Hospitals and health centers were forced to manage substantial patient loads beyond their operating capacities during and post pandemic – and this problem is magnified in intensive care units. As a result of the increasing strain on the healthcare system, managing the efficiency of patient flows from admittance to discharge has become crucial in maximizing capacity while delivering an optimal patient experience. Enhancing patient flows is not only important in ensuring healthcare units continue to run smoothly, but in maintaining a high level of patient satisfaction. Extended wait times in admitting and discharging patients, diagnostic tests and results, as well as delays in being seen by doctors and specialists are all factors that can impede patient flow through health centers and hinder essential care. These hurdles decrease the quality of care delivered and may negatively affect patient satisfaction scores. In order to optimize patient flows, healthcare providers should look to assemble departmental consultation teams to audit processes for bottlenecks, and acquire technology and equipment, such as stretcher chairs, like the Champion Chair TransMotion product line, and real-time location systems, that can streamline patient journeys. Taking these steps will help to improve the processing of patients as well as staff satisfaction and job performance.
Problems in Patient Flow for Hospitals and Ambulatory Surgery Centers
The first and foremost issue that arises from inefficient patient flow through hospitals and ambulatory surgery centers is the generation of waste, and the subsequent reduction in ROI. When bottlenecks occur, the valuable time of nurses and doctors is diverted away from face time with patients, hampering their ability to deliver quality care. On average, a typical hospital doctor wastes up to 45 minutes per day as a result of an inadequate communication system. This wastage quickly accumulates, and comes at a high cost in terms of lost time that could be given to patients or used on other important duties. Inefficiencies in the processing of patients create blockages, which then cause delays in delivering care and reduce the availability of clinical staff to attend to patient needs. A product-based solution in this instance can help to give valuable time back to staff, by reducing the amount of time spent on low-value add activities, such as transferring patients between seating and beds. Champion Chair’s TransMotion (TMM) product line is designed to eliminate patient transfers, which are not only time-consuming, but pose an injury risk to staff and patients. One single movement onto the TMM product is needed at the admission stage and patients then remain on this single surface for the duration of their stay in the healthcare facility. This eliminates the need for several staff to engage in each patient transfer, which would otherwise occur at several stages in the patient’s processing cycle. Furthermore, using a single surface for patient transit and surgical procedures where appropriate substantially reduces the amount of cleaning and maintenance required for patient processing. Instead of using and contaminating multiple surfaces for patient movement and treatment, TMM stretcher-chairs provide an all-in-one solution, reducing staff time spent on equipment and room turnover. In turn, seating capacity is expanded in waiting areas, as each patient only occupies a single surface instead of moving between multiple seats and beds.
Longer wait times are one of the consequences of processing bottlenecks, which work to reduce patient satisfaction. Satisfied customers are happy to return to businesses time and time again – but a suboptimal experience may cause patients to look elsewhere for healthcare. Furthermore, higher levels of patient satisfaction are correlated with an increased likelihood of patients completing treatment cycles. High levels of patient satisfaction, therefore, directly contribute to better treatment outcomes. In this way, minimizing delays and wait times is instrumental in improving the efficacy of care. Ambulatory patients who experienced a combined wait time between waiting and exam rooms of 10 minutes or less were most likely to rate their experience highly. Conversely, a wait time of 20 minutes or more led to a 69 percent chance of patients rating their experience unfavorably. In this way, inefficiencies culminating in care delays and long waiting times cause patient satisfaction and care outcomes to suffer, with the possible consequence of adversely affecting revenue should patients choose to seek treatment elsewhere. As well as looking to reduce waiting times, healthcare providers should aim to improve patient satisfaction while waiting. Giving patients more control over their waiting environment and comfort is likely to boost satisfaction and the perceived quality of care. To this end, the TMM product line provides patients with the ability to recline and tilt their stretcher-chair, allowing for a more comfortable waiting experience and reducing reliance on clinical staff.
Adopting a Holistic Approach to Optimizing Patient Flow
HIPAA Journal suggests that a holistic approach is needed when optimizing patient flow, that ‘the key to success and improving patient throughput is to make changes to improve efficiency through the entire care continuum. This means streamlining patient admissions and handoffs, optimizing discharges, improving scheduling, and to create processes that facilitate good patient flow. It’s important not to address bottlenecks in each department in isolation, but to view each unit as interconnected. Bottlenecks are likely to occur much earlier in the flow than the stage at which they become visible. Centrak comments on this phenomenon, noting that often patient flow issues in inpatient units result from inefficiencies in discharge practices. Subsequently, optimization needs to be carried out with inter-departmental collaboration in order to be effective.
