The best hospital design plans are only as good as the processes and systems they support. What this means when it comes to patient throughput is that a well-thought-out built environment needs to have well-functioning services and policies in place to ensure that things run in a truly optimal way. One way to do this is to include the “right” people in your efforts from the very beginning onward.
Putting a Team in Place
The Agency for Healthcare Research and Quality (AHRQ) recommends that hospitals appoint a patient flow team to oversee quality improvements in the Emergency Department (ED) and beyond. This team should include representatives from all of the departments impacted by this issue, such as a team leader, a senior hospital leader, an IT specialist, an inpatient representative, a research/data analyst, and ED physicians, nurses, and support staff. Reaching out to your Quality Improvement specialists, as well as getting the support of your CEO, is essential.
Tackling Quality Improvement Issues
The team can play an important role in helping to measure and assess your ED’s throughput, identify areas for improvement, and measure the impact of your efforts.
For instance, one of the biggest issues that can cause backlogs in the ED is a shortage of inpatient beds. This problem can be easily addressed by the patient flow team, however, in the form of some simple operational changes:
You can even offer a phone triage for patients with non-urgent issues to call before heading to the ED. This provides an opportunity to divert them to ambulatory urgent care settings.
Stepping Up Communication Efforts
Another major contributor to slow throughput is poor communication between ED and inpatient units. The patient flow team can come up with strategies to address this so that ED staff are aware of bed availability in advance and units will have a better idea of who is coming up from the ED. Written and/or electronic reports support information sharing between ED and inpatient staff. A point person for each unit—someone in charge of communicating needs and concerns—can help to head off problems before they escalate and serve as a patient advocate to ensure their needs are being met.
With the guidance of the patient flow team and the support of the rest of your facility, you can successfully address backlogs in your ED to meet the latest healthcare reform guidelines in the most efficient—and caring—way possible.