Recent research shows a high number of patient-handoff-related errors, especially when it comes to examinations and vital-sign communication.

Advanced analytics tools enable interdepartmental performance-improvement conversations.

When it comes to improving emergency department operations, even small, seemingly simple operational changes — like staggering arrival of attending physicians and smoothing out surgical flow — can lead to significant improvements.

These types of changes can reduce ED crowding, improve patient handoff and its related errors, and lead to improved patient flow and safety across all hospital departments.

Advanced performance analytics can help you target the areas most ripe for improvement and how best to change the process. d2i’s solutions can help organizations understand the potential impact of adjustments and achieve measurable process improvement.

Staggering ED Physician Shifts

According to a study conducted at Seattle Children’s Hospital, one way to improve patient flow is to overlap the shifts of attending ED physicians. The change was made after earlier research showed a high margin for error associated with ED patient handoff, especially in areas like vital-sign communication. One study reported errors in one in seven ED handoffs, and another reported 58 percent handoff examination errors and omissions.

When Seattle Children’s Hospital ER started overlapping physician shifts in a so-called “waterfall” pattern instead of handing off multiple patients to an incoming attending physician, patient care prioritization shifted. The new model allowed for:

  • Reduced opportunities for patient harm
  • Reduced workloads and accompanying stress
  • 25 percent fewer patient handoffs
  • Increased opportunities for physician collaboration
  • Decreased delays in patient care

Integrating All Departments

Another way to help optimize patient flow is to integrate all departments, which improves care quality, clinical outcomes, and patient satisfaction, and reduces safety risk. Clinical teams at Envision Physician Services, a large national HCO, improved patient throughput by approaching it as a whole-hospital issue, not just an ED problem. This approach demonstrated that when all departments align their goals, an HCO can reduce operational bottlenecks. Departmental integration, in turn, also creates more visibility. When the whole system is integrated, operational performance reviews are collaborative and constructive, which can lead to high impact actions.

Operations Research Strategy

HCOs don’t need a lot of money to make small adjustments that go a long way. Eugene Litvak, a professor at the Harvard T.H. Chan School of Public Health and president of the Institute for Healthcare Optimization, recently suggested that Ontario hospitals could reduce overcrowding and decrease mortality and infection rates just in time for the flu season by adopting an operations research strategy. At its core, this approach uses scientific methods to evaluate demand and try to make hospital capacity meet it by:

  • Spreading elective surgeries throughout the week, thus smoothing out surgical flow and reducing surgery mortality rate
  • Turning around hospital beds faster due to earlier discharges
  • Separating patients by level of care (one way to do this is adhering to protocol for using stepdown beds)

Shared Metrics for Shared Goals

Advanced analytics like d2i’s Performance Analytic Application can be instrumental in all of these adjustments and more. Analytics that enable interdepartmental conversations with shared metrics and shared goals can help advance performance improvement initiatives.

d2i can take data from a wide range of sources to help identify opportunities for improvement and then continuously reinforce behaviors that support new processes, providing a holistic, accessible, and trusted view of all related data.

To learn more about how we can help your organization identify strategic adjustments for performance improvement, as well as monitor the impact of your changes, contact us to schedule a 30-minute demo.

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