How can you know how far you’ve come if you don’t know where you started?
The fact is that you can’t.
Yet many hospital productivity initiatives get underway without establishing the status quo. Patient flow is a good example.
Homegrown programs always start with very good intentions, but often very little in the way of measuring improvement. And if you don’t know where you are, how can you establish a goal and a realistic timeframe for reaching that goal?
Setting arbitrary goals without a baseline for measurement may be setting yourself up for failure because improvement is typically measured by how short of the goal you still are, and not how far you have come.
Psychologically speaking, staff is forced to focus on how much or little they fail, not how much they improve.
Establishing a baseline has the benefit of showing how much of the struggle your team has “won” during any given measurement period. While they still have an ultimate goal, they can feel good about the fact that they are making steady progress, rather than just coming up a little less short of the goal each time they are measured.
The best way to begin is to take “snap shots” of your organization’s performance. If the problem is patient flow, then take stock of each element of the patient flow continuum (i.e., transport times, bed turnover time, “dead” bed time, bed request to assign time, etc.)
Your goal is to get a baseline measurement of the following:
“Baselining” also has the advantage of keeping expectations more realistic. It might be nice to arbitrarily decide that a room should be ready for new occupancy within 30 minutes of discharge, but if your current average is four hours, setting a goal of 30 minutes six months from now is a recipe for failure.
Small wins build confidence and keep people involved. Big failures break confidence and lose loyalty.
Making comparisons to other institutions gets a bit more involved. You may or may not have contacts at facilities that are similar to yours and the process can be time consuming. But it is well worth the effort.
We will discuss benchmarking in a future blog.
Goals should be set by a team of hospital staff members from a variety of areas, so obstacles such as process, personnel and culture can be taken into account. Always take into account where you have been to set targets that are reachable. This is vital to getting “buy-in” from the front line staff that will be accountable for reaching those goals.
Taking stock of where you are starting often is perceived as an unnecessary step that looks backward rather than forward. In reality, it is actually the “best” first step forward in any improvement initiative.
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