A Discussion on Automating Patient Flow
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1 A Discussion on Automating Patient Flow Because improving patient flow means improving patient care University of Utah Hospitals and Clinics TeleTracking Technologies, Inc. 11:00 a.m. Eastern / 8:00 a.m. Pacific March 11, 2009
2 Housekeeping 1. Viewer Window 2. Control Panel
3 The Participants University of Utah Hospital & Clinics David Entwistle, CEO Quinn L. McKenna, COO TeleTracking Technologies, Inc. Anthony Sanzo, President & CEO Moderated by Fawn Lopez, Publisher, Modern Healthcare
4 University Health Care About University of Utah Hospitals & Clinics (UUHC) 560 beds Academic medical center 120+ specialties Tertiary care referral center Level 1 Trauma Center, Burn Unit, Ortho, Stroke, Ophthalmology, Cancer, NICU, Radiology, Organ Transplant More than 26,000 admissions / 38,000 ED visits Nearly 1.0 million outpatient visits Consistently ranked among U.S. News & World Reports Best Hospitals
5 Key Issues & Priorities UUHC was experiencing increasing period of critical census resulting in: Long patient wait times prior to admission Ambulance diversion in the emergency department Patients being held in the ED or PACU for extended periods prior to admission. Diverted admissions from hospitals and physicians. To be able to better compete for patient loyalty, UUHC recognized it needed to improve the overall patient experience. Admit to discharge. Right patient, right bed, first time.
6 Key Issues & Priorities We were concerned that our patient flow process was creating some of the critical census issues, as well as negatively impacting our patient experience. Inefficient communication channels between constituents Rumors of significant delays in bed turnaround times The desired outcomes and benefits for focusing on the patient flow included: Improve Patient Throughput by Removing Inefficiencies More patient volume / same bed capacity Decreased Length of Stay Improved patient loyalty. Decreased times of critical census. Better Manage Surge Capacity / Disaster Planning
7 The State of Hospitals & Healthcare
8 In today s s economy, hospitals need to: Manage increasing patient demand without adding beds Maximize existing bed capacity Improve a Fragmented Patient Flow Process Automate communications across constituents Provide transparency / visibility of patient flow information Encourage Accountability Automate patient flow processes / understand workflow Measure, set the bar, re-measure, re-set the bar Implement Cost-Effective Process and Technology Refine process with understanding of technology benefits
9 Steps to improve UUHC patient flow: Historically, UUHC was only using a manual bed board with inconsistent communication paths. Step 1 was to provide an automated bed board tool as the foundation of a revised patient flow system. Changes to operational processes were also required, including: Streamlining the ED intake process. Enhancing the IP discharge process. Clarifying discharge transportation roles. Adding a discharge lounge function. Providing education to nursing and support staff regarding the new tools and patient flow processes. Implementing dashboards to monitor key patient flow elements and provide feedback.
10 Patient Flow Challenges The bed board process was manual. There was no patient flow dashboard with reliable metrics. Concerns regarding the patient flow were anecdotal and could rarely be substantiated. Beds were frequently hidden based upon individual preference. Patients were frustrated about how long it took to be placed in a bed either through transfer, the ED or from inpatient procedures. Times of critical census were increasing.
11 Steps to improve UUHC patient flow: Customer Satisfaction Patient Satisfaction with speed of discharge process has improved by 5% post implementation. Overall patient satisfaction has steadily improved and is now approaching 70 th percentile. Employee Satisfaction UUHC employee satisfaction is consistently above the 90 th percentile. Anecdotally, the staff are very pleased with the new tools and systems supporting their jobs. Discharge Rate Approximately 10% improvement in discharge rate prior to 2:00 pm. 55% of discharges are escorted through transporters saving 15 minutes in room turn time per discharge. 53 minute average room turn time (reported to clean). 3% growth in patient days with no added beds and a 2.4% increase in patient acuity. ALOS 5% improvement in ALOS. 3% increased occupancy rate.
12 Key Patient Flow Results These systems will create transparency among areas, which is not always readily embraced Bed Availability Occupied, Clean, Dirty, In Progress Pending Status Discharges, Transfers, Assignments Incoming patients How many and from where (ED, PACU, etc.) Projected Census
13 Return on Investment University of Utah Hospitals & Clinics Increased admissions through ALOS reduction and improved bed capacity has resulted in net CM of $2.5 million. 14% reduction in diverted transfers. Estimated contribution margin increase of $275,000.
14 Average Annual Bed Turns (Admissions/Staffed Beds) Bottom Quartile Median Top Quartile Source: Financial Compass, (Fourth Quarter, 2004); Health Data Insights; True North interviews and Analysis
15 Return on Investment OSF Saint Francis Medical Center, Peoria, IL
16 Return on Investment OSF Saint Francis Medical Center, Peoria, IL Improved ED Throughput
17 Tips for Patient Flow Solutions Don't look to implement technology with out defining what you are trying to accomplish. Establish your performance parameters for the system when you are selecting a vendor. Identify realistic timelines for implementation with clear accountabilities. Training is key to a successful implementation and should be planned as part of system costs. These systems will create transparency among areas, which is not always readily embraced
18 Audience Questions A Discussion on Automating Patient Flow Because improving patient flow means improving patient care Q & A
19 Thank You & Contact Information University of Utah Hospital & Clinics - David Entwistle, CEO / David.Entwistle@hsc.utah.edu Quinn L. McKenna, COO / Quinn.Mckenna@hsc.utah.edu TeleTracking Technologies, Inc. - Anthony Sanzo, President & CEO / anthony-sanzo@teletracking.com For questions, contact TeleTracking: Chris Anderson, Director, Marketing / canderson@teletracking.com
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