broken equipment.

Balancing your workflow will ultimately help your patient flow.

Tip #16: Utilize Advanced Data Analytics?

A big data trend in the marketplace is the increased use of analytics to advance patient safety. Valuable insights in real-time can impact patient care and safety.

Big Data works on the principle that the more you know about something or an event, the more you can gain new insights and make predictions about what will happen in the future.?

This theory can also be applied to forecasting trends in your healthcare facility. "Neural Networks are a?predictive technique?that can recognize and learn patterns in data."

Advanced analytics will provide better coordination of care, customer service, and operations.

Conclusion

Today the healthcare environment notices that enhanced and efficient patient flow is critical in achieving value-based health. Optimizing patient flow is essential for healthcare facilities for two main reasons - patient safety and quality of care. Improving your patient flow is also a way to increase revenue and patient satisfaction. With technology, hospital leaders can generate the statistics administrators desire in real time.

?