Bottleneck. It’s a word that is sure to give any hospital administrator, especially the ones who manage patient flow, a headache.
From hospitals to small medical practices, healthcare providers across the country are investing in systems designed to reduce bottlenecks at the point of check-in. In hospitals especially, these systems not only aim to get patients into a bed (or in front of a clinician) quicker, but they can improve quality of care measures such as readmission rates while reducing costs at the same time.
At Hugh Chatham Memorial Hospital, an 81-bed, acute facility in Elkin, N.C., 60 percent of the patients are admitted through the emergency department (ED). With this kind of volume, it’s easy to see why the hospital might suffer from long wait lines, dissatisfied patients, and a decrease in quality. Thus, the hospital looked at the various components which cause long waits in the ED. It then decided to invest in enterprise-wide patient throughput software from MedHost, a Plano, Texas-based provider of process management software solutions.
The software gives administrators many views, including a virtual map of the various beds in the hospital. From a pure patient flow standpoint, Hugh Chatham CIO Lee Powe says the system can improve throughput significantly. It gives nursing managers three beds to choose from for the next patient.
“On the first day, we improved our [throughput] time by 25 minutes. That was the first day,” Powe says. In addition, he adds, the system can reveal real-time metrics on quality measures such as length-of-stay and 30-day readmission, information that can help hospital administrators determine what patients are costing them money. “You know what you’re getting paid. You know what it’s costing you. It’s right in your face.”
The information can be taken back to nurse managers that are dealing with the throughput. The transparency of the system has helped reduce length-of-stay and readmission rates, while raising the accountability of everyone within the hospital.
“For us and small hospitals we’re struggling financially, so we have to figure out ways to reduce our costs and maximize our reimbursement. With the knowledge this brings us, this is a huge help,” says Don Trippel, Hugh Chatham’s CFO.
Reducing Registration Headaches
For some providers, like Elaine Montano, CNP, founder, CEO, and one-half of the Santa Fe, N.M.-based primary care and diabetes management family practice Life Care Health Services, patient flow improvement didn’t come through a broad-based system. Instead, for her practice, it came through a mobile health (mHealth) application.
As Montano tells it, with a poorly educated and low-income patient population, the organization found that it was taking patients a long time to go through registration paperwork. This was the case even after the organization had switched to an electronic medical record (EMR).
Within the city confines of Santa Fe was a patient engagement vendor by the name of Seamless Medical Systems, which basically told Life Care that they in fact had an app for that. The app, called SNAP, puts registration paperwork onto an Apple iPad app, which Montano says, is easier to maneuver through since they’re often just simply clicking on information. The app thus far, she says, has shaved off 15-20 minutes of waiting time for her patients.
Furthermore, Montano notes, the app, which is touted as HIPAA-compliant, can integrate the data with other systems within her practice, such as her athenahealth patient portal and the practice’s EMR. She says this helps shave down the time she spends with new patients from an hour to about a half-hour.
Overall, the app is part of a wider trend that Montano sees is necessary for the industry to adopt. “I think, as time goes on, even other practitioners, other healthcare providers, other facilities are going to see what the rapid flow is for their patients and for themselves. We’ve got to go electronic. We have to go with what the future is bringing. It’s not going to get easier for us, as far as continuing to do paper,” she says.
