Videos
Driving Capacity and Patient Flow
Jeff Terry, Managing Principal for Clinical Excellence, GE Healthcare, discusses improving the admissions cycle, discharge planning and the discharge process.
Transcript:
In patient flow we do a variety of things, but the net of it is how do we help them reach a new optimal level of operating capacity, how do we get them to consistently run at a higher level of patient volume. Solving that problem - we have found again and again - is really about three things: its about improving the admission cycle, improving discharge planning, and improving the discharge process. When you do those three things together and you combine it with a very targeted approach, what we've shown is that targeting specific discharges - shifting them earlier in the day - it has a disproportionately large impact on the improvement on the system as a whole.
An example in the OR that's key is that we help the hospital better allocate time in the OR. OR time might be the most precious commodity a hospital has, it's allocated in blocks - typically it's utilized 50-60-70, maybe 80% of the time. What the means is, while the surgical schedule was full, the OR's are not actually being used. So we'll work with them to scientifically de-fragment that time, and when we do that it produces 10-20% of incremental capacity on the surgical schedule. We then work with the hospital to scenario plan. Maybe one scenario is that we go after a new group of surgeons and we fill it with new volume, maybe another scenario is we streamline our operation, we bank that capacity, and we reduce our costs. Then the question is what are the trade-offs associated with doing that? And that kind of strategic planning helps them to make decisions over the long term. The other thing that we bring to bear - and I will use the OR as an example, but it applies elsewhere - is to improve the governance in the department. So how do we improve both the policies and procedures that the surgical committee uses to govern their operation, as well as give them better information to manage to those policies and procedures? So we work on both sides, lets fix the schedule, and then lets improve the governance so that it is sustainable over time.
We're going to have to have a new generation of technology platforms to manage the flow of patients at hospitals. We have a system - our is AgileTrack - that is on the vanguard of that, it brings together information about each patient, and where that patient is in his or her specific and individual care plan, and also real-time locating information about where is the patient, where is the caregiver, where are the assets, where are the clinicians. When you put all of that information together and start to apply a rules engine to it, you can make better operational decisions, meaning where should the next patient be admitted. What's the status of all of my patients? When should I turnover my beds? And where we are going, is to be able to predict the status of beds days in advance. Where we improve patient flow, we enable the system to care for more patients with the same physical infrastructure and the same staff. It means faster, more predictable care, and in some cases it means dramatically better outcomes.
Transcript:
In patient flow we do a variety of things, but the net of it is how do we help them reach a new optimal level of operating capacity, how do we get them to consistently run at a higher level of patient volume. Solving that problem - we have found again and again - is really about three things: its about improving the admission cycle, improving discharge planning, and improving the discharge process. When you do those three things together and you combine it with a very targeted approach, what we've shown is that targeting specific discharges - shifting them earlier in the day - it has a disproportionately large impact on the improvement on the system as a whole.
An example in the OR that's key is that we help the hospital better allocate time in the OR. OR time might be the most precious commodity a hospital has, it's allocated in blocks - typically it's utilized 50-60-70, maybe 80% of the time. What the means is, while the surgical schedule was full, the OR's are not actually being used. So we'll work with them to scientifically de-fragment that time, and when we do that it produces 10-20% of incremental capacity on the surgical schedule. We then work with the hospital to scenario plan. Maybe one scenario is that we go after a new group of surgeons and we fill it with new volume, maybe another scenario is we streamline our operation, we bank that capacity, and we reduce our costs. Then the question is what are the trade-offs associated with doing that? And that kind of strategic planning helps them to make decisions over the long term. The other thing that we bring to bear - and I will use the OR as an example, but it applies elsewhere - is to improve the governance in the department. So how do we improve both the policies and procedures that the surgical committee uses to govern their operation, as well as give them better information to manage to those policies and procedures? So we work on both sides, lets fix the schedule, and then lets improve the governance so that it is sustainable over time.
We're going to have to have a new generation of technology platforms to manage the flow of patients at hospitals. We have a system - our is AgileTrack - that is on the vanguard of that, it brings together information about each patient, and where that patient is in his or her specific and individual care plan, and also real-time locating information about where is the patient, where is the caregiver, where are the assets, where are the clinicians. When you put all of that information together and start to apply a rules engine to it, you can make better operational decisions, meaning where should the next patient be admitted. What's the status of all of my patients? When should I turnover my beds? And where we are going, is to be able to predict the status of beds days in advance. Where we improve patient flow, we enable the system to care for more patients with the same physical infrastructure and the same staff. It means faster, more predictable care, and in some cases it means dramatically better outcomes.