Inefficient usage of hospital resources
is bad for both patients and hospitals
One of California's busiest hospitals was operating in a permanent state of crisis. Its emergency room had one of the longest wait times in the nation. For patients needing admission, the situation was even worse; on a given day, up to 90 patients had to wait many hours for a bed to become available. The delay in getting care presented obvious risks for patients, but impacted hospital financials too, on account of possible fines from Medicare and Medicaid.
New information systems, and new styles of treatment
We discovered that part of the hospital's problem involved inadequate facilities monitoring; empty beds were often erroneously listed as being unavailable. Solving that problem helped us with the next step, establishing an innovative "command center" to oversee patient status, from ER to admission to discharge. Criteria were developed to help staff determine which emergency patients were sick enough to immediately require beds, and which could instead be moved to a newly-enlarged observation unit with less intensive, and thus less costly, monitoring. The accumulated changes meant learning new skills for the hospital's healthcare professionals; nurses, for example, were trained to use newly-developed software to aid in their triaging decisions.
A complete clinical transformation
With more accurate tracking, the 685-bed hospital was able to increase its annual billable bed days by 1,400. Improved triaging allowed for more effective patient care; the average time spent in the observation unit fell from 36 to 22 hours. Its command center concept proved to be so effective that other hospitals have begun setting up their own. Finally, the hospital's finances grew healthier, with it receiving $6 million more a year in Medicare compensation.
in patient stay