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Case Studies

Lehigh Valley Hospital Tackles Capacity Crunch

Challenge
Lehigh Valley Hospital and Health Network, based in Eastern Pennsylvania, has three hospital locations with a total of 750 acute beds.

Each year the hospital admits more than 25,000 patients through its emergency department (ED) and like many hospitals across the country, Lehigh Valley Hospital and its EDs were overcrowded.

To address the problem, the hospital embarked on an extensive process redesign that resulted in the automation of the entire bed turnover and patient placement process.

Also like many other hospitals, the ED is one of their chief admission sources. Patients that need to be admitted through the ED require hospital beds quickly. When beds are not readily available, patient stay in the ED is elongated, and at times, ambulances had to be diverted to other hospitals.

The hospital created a task force to study the problem. It soon discovered that the situation extended beyond the ED and involved procedures and processes in many different departments within the hospital.

Solution
After careful review of the problem by hospital leadership, which included consultation with the Healthcare Advisory Board, a decision was made to examine bed-tracking software.

A team, led by Mark Holtz, Vice-president of Operations, examined multiple tracking systems. As there was already a database customized for bed management, it was important that a bed tracking system did more than just collect data and reposition it.

While it was clear that moving away from a paper system to track beds to an electronic system was crucial, Holtz felt strongly that attention needed to be paid to the work processes surrounding software. He worked closely with the Director of Bed Management, Lisa Romano RN, MSN, to ensure that software selection as well as the timing of implementation would enhance work process redesign.

Romano liked that with TeleTracking Technologies all the information could either come from the ADT interface or from phone entry. There was no duplication of information. “I found the reports excellent and very user-friendly,” recalled Romano. “It was clearly superior to the other products I had seen.”

Results
“The Bed Management Suite gives us real-time, manageable information,” she continued. “It’s active, not retrospective. I can go in and actually project the census for three hours from now. Then I can start to build a plan. It has greatly improved our ability to manage beds and improve our patient’s experience at Lehigh Valley Hospital.”

Romano recommended the hospital install PatientTrackingVIP® from TeleTracking Technologies, (now called TransportTracking™). TransportTracking™ helps to streamline the transport of patients throughout the hospital by alerting employees in an automated way and tracking patient status.

Lehigh Valley Hospital put TransportTracking™ into use at its Cedar Crest campus. “We had great success with it in moving patients to and from and getting the data that we needed,” she said.

Two more software solutions, BedTracking® and PreAdmitTracking™ with the electronic bedboard®, were added over the next year. BedTracking® uses computer software and the hospital’s own telephone network to simplify the process of preparing a bed for the next patient.

BedTracking® is user friendly. The use of color as a prompt is very helpful,” says Romano, adding that the staff can’t imagine going back to the mountains of papers that comprised the old manual system of tracking bed availability and patient placement.

Today, when a nurse requests transport for a patient who is being discharged, it starts a chain reaction. As the transporter leaves a room, he or she calls into TransportTracking™, which prompts housekeeping through BedTracking®. Then the housekeeper arrives and dials in. In the Patient Logistics department, staff members see that the room’s status has changed to “In Progress” on the screen. When the housekeeper dials in that the job is complete, the system changes that room’s color on the screen as it is designated “Clean”. This allows all departments to easily view bed status. The system also notifies supervisors of non-compliance or late starts.

Following installation of BedTracking®, the hospital installed TeleTracking Technologies’ PreAdmitTracking™ with the electronic bedboard®, which displays all of the hospital’s beds on a four-foot, color, plasma screen. The electronic bedboard® allows a consolidated view of bed and patient status, enabling hospital personnel to efficiently prepare for patient arrivals. They can coordinate patient admissions from the ED, a doctor’s office, long-term care facility or ambulance, all through a direct link with the hospital’s admitting and housekeeping departments.

“We can view the progression of the room’s status on the color screen,” said Romano. “Everyone in the hospital can see when beds are available. This has helped staff think outside of their department and understand what is going on hospital-wide. Moving patients through our health system -- with the patient in the right place at the right time -- is everyone’s business.”

Benefit
After BedTracking® was installed, Lehigh Valley Hospital’s bed turnaround time– the time from discharge until a room is clean and ready for the next patient – went from 240 minutes to 60 minutes at the Cedar Crest site, to 45 minutes at the 17th and Chew Street location and 37 minutes at the hospital’s Bethlehem campus.

The hospital is also closely watching ambulance diversion hours. [Hospital administrators estimate they lose 2.2 ambulances and approximately one admission for each hour on diversion.] Though Romano explains that fluctuations in diversion hours can depend on many factors – such as a high demand for beds due to a rise in flu cases or ICU patients – she does say that better management of bed capacity through BedTracking® has helped control the situation. “It could have been significantly worse without the electronic bedboard®,” she said.

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