One obvious fix for bottlenecks is to expand staff resourcing by recruiting more staff. While this approach works to expand capacity, it fails to address underlying logistical and operational speed bumps that cause process slowdowns. An example of this is the occurrence of the ‘bottlenecks, batching, and boarding’ problem. This occurs when bottlenecked departments that are short on available beds send patients to the emergency department or other neighboring departments while waiting for beds to become vacant; this is the boarding component. Batching then follows when staff wait until a specific time (e.g., towards the end of a shift) to complete specific important tasks, such as returning patient calls or completing paperwork. This then creates new roadblocks which continue to spill over. In this case, ‘adding physical resources without balancing the other needs of efficient patient flow obfuscates the root cause’. The underlying logistical pinch points need to be addressed in order to meaningfully improve patient flow and expand capacity.
Tools and Systems for Improving Patient Flows
Auditing Processes to Enhance Patient Flow
In order to create long-lasting and impactful efficiencies, hospitals and medical centers need to audit the processes comprising patient flows between admission and discharge to identify bottlenecks, and then streamline processes and redirect resources as needed. As discussed, hiring additional staff works to expand capacity and tackle bottlenecks, but fails to address the root causes. Instead, healthcare providers should examine their processes to find opportunities to streamline operations. For example, Cincinnati Children’s Hospital was able to improve patient throughput by streamlining their discharge processes and surgical scheduling. This led to a 7 percent improvement in surgical volume, without any increase to staffing resources.
Audits of your processes should be undertaken in collaboration with clinicians in order to incorporate operational feedback on where and how bottlenecks occur. Involving staff and departmental heads in this process ensures that staff on the ground can provide input that shapes processes in a way that will enhance job satisfaction and performance. The consultation team should be formed of representatives from each department in order to identify bottlenecks specific to each unit, as well as delays that affect the hospital or medical center as a cohesive unit. These teams should ask where current bottlenecks occur, whether all steps in the patient flow sequence are necessary, and whether some steps can be completed simultaneously, or carried out by less-skilled staff.
An area of concern for all healthcare facilities will be the management of risk to patients and staff. Patient transfers between surfaces need to be carried out by multiple staff, and create substantial injury risks to all parties. Reducing the amount of patient transfers during the processing workflow can play a role in mitigating fall risks and the occurrence of strain injuries. The Centers for Disease Control report that the average weight for males and females have increased by nearly 20 percent in the past fifty years – representing an increased challenge in safe patient handling for staff. Champion Chair’s TMM stretcher-chairs are designed to be suitable for use in all patient movement during their stay, as well as for suitability in surgical procedures. The incorporation of this product into your processing workflow eliminates the need for additional patient transfers after admission, thereby reducing the amount of times staff need to lift patients into and out of chairs and beds, and can therefore be helpful in managing injury risk. In turn, this may contribute to fewer patient falls, fewer worker’s compensation incidents, and greater patient satisfaction due to a more comfortable and relaxed treatment journey. We also discuss how design can aid risk management here.
Another area where efficiencies can be created is in staffing. By auditing the peaks and flows of patient volumes and demand, hospitals and health centers can map out the times where resources are most stretched. Subsequently taking a dynamic approach to staffing and matching resourcing to demand on hospital resources will help to ensure that healthcare centers are better prepared for influxes of patients and less likely to be overwhelmed.
Taking steps to reduce clinician time away from patients also works to reduce bottlenecks. This could be achieved through creating centralized hot desks or standing workstations to allow clinical staff to access health records quickly in busy areas, and reducing administrative and transit time. Incorporating these workstations can be part of a larger scale process of optimizing the hospital’s built environment to ensure that the layout supports the flow of patients through each event, minimizing the need for patients to backtrack or interrupt other patient flows.
Using Technology to Alleviate Bottlenecks in Patient Flow
Many operational bottlenecks in the patient flow sequence can be alleviated partially through the use of mobile and locational technology. Ninety percent of hospitals have made or are planning investments in smartphones and unified communications platforms in order to generate efficiencies, reducing reliance on in-person administrative work. One example of an efficiency-generating technology is real-time location systems. This software can be used to track physicians and nursing staff, as well as medical equipment, to reduce delays in care handoffs and consultations. Knowing where key staff and assets are within the healthcare facility helps to significantly reduce time wastage in coordinating care and the delivery of treatments.
Champion Chair’s Patient Flow Product Solutions
Optimizing patient flow can yield a number of financial and operational benefits to hospitals, ambulatory surgery centers, and other healthcare facilities. Here at Champion Chair, our business is helping you to deliver quality care at every stage along the patient treatment journey. That’s why our Stretcher-Chair TMM product line is developed with your work in mind – to help deliver excellent care to your patients, while looking after your staff too. Get in touch today to find out how our products can help you streamline patient flows and provide your patients with an outstanding care experience during every visit.