Patient Flow Software Blog

Patient Flow Technology for Medium Sized Hospitals

Posted by Ron Gregg on Fri, Jul 19, 2013 @ 06:08 PM

Saving You Money & Time, So You Can Save Lives

Patient care is largely about getting people into the hospital to receive treatment and initiate their recovery process so they can continue healing after discharge. Unfortunately, individualized patient work flows are often interrupted, which has the potential to delay treatments, lower clinical staff efficiencies and extend the length of stay. This is costly to hospitals since labor and space are the top two most expensive resources of a hospital’s budget.

But hospitals equipped with technology used for tracking and optimizing patient and equipment transport, as well as managing housekeeping duties that impact bed availability, have the opportunity to reduce a patient’s length of stay, improve the quality of care, reduce the average cost per procedure, increase bed utilization, and improve patient satisfaction. What could this look like for a medium sized hospital? How about a $34,500 savings for every 50 occupied beds? So, for a hospital that has a census of 150 transportable patients*, we are looking at $100,000 annual savings in clinical labor. Continue reading if you’re interested in why getting from Point A to Point B can be so expensive and how Patient Flow Technology helps that journey run much more smoothly (and cheaply).

What is patient flow and how can it be measured?

Patient flow can be defined as the progressive movement of patients through a sequence of processes in a timely and efficient manner. That definition points to measurements that directly relate to identifying delays, diversions, and wait times incurred by patients or by clinical staff. So the metrics could include such things as the time from admittance from the ED and PACU to placement in a bed on a unit, time nursing staff is "off unit" performing non-clinical tasks, and percent of on-time patient deliveries to testing and treatment areas. The idea is that reducing or eliminating delays, diversions, and wait times will provide the benefits described above.

What is the challenge of patient flow for medium sized hospitals?

Conventional wisdom suggests that the technology required to manage patients’ logistics does not produce a financial ROI (return on investment) in hospitals with fewer than 200 patients. However, according to Peter Van de Kerkhove, the principal architect for the original PFS bed and patient management support technologies and an experienced patient logistics consultant, “smaller hospitals tend to be more unconventional than larger hospitals, out of necessity. Medium sized hospitals intuitively integrate more services to create natural economies of scale. They have already redesigned workflows and eliminated a lot of waste and overhead.” Peter goes on to say that, “because of these efforts, they can have more difficulty in lowering the direct labor costs associated with non-clinical labor used for patient flow processes. However, because efficiency “is their norm,” they tend to overlook the clinical labor being used to perform non-clinical tasks, such as patient transport, running off-unit to get patient equipment and supplies, or making a bed in a clean room.”
When medium sized hospitals marginally improve their occupancy, they don’t tend to add clinical labor, but the clinical staff has to prioritize and take care of patients first and non-clinical tasks second. This is when the support staff appears to be “dropping the ball” when, in fact, they were never carrying that ball to begin with.

It’s at this time that we need to be looking at the “missed opportunities” and the cost of missing them. Are physicians starting to re-direct patients to another facility? Are the risk factors starting to increase because staff has to cut corners to get the job done?
The challenge is to measure the impact that efficiencies created by logistics technology have on reducing the full labor cost of clinical staff time currently used to perform non-clinical support work.

When clinical staff are over-worked and begin to stress out, their ability to remain focused on patient flow efficiencies is reduced, and patients’ length of stay will increase, thereby solving their “capacity issue”… by lowering it. It’s the law of nature for “systems” to return to a state of equilibrium, and that includes patient workflow systems. However, this impedes any efforts made toward growing the hospital.

How does patient logistics technology meet the challenge for a new equilibrium?

The answer is that it expands staff capacity to do their respective jobs. The following features are common to all “real-time” task management software systems designed for logistics centers that coordinate on-demand requests for housekeeping, patient transport, patient equipment, supplies, and minor maintenance:

  • Automatic notification of patient discharges (by transporters) to bed control
  • Improved visibility of patient locations, updated in real-time by transporters 
  • “GPS-like” features that estimate “standard completion times" for support tasks 
  • Comprehensive, or filtered, visibility of patient flow tasks impacting the care plan
  • Opportunity to make patients pending discharge times “visible” (HIPAA compliant)
  • Multiple methods to communicate, making communication more accessible
  • Ability to capture critical time segments when, and where, most delays occur
  • Ability to report, analyze and make fact-based decisions in a timely fashion
What are some measurable results from using Patient Flow Technology?

The following are examples of a variety of on-demand support services that have been improved by the patient flow technology:

  • 15% improvement of “on-time” deliveries of patient to ancillary procedures
  • Ancillary technicians’ billable procedures increasing by 10%
  • The elimination of “outlier delays” from decision to admit to getting the patient in the +bed
  • 10% reduction in capital replacement for patient equipment due to increased utilization
  • Bed availability by hour of day shifts 30 to 60 minutes earlier in the day
  • A 10-15% increase in capacity of transport staff to take on additional non-clinical trips 

Efficiencies of Patient Flow

 

What does this mean for medium sized hospitals?

For every 100 occupied beds with transportable patients, hospitals consume approximately seven Full Time Equivalents (FTEs) of patient and equipment logistics labor to perform on-demand trips, on and off nursing units, assuming that staff is 95% efficient and 95% utilized. For every 1% drop in efficiency and utilization, hospitals need to add 1.95% more staffed hours for the same level of work. For every 100 patients, 1.95% loss in productivity adds 5.5 hours of labor required per week to do the same amount of work. That “lost time” usually means that nursing and ancillary staff need to perform 11 patient transports per week, and lose 5.5 hours of time for hands-on patient care.

Hospitals that run manually, without intelligent logistics software, stand to lose an average of 18% productivity on tasks related to patient transport, equipment delivery and other on-demand tasks that will affect patient workflow and bed availability. For performing just those patient logistics activities alone, for every 100 patients there will be 1.28 FTE’s of non-clinical support work that will be picked up by clinical staff.

Assuming the “weighted average” wage of the clinical staff that are actually performing the non-clinical patient logistics work costs $20 per hour and, after adding full-time benefits, 1.28% of clinical staff FTEs are costing the hospital over $69,000 for every 100 patients.
While these are tested assumptions, they do not include the additional cost of Nursing Supervision’s time wasted on running around the hospital looking for “hidden beds” and negotiating for an available bed to place admitted, waiting patients. Also not included is the opportunity to respond to demand for more bed capacity through higher bed utilization.
Want to do the math yourself? Using your annual “transportable patient days,” divide by 365, divide that by 100 and multiply that by $69,000.

As Peter Van de Kerkhove said, the issue small hospitals face is not a lack of efficiency; it’s a lack of clinical labor that is capable of meeting growth without upgrading the system. Patient Flow Technology is that upgrade; the tool that allows staff to continue to function even when the current is fast and the tides are heavy. Getting from Point A to Point B doesn’t need to be a race, a challenge, or a financial setback. Interested in learning more? Then visit our website or get more info on how we provide tools for medium sized hospitals.

 * Transportable Patients typically exclude mental health, long-term care, newborns, and monitored patients requiring clinical staff escorts. 

 

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Topics: patient flow, patient transportation, patient transportation software, patient flow software, bed management, patient placement, patient tracking