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Tomball Regional and Good Shepherd use OpCenter to improve throughput
MEDHOST OpCenter Addresses Throughput and Operational Issues at the Executive Level.
The stark reality today in healthcare is that hospitals are being asked to care for more patients, especially through their Emergency Departments, with resources that are harder to find and retain while receiving lower reimbursement from payers. Maximizing the productivity and utilization of their staff, their equipment and their finances is the only way hospitals can be successful today and in the future. This maximum utilization of resources has to make the delivery of patient care very efficient and streamlined. It starts with gaining a better understanding of how patients move through your healthcare system; from presentation in the ED, to the flow of inpatient care, to discharge planning. The ripple effect of a delay early in the admit processes can have serious consequences throughout your hospital.
In the ED, much of the backlog of patient flow is not related to ED problems, but instead is caused by systemic issues that delay moving patients from the ED to inpatient floors. With 60 percent of admits coming from the ED, these in-house delays drive up ED wait times and ultimately lead to lost revenue, increased costs and decreased patient satisfaction.
MEDHOST’s executive decision-support tool, called OpCenter, was designed with executive pain points in mind. OpCenter puts actionable information into the hands of executives, so they can drive house-wide efficiencies and focus on high-level issues such as patient throughput, patient satisfaction, culture change and resource utilization.
Good Shepherd Medical Center in Longview, Texas, and Tomball Regional Medical Center in Tomball, Texas, deployed OpCenter to streamline patient flow, not only in the ED, but also across their entire hospital. Increased visibility and access to real-time data empowered hospital leadership to improve throughput, enhance the patient experience and maximize resource utilization. Executives also use data from OpCenter to facilitate culture change and promote a more cohesive workflow, and Good Shepherd leverages the House Census feature to monitor saturation levels and bed availability on the inpatient floors.
“Using a pen-and-paper documentation and data collection model, our Emergency Department was ‘under-bedded’ 40 percent of the time, operating out of only 80 percent of available beds due to staff shortages. Lack of real-time understanding of our hospital’s barriers to patient flow limited our ability to address the problems objectively. Daily bed meetings were held by mid-level management Monday through Friday to gather information and plan for patient flow. To ensure the safety and satisfaction of patients with our limited resources, we needed a solution that would dramatically expose operational inefficiencies,” said Ron Short, vice president of operations at Good Shepherd Medical Center.
Throughput
In healthcare today, most patient flow operations are reactive. Without the proper analytical tools at their disposal, hospital leaders default to time-consuming , expensive, manual “bed meetings” to share information and plan for patient flow variances. OpCenter provides the real-time information necessary for management to predict flow issues and change processes before slowdowns create house-wide problems.
With the ability to monitor patient milestones, wait times and inpatient bed availability, OpCenter can identify risk areas that could lead to delays in care and bed placement, as well as hinder patient safety. The longer patients wait for treatment or for placement in their inpatient bed, the harder it is to mitigate the associated risks.
By empowering hospital leaders with decision-support tools, they can improve processes that influence throughput. For example, EDs can utilize OpCenter’s Bed Ahead feature to create more fluid patient flow. Bed Ahead allows the bed assignment process to begin sooner for patients likely to be admitted, such as high acuity ED patients who present with obvious trauma or other illnesses. Bed Ahead improves throughput by allowing the admit process to begin while the patient is receiving care or being stabilized in the ED. This not only shortens the time from the official admit request to when the patient is moved, but it also creates a smoother, more efficient transition between the ED and inpatient floors.
“OpCenter enabled us to make traditionally sequential tasks concurrent, which has reduced our TAT for admitted patients by 30 minutes,” said Robb White, director of emergency services at Tomball Regional Medical Center. “We use Bed Ahead to alert the inpatient floors of incoming admits and work to obtain a bed while we are completing the process and waiting for written orders.”
“Since implementing OpCenter, ED patients are assigned inpatient bed numbers very early in the ED stay, usually before an official admission occurs and with 99 percent accuracy based on data from OpCenter. The 1 percent variance was due to deaths and transfers. This real-time communication puts us ahead of bed needs, especially for acute areas like ICU,” Short stated.
The healthcare climate continues to emphasize the importance of efficient delivery of care, patient safety and patient satisfaction, which is why executives need solutions that will enable their hospitals to accommodate more patients while still providing quality care. And, the financial health of hospitals will continually rely on their ability to safely and efficiently move patients through the care process. OpCenter’s powerful data helps develop an effective patient flow model, which not only benefits the hospital financially, but also boosts patient satisfaction.
Patient Satisfaction
A patient’s experience in the ED often decides their satisfaction level with the entire hospital and whether they will return for future care needs. Long wait times and being boarded in the ED due to a slow admission process generally leads to lower satisfaction rates and can ultimately impact a hospital’s market share.
EDs are competing for a smaller and smaller piece of the market as freestanding “emergency rooms” and “mini-clinics” continue to pop up across the country. Hospitals need to find ways to provide the same efficient service as these freestanding facilities but with a higher level of care. By correcting problems before patient satisfaction suffers, hospitals can establish a positive perception within their community and increase their repeat business.
