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University of Alabama Medicine, a 1,157-bed academic medical center, manages 50,000 annual admissions and 300 daily emergency department visits. It has 57 operating room suites, with 130 surgeries per day.
UAB, the only American College of Surgeons-designated Level 1 Trauma and Burn Center in Alabama, also serves as a safety net hospital for the Birmingham community, since some 35 percent of the patients who come through the door are uninsured.
Given these demographics, high patient volume was creating significant challenges for the hospital, such as being on diversion 60 percent of the time; an average wait time for an inpatient bed up to 210 minutes; only 15 percent of discharges occurring before noon; more than 45 percent of transfer requests denied; midnight occupancy averaging 94 percent, and 6,000 clinic encounters a day.
UAB knew it needed to take an enterprisewide approach to throughput efforts, working simultaneously across primary care and ambulatory clinics, perioperative services and inpatient areas, said Brittany Lindsey, director of patient throughput at UAB Medicine.
"A cultural shift also needed to occur with a heightened focus on throughput as a daily priority and a commitment to centralize responsibility, accountability and authority for decision making within the new Center for Patient Flow," she explained.
To address those capacity issues, a strategic patient flow plan was developed that included a centralized patient placement center, the Center for Patient Flow. UAB implemented patient flow systems from vendor TeleTracking, Lindsey explained, to: