Today's reality―an aging population with increasing healthcare needs, highly complex inpatient cases, and sharply rising costs combined with shrinking reimbursement, are challenging hospitals to optimize internal operations and improve the efficiency and effectiveness of care. Additionally, emergency department (ED) overcrowding that results from delays in getting patients placed in a bed can also result in ambulance diversions―all of which negatively impact the quality and safety of patient care. Not to mention the fact that hospitals risk losing revenue from inefficient processes.
This is where effective patient flow comes into play. Hospitals that have successfully tackled the delicate matching of available capacity with the demand for care have learned that: it is a critical operational priority, it requires executive sponsorship, and both people and technology resources are necessary. Rigorous process improvement approaches, such as Lean and/or Six Sigma methodologies, are often used to uncover blockages in the system, as well as underlying root causes. These operational improvement strategies often include engaging with nurses to share their expertise in clinical decision-making, a critical variable in effective patient flow management.
In August 2017, TeleTracking interviewed eight nurse leaders at hospitals using TeleTracking’s solutions about the role that nurses play in flow management at their institutions.
The questions included:
And the key takeaways included:
Janet Hanley, Vice President Patient Technology, Innovation, Efficiency at California’s Sharp HealthCare noted, “It is important to understand that these nurse navigators perform different work than that of case managers; patient flow or navigator nurses must focus on movement of patients at the system level and not get too involved in individual patient care management or daily operations. They are often seen as the unsung heroes of the system who are passionate about their work in assuring safe and high quality patient care.”
The nurses also shared their thoughts on the DAISY Award for Extraordinary Nurses in Patient Flow, agreeing that compassion, drive for results, leadership, change facilitation, resource management, and clinical knowledge are the necessary competencies to be an extraordinary patient flow nurse.
Susan Kilgore, RN, Vice President Patient Management/Rural Outreach for Methodist Healthcare in San Antonio, TX, is the winner of the inaugural DAISY Award for Extraordinary Nurses in Patient Flow. Ms. Kilgore underscores the criticality of planned patient flow in her description of her health system’s response to Hurricane Harvey in September 2017. The system had only 48 hours to prepare for the potential large number of transfers or patient admissions―in all, a total of 190 patients were placed at Methodist Healthcare, a process that with real-time technology was handled seamlessly.
I'd like to acknowledge and express appreciation to the following nurse leaders who participated in the structured interviews about the role of nursing in managing patient flow:
Nanne Finis, RN, MS
Nanne Finis leads TeleTracking’s seasoned team of former hospital nurses and administrators in helping clients apply Lean Six Sigma methods and technology to process redesign and workflow automation.
She joined TeleTracking in 2013 after more than a decade with Joint Commission Resources (JCR), a not-for-profit affiliate of The Joint Commission.
A passionate and collaborative nurse leader, Ms. Finis brings expertise in health reform and regulatory policies, front-line leadership, and years of experience in patient safety and quality initiatives. As a certified change agent she has worked across the industry with many teams of professionals pushing creative approaches and innovation.