“OpCenter supports our throughput initiatives and plays a key role in our ability to stay competitive. The increased visibility enables us to streamline the delivery of care to positively affect the patient experience,” said Lynn LeBouef, CEO at Tomball Regional Medical Center. “To grow our market share, it’s imperative that we take extra measures to ensure patients leave the hospital with a positive experience, and OpCenter gives us the tools to accomplish this. Its mobile alerts allow us to effectively coordinate resources and establish action plans before issues become unmanageable. For instance, our radiology manager receives customized alerts if several scans were ordered so additional staff can be called before a backlog occurs and patient wait times increase.”
Because of the direct correlation between patient throughput and patient satisfaction, OpCenter’s throughput solutions can be leveraged to enhance the overall patient experience. Hospitals can customize mobile alerts to notify management when ED saturation levels are higher than normal or when the ancillary departments are starting to backlog. OpCenter’s custom alerts make sure critical information is pushed to the mobile devices of people who need it when it matters most.
Short added, “With OpCenter, I know immediately when issues arise and can go straight to action instead of investigation, getting quickly to the root of the problem. Our patient satisfaction scores improved from the 20th percentile to the 60th in the first full quarter we used OpCenter.”
Culture Change
Another way to enhance the patient experience and improve processes is by promoting a cohesive work environment. Delivering a higher quality of care is easier if staff is aware of occurrences beyond the walls of their own department and share the burden of delays. With increased operational insight, executives can create an atmosphere that promotes a holistic approach to patient care. OpCenter’s Web-based design allows executives and other managers to access critical information across the hospital, which prevents departments from working within silos and creates a more horizontal patient flow model.
At Good Shepherd, the inpatient floors have access to OpCenter’s real-time data, so the ownership of patient flow issues is no longer just in the ED. For instance, when the ED is saturated and patients waiting to be admitted cannot be moved to their room, inpatient nurses at Good Shepherd now automatically assist with the transport of these patients to prevent ED boarding and hospital-wide slowdowns.
“The increased visibility has led to a more cohesive staff and the unification of departments. Overall, OpCenter has changed the way we operate and how we deliver patient care,” said Short.
The availability of hard data and the ability to easily share it allows everyone to be more aware of issues, such as long wait times, staffing shortages or ancillary backlogs. Problems are no longer “out-of-sight” and “out-of-mind.” OpCenter’s visibility into hospital operations not only helps departments to better understand each other’s needs, but it also can drive organizational efficiencies.
Resource Utilization
Every department in the hospital feels the pressures of patient care and could use additional resources. Unfortunately, the business of healthcare has consistently tightened its purse strings year after year, and leaders are constantly seeking ways to maximize available resources while keeping safety and satisfaction at record high levels. OpCenter provides hospital executives with operational insight, so they can strategically align resources that yield the most benefits for the hospital.
OpCenter’s unique algorithms can predict daily admissions, and an active trending line allows executives to monitor the number of patients per hour. The vast amount of OpCenter’s data about previous admissions is harnessed to establish patterns and forecast daily admissions for each department.
OpCenter also helps administrators make proactive staffing decisions by providing information about incoming admissions, nurse workloads and patient acuity levels. This robust information can be utilized to reduce instances of staffing too many nurses, or worse, not having enough nurses when volumes are high.
“By leveraging the status of incoming patients and trending current patient volumes against a historical, same-day hourly census, we are able to more accurately assess our staffing needs for the day,” said Short. “If we see that we have six upcoming IMC admissions and are busier than what the trend shows, we are going to keep an extra nurse on staff. This way we can ensure that we have the proper resources available to provide premium care to our patients.”
Good Shepherd has also leveraged OpCenter to even further streamline the admit process and free up bed space, which is in high demand in their busy ED.
“Patients admitted using OpCenter’s Bed Ahead feature receive a bed assignment 20 minutes faster and are admitted nine minutes faster than patients admitted using the standard process,” Short said. “When considering our 1,500 admissions per month, we have eliminated 225 hours of patients waiting per month through the use of Bed Ahead. This equates to having capacity for an additional 75 patient visits per month without the need for additional beds or staff.”
The House Census feature provides hospital leaders with an at-a-glance status of hospital bed availability, pending discharges and departmental saturation. The ability to anticipate daily bed needs and monitor inpatient saturation levels without holding daily bed meetings has enabled managers at Good Shepherd to have continuous surveillance of the hospital’s pulse rather than intermittent updates.
“We felt that telemetry beds requests were a pain point for our hospital, but OpCenter delivered the analytics that made it apparent that it was time to take action,” said Short. “With this insight, our medical staff is re-addressing the tele-admit criteria to ensure that telemetry beds are properly utilized. By re-evaluating this process we are better utilizing our resources to care for those patients that need to be monitored more closely.”
The challenges facing hospital executives today, such as improving patient safety, satisfaction and flow; changing the hospital’s culture; and maximizing resources are all connected. OpCenter addresses each of these executive pain points, and because of this direct relationship, improvements can immediately ripple throughout the hospital.