Good patient flow is instrumental for delivering high-quality and timely care and enhancing efficiency in any hospital.
Despite that, overcrowding remains widespread in healthcare facilities. Various factors contribute to patient flow issues: understaffing, an insufficient number of hospital beds, or failure to follow procedures.
Patient ED wait times vary significantly. Several hospitals in the USA can boast zero wait time, while the record longest average ED wait time is the staggering 53 minutes per patient.
Although there’s no silver bullet to resolving departmental overcrowding, considerable improvements can be made within some areas to reduce patients’ congestion and cut down wait times in ED.
Dealing with Poor Patient Flow. Areas for Improvement
Sometimes a sudden influx of emergency patients can throw the entire ER out of balance. Ineffective admission and handoffs create delays, slow down operations, and jeopardize patients’ safety. Hospitals can offset those risks and combat overcrowding by introducing a set of regulated practices:
1. Establish department standards for triage and treatment
Most hospitals have a triage system already in place, but a more strategic approach is required to improve the flow of patients. Start from identifying the most frequent diagnoses among patients coming to the ER. Document each stage of their visit, and establish a standard protocol for each diagnosis to streamline patient handoff from one step in the treatment process to another.
An effective triage system can decrease the number of visits for minor illnesses by 20-60%
2. Introduce a digital queueing system
Automation of manual procedures is one of the most effective ways of managing patient flow. Modern software systems such as Qminder can automate the entire patient path from check-in and queuing through routing. Some of them can also handle appointment scheduling to orchestrate the flow of patients before they arrive at the hospital. Regardless of which queueing solution you choose, all of them will help you shorten the admission process, optimize patient data tracking, and improve floor operations and staff productivity.
3. Define an ER ‘fast-track’
Triage system assigns urgency to your patients, but it’s incomplete without an effective ‘fast-track’ system for lower-priority patients. By implementing it, you will be able to efficiently deal with patients with minor ailments (sore throat, rash, small cuts) without interfering the treatment of seriously ill patients.
How to proceed? Designate a separate area to isolate high-priority patients from those with less severe conditions. Ideally, assign dedicated staff to attend to each of these groups. If that’s not possible, specify procedures when a nurse or a physician can treat a low-acuity patient while they are free. The fast-track strategy implementation requires some effort, but it is extremely efficient in decreasing wait times and improving the overall ED turnaround time.
Thanks to launching a fast-track program, San Juan Medical Center reduced turnaround time to discharge by 20 minutes for low-acuity patients.
4. Optimize patient experience after check-in
Patients coming to ER often follow a chaotic path where they arrive, sit in the waiting area, register, and come back to the waiting hall again as they expect to be admitted. A faulty patient path leads to a line build-up. What’s more, it negatively affects patient experience and creates a sense of disorder.
To enhance the patient path and reduce wait times, map out and re-evaluate each stage of the patient’s visit to your hospital. Are there some common patterns emerging? Can some procedures be inverted to help your patients progress more smoothly (and faster) through their visit? Answering these questions will help you optimize the flow of your patients once they’re admitted.
5. Improve communication
Communication breakdowns lead to chaos, confusion, and delays. Fortunately, technology comes to the rescue as you can leverage it to streamline communications in your hospital across several critical touchpoints.
Consider introducing a single, centralized phone number for all hospital staff to let them immediately reach any hospitalist or relay consults to the relevant personnel. Facilitate the transfer of knowledge about your patients between the staff members by establishing a patient communication system. Leverage mobile technology to quickly distribute emergency notifications, critical test results, and other crucial updates among your staff.
Reducing hospital overcrowding is a challenging but feasible task. Hospitals that wish to achieve that goal and enhance the patient experience must seek innovative strategies and apply them systematically.
To start working towards better patient flow, define current metrics, set realistic, measurable goals, and systematically proceed with the above measures, taking one step at a time. That will put you in the right position to optimize throughput, increase revenue, and provide high-quality care to your patients.