As the saying goes, if you think you can have it all, you probably don’t know what you’re missing.

That’s very often the case when hospital technology vendors “throw-in” free software. The cost of “free” goes up in direct proportion to the number of capabilities left out.

Hospital patient flow and capacity management software is a very good example.  As federal incentives gave the EMR market a huge boost, some vendors acquired start-up patient flow companies. Others developed “bed tracking”, “bed management” or “transport” applications and offer them “free” as part of the multi-million dollar price tags and multi-year implementations hospitals sign up for.  While these offerings may provide basic patient flow, or more likely, visibility into broken processes, they do not offer the true sophisticated data analysis capabilities, workflow automation and hospital operations expertise needed to manage hospital enterprise capacity in real time.

Let’s face it – EMRs manage the patient record, capacity management experts manage the patient care path.  They are two very different proficiencies that require very different disciplines, expertise and solutions.

If you accept “free” patient flow software from an EMR vendor, here’s what it can actually cost you in terms of what you don’t get:

•    Reporting: Most EMR vendors offer little to zero capacity reporting capability, and what is provided is focused on clinical documentation and the patient record, rather than improving patient flow and increasing efficiency.  Without quality reports, it’s virtually impossible to continue improvement or maintain accountability and compliance.

•    Measurement: The ability to instantly analyze what’s going right and what’s going wrong with your patient flow and the ability to accurately measure workflow improvement.

•    Speed:  Significantly delayed discharge notification, on average between 90-120 minutes per discharge, when you rely on discharge notification from the ADT system

•    Discharge planning: The absence of discharge milestones that allow you to pre-assign patients to beds because you can tell how close to discharge is the patient occupying the bed.

•    Prediction:  The ability to project census in order to match staffing levels with demand.  ADT systems provide current occupied census but do not take into consideration pending and confirmed discharges or transfers and incoming admissions.

•    Real Time Capacity Management™:  The leverage to combine Real Time Locating Systems (RTLS) patient, staff and asset tracking technology with an advanced patient flow system in order to manage the physical operations of an entire enterprise on a single platform.

•    Consulting:  The expertise necessary to recognize and change workflow processes which are inherently unsuccessful.   Without this, the same processes and problems remain, but are now simply visible in an electronic database as opposed to a paper one.

•    Precision Placement:  The capability of placing the patient in the right bed the first time via the use of an unlimited number of Patient Placement Indicators.

•    Reduced Chaos:  The convenience of Automated Notifications and Alerts, which can eliminate thousands of phone calls and reduce the overall time from bed request to assign to occupy.

•    Smart Software:  The exclusivity of Dispatching Logic, which makes dispatches based on proximity, priority, appointment and equipment availability. Fully automated, dispatcher-less patient transport systems use complex dispatching logic to match the most appropriate transporter to the transport need.

•    Enterprise Capacity Management:  The ability to place patients wherever there is capacity anywhere in the enterprise, rather than within only one hospital, affecting both patient flow and FTE requirements.

This translates to increased Diversion, ED boarding, elopement, longer LOS, more holds in the PACU and OR, etc.  And here is what it will cost your bottom line:

•    A single hour of lost bed time equates to a loss of $11,250 per room per year. For a 300-bed facility, a single hour lost per bed would cost $3.4 million per year.

•    ED diversions, generally caused by poor patient flow, cost on average over $1,000 per hour per diversion. Longer ED hold times can lead to hospital acquired infection.

•    PACU holding times increase, backing up the recovery room and thus interrupting the OR schedule. Average contribution margin of one hour of OR time is $1,773.

•    Shaving five minutes off of the time of the average patient transport, multiplied by an average of 300 daily transports, would save 25 hours per day, or three FTEs.

•    Housekeeping and Transport personnel can compromise infection control procedures, or be compromised themselves, as they are not made aware of room or patient conditions that may be infectious. Average cost of a hospital acquired infection is $15,275.

Additionally, consider that installing a new solution is disruptive to patient flow. Between installation, training and corrective action, this could easily take 12-24 months, resulting in significant revenue loss, lower patient care quality and a decline in patient satisfaction.

If you’re offered “free” software, you may first want to calculate how many millions it will actually cost your hospital in revenue, inefficiency, risk and satisfaction. In this case, free certainly isn’t free!

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