Does your facility employ a “push” or “pull” approach when it comes to patient placement in hospitals in order to increase hospital efficiency?
That was the subject of the 4th session in our webinar series entitled: “7 Ways to Master Operational Efficiencies in Your Hospital” hosted by Maria Romano, Clinical Product Consultant at TeleTracking.
The notion of pull vs. push is an important concept when it comes to hospital efficiency and effectively placing patients — and in order to understand the concept, one must first know the difference of the definitions.
So why are these definitions important? The pull methodology significantly improves patient flow through the system and is based on principles of “lean methodology“, whereas the push methodology detracts from it. The pull methodology focuses on the following principles:
This type of methodology begins and ends with the patient who best defines and determines the value of care. To create value for patients, it’s important for hospitals to focus on improving patient flow, applying pull and striving for perfection in hospital efficiency.
The following chart outlines how pull vs. push affects patient placement:
|Patients being pulled through the hospital as a result of diagnosis||Unable to keep up with the demand of patients related to a problem with the flow of patients moving from one point of entry to another|
|Patients are prepared with precision patient placement in less than 60 minutes from any portal of entry||Results in:
|Will receive the right services for the right reason at the right time||Increased LOS|
|Healthcare workers are anticipating the next patient and preparing accordingly||Increased readmissions|
We asked the audience to identify the main cause of issues with patient placement in hospitals as well as the reason why their patients remain in beds after they’ve been discharged. The responses were split 50/50 between physician orders and “don’t know — can’t track it.” What roadblocks does your hospital face when discharging your patients?
Romano stressed the need to set goals for the organization discharge process in order to overcome patient flow barriers and increase hospital efficiency. New patient admissions should begin with discharges, and hospitals should utilize a centralized process to ensure that patients are discharged in Real-Time.
Also, all portals of entry need to use the “Ready to Move Timer” to hold employees accountable. Once a bed is cleaned and assigned, and the patient is clinically “ready to move,” the actual transfer into the bed is completely controlled by the organization and not dependent upon occupancy. If confirmed discharge beds are assigned, the time from bed assignment should not exceed 30 minutes and SWAT teams should be deployed to ensure efficient room turnover. Furthermore, the recommended goal is less than 60 minutes for a clean bed to assignment to transfer.
So how does the pull methodology relate to patient flow and patient placement in your hospital?
Maria presented two success stories of TeleTracking clients who embraced the pull methodology for patient placement:
To end her session, Maria outlined 6 key takeaways in regards to patient placement and the importance of employing a “pull” vs. “push” methodology:
1. Implement a precision placement strategy (assign your beds in real-time)
2. Institute an “open-door” unit policy for all admissions and transfers at any time of day
3. Implement a ‘No Delay Nurse Report’ to streamline the admission process
4. Minimize bed changes by nurses — monitor frequently and report
5. Set a 60-minute target from patient bed request to bed placement
6. Hold accountability with two reports: Processing Time Analysis and Ready to Move