Operational bottlenecks are a common occurrence at health systems across the country―especially in the emergency department [ED], where boarding, left without being seen and long wait times are symptoms of a larger visibility problem. Departments often don’t know what beds are available for new patient placement and/or too much control is given at the unit level vs. centralized operations. Solving these issues requires innovative approaches at the intersection of healthcare and technology―including solutions that work collaboratively with EMRs.
Currently in the United States:
1.9 million patients leave without being seen
Every minute, of every day, an ambulance patient is diverted away from their hospital of choice because of insufficient capacity
An estimated 1.2 million admitted patients face an 80% or greater increase in the risk of death because they spent 12 or more hours waiting for an appropriate bed
A projected nursing shortage of 260,000 by 2025
Addressing these challenges goes beyond digitized records. Today’s world requires an integrated approach that includes multiple, specialized, best-in-class vendors, such as ADT, an EMR, order/entry system―and TeleTracking for operational visibility and actionable metrics to increase access to services. The result is maximum efficiency by maximizing resources.
One way TeleTracking achieves this is through operational command centers that break down silos and centralize functionality. TeleTracking has more than 26 years of experience in this space driving best practices with industry-leading technology; well-trained team members; and Lean Six Sigma tactics, process redesign and workflow automation. Currently in practice at more than 100 health systems across the U.S. and UK, this is a proven way of coordinating care across systems and across departments [from the ED to post-acute care], expanding patient access, and continually improving outcomes.
Improved access and transparency means patients are seen and placed in the right place, the first time. An academic study suggests that reducing the average boarding time in the emergency department (ED) from 6 hours to 4 hours across the US could create the capacity to help 9.7 million more patients per year in urban EDs with a potential of $12 billion in additional revenue per year. At a time when 30% of all hospitals have negative operating margins, these types of revenue gains are important to keep our system from collapse.
One example is Carilion Clinic, an Epic system in Roanoke, VA that serves 1 million residents in western Virginia, and had 167,211 patients visit their ED in 2016. The command center at Carilion Clinic is composed of patient placement, transfer center, case management, patient transport, environmental services, behavioral health call intake, and ambulance/helicopter dispatch, all staffed 24-7-365 under one roof. With these departments working together, it’s possible to know when patients are coming in and going out; it’s also possible to predict the times that will be busier to effectively staff for them.
Another example is Baptist Memorial Health Care, an Epic system based in Memphis, TN, which has 14 hospitals across Tennessee, Arkansas and Mississippi; 2,300 beds system-wide; and 350,000 annual ED visits system-wide. Baptist worked collaboratively across departments and with TeleTracking to align system, hospital and individual goals through a combination of people, process and technology. They implemented a patient placement center that also added transparency to the process, eliminated silos and reduced issues with leakage. Again, knowing that ED boarding leads to increased mortality and extended lengths of stay, solutions were implemented to improve discharge efficiency, including a 24-hour discharge planning process.
Eliminating 30 minutes of wasted time per patient means beds become available 30 minutes quicker and overall length of stay decreases
Using the metric of 1,900 admitted patients per month moving through the ED via the command center translates to approximately 60,000 hours saved per month and 720,000 hours per year
Real-time emergency department alerts make it possible to precisely place patients and free up space to treat more people, resulting in a 50 percent reduction in the time it takes to place a patient in a room
A real-time dashboard for senior leadership helps them monitor patient flow and make short- and long-term strategic decisions
System ED volume has increased 15% while ED hold hours have decreased by 52% at the flagship hospital
Patients from the ED receive bed assignments within 14 minutes―83% of the time.
ED length of stay, discharge and admit turnaround has decreased by 10%
Previously 80% of transfers were sent to competitors—nine months after implementing the patient placement center that number declined to 40%
Carilion Clinic go.teletracking.com/carilion-c...
Baptist Memorial Health Care go.teletracking.com/baptist-me...
Our Mission is What Drives Us go.teletracking.com/mission-is...
Our Mission is Simple go.teletracking.com/mission-is...
PFQ Spring 2017 – The Power of Integration and Automation go.teletracking.com/the-power-...
PFQ Summer 2017 – Taking Command, Improving Access, Enhancing Outcomes go.teletracking.com/taking-com...
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