Unclogging Patient Flow in the ED and Beyond

This Leadership infographic highlights more than 20 innovative practices that hospitals and health systems are adopting to improve patient flow in the emergency department and beyond.  

Automation Proves to Be the Right Medicine to Improve Pain Management

Thanks to a creative solution to pain documentation, Winchester Medical Center has seen a 21 percent increase on HCAHPS patient satisfaction scores related to pain control. The new process also saved 1,526 nurse hours in 2010.

Asked to develop a more efficient pain management process, clinical manager Sue Clark, RN, MSN, and then administrative director Janet Palutke, RN, MSN, suggested using the hospital's in-room televisions-which are connected to an interactive information, education, and entertainment platform-to enlist patients' assistance in assessing and documenting their pain.

"We thought: What if alert patients could assess their pain levels through a prompt on their TVs, which would automatically notify nurses via pager and document the pain assessment in real time in the EHR?" says Clark.

In just one year, Winchester Medical Center realized a 22.7 percent increase in pain assessment documentation-and, today, the documentation rate sits at just above 90 percent.

By Consolidating Labs, Scripps Expects to Achieve Major Savings and Improve Care

San Diego-based Scripps Health is wrapping up a systemwide laboratory consolidation and overhaul initiative that is expected to save the health system up to $6 million a year through improved clinical laboratory productivity and a major reduction in the cost per lab test.

Multiple Scripps laboratories have been consolidated into a single entity that is processing all lab tests for Scripps' five hospitals and 19 outpatient facilities. The overhaul is creating economies of scale that are expected to reduce laboratory staff numbers by about 5 percent. "When you are able to centralize a significant volume of work, you can then use innovation and automation to gain efficiency," says Chris Nicholson, senior administrative laboratory director.

Two key pieces of technology-a laboratory IT system that links with Scripps' electronic health record and an automated processing system-will enable the centralized laboratory to process about 8 million billed units this year. It is estimated that the cost per unit will be cut by 50 cents to $1.

Patients are also benefitting from the laboratory overhaul, now that physicians and pathology staff can more easily exchange information that is needed to coordinate care. Plus, Scripps is turning tests around faster, which helps ensure that patients get needed treatments in a more timely manner.

CEOs Offer Successful Strategies for Clinical Alignment

CEOs are using a variety of approaches-such as physician employment and Mayo Clinic's "dyad model"-to actualize physician alignment. But structuring business relationships with physicians-employed or otherwise-can be challenging, and CEOs are employing ways to protect their organizations' interests within these structures. For example, one hospital includes a contingency clause in its physicians' contracts that protects the hospital if a bundled payment model is put in place.

"We need to be careful not to make deals that physicians can bail out of," says William Atkinson, PhD, president and CEO, WakeMed Health & Hospitals, Raleigh, N.C.


Publication Date: Tuesday, April 17, 2012