Capacity Maximization and Throughput

1
Capacity Maximization and Throughput

• Patient Placement partnered with
• TeleTracking Technologies

2
Agenda

• SJMC facts
• Problem Statement
• Bed management/ pt. Placement processes prior to
  TeleTracking
• Partnering with TeleTracking
• -Bed Tracking
• -Transport Tracking
• -PreAdmit Tracking and the Bedboard
• Where we are now
• Results
• Vision where we want to go

3
Agenda Continued

• Visitation
• - BedTracking - EVS
• - TransportTracking Pt. Transport
• - Bed Meeting Conference Room
• - Pt Placement/Admitting Department
• Lunch
• - Networking
• - Questions

4
SJMC Facts

• Regional Medical Center
• Licensed Beds 350 Acute Care
• Staffed Beds 343
• Primary Service Lines
• - Heart Institute
• - Orthopeadic Institute
• - Stroke Center (certification Spring
  2006)
• - Development of New Cancer Care
  Center

5
More SJMC Facts

• Volumes
• - Admissions - FY04 21,306
• - FY05 22,655
• - FY06 YTD 24,401
• - ED-Visits - FY04 42,698
• - FY05 45,863
• - FY06 YTD 50,577
• -ED-Admits - FY04 9,409
• - FY05 9,876
• - FY06 YTD 10,481

6
St. Joseph Medical Center
7
SJMC Facts

• ED Divert Hours
• -Red -FY04 - 968
• -FY05 430
• -FY06 YTD - 790
• -Yellow -FY04 - 1,236
• -FY05 407
• -FY06 YTD - 949

8
ED Divert Hours
9
SJMC Facts Continued

• Surgery Volumes
• -10 General ORs
• -17 Bed Inpatient PACU
• In Patient Surgery Volumes
• -FY04 5,925
• -FY05 6,110
• -FY06 YTD 6,175

10
Inpatient Surgery Volumes
11
SJMC Facts Continued

• Heart Institute Volumes
• -6 Cardiac Cath Labs
• -15 Cardiac Cath Recovery Beds
• -Cath Lab Cases
• -FY04 6,993
• -FY05 8,824
• -FY06 YTD 9,269
• -4 Cardiac ORs
• -OH Procedures
• -FY04 1,063
• -FY05 1,240
• -FY06 YTD 1,264

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Cardiac Service Volumes
13
Problem Statement

• SJMC was struggling to serve more patients within
  the community which taxed our ability to provide
  easy, efficient access to healthcare within our
  hospital system
• Lost admissions due to
• -Extended ED wait times
• -ED Diversions
• -OR holds
• -Cath Lab holds
• -Daily patient placement challenges
• related to throughput
• -Poor discharge process

14
Bed management/ pt. Placement processes prior to
Teletracking

• Patient is requested for admission via Physician,
  ED, PACU, CCPR/Cath Lab
• Admission and Transfer requests are generated by
  a phone call to admitting
• Admitting Department would record information on
  paper block
• Admitting Calls Nursing Units to request bed
  assignment
• Nursing Unit calls admitting to assign patient
• Admitting calls sending unit to assign bed
• Sending Unit calls Receiving Unit to inquire
  about bed status and ability to take report

15
Bed management/ pt. Placement processes prior to
Teletracking

• Problem with Process
• -time consuming
• -inefficient
• -multiple phone calls
• -delayed identification of discharges bed
  hiding
• -delayed ability for EVS to identify dirty
  beds and implement cleaning
• -delayed identification of available clean
  beds

16
Partnering with TeleTracking

• BedTracking implementation date 9/03
• Capacity Maximization Initiative promoted
  investment in technology-assisted patient
  placementPatientTransport and PreAdmitTracking
  with electronic Bedboard added to complete the
  TeleTracking Bed Management Suite
• PatientTransport implementation date 1/05
• PreAdmitTracking with electronic Bedboard
  implementation date 3/05
• Bedboard Mobile implementation 7/06

17
Where we are now

• Process Enhancements and Resolutions
• -Capacity Maximization Initiative
  hospital-wide
• accountability for patient throughput
• -Centralized person to control beds
  
• Clinical Placement Nurse
• -Bed Meetings twice daily
• -Hospital Diversion Policy Stricter criteria
• -Direct Admit Policy - InterQual Criteria
• - Physician Advisor Role
• -Technology Enhancements TeleTracking
  Technologies Bed Management Suite
• -Score Cards departmental organizational
  identifies
• areas for improvement, progress,
  accountability

18
ResultsImproved Patient Throughput!

• Significant reduction in phone calls to nursing
  units and admitting department
• Improved communication for patient placement,
  transports, and EVS requests
• Significant reduction in ED wait times and
  diversion hours
• Improved ED patient satisfaction scores
• Real-time reporting of patient discharges
• available beds
• Reduction in bed turnaround time
• Reduced patient placement delays
• 8 growth rate annually x 3 years

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VisionWhere we want to go

• Centralized Patient Logistics Area Placement,
  Transport, EVS War Room
• Scheduled Discharge Appointments
• hospital-wide initiative 1/2007
• Bedboard Mobile 6/2006
• Beta site for Teletrackings OR Tracking 9/2006
• Continual decrease in ED diversion times, patient
  throughput delays bottlenecks
• Implement independent use of TeleTracking Systems
  within MCH Division

20
2005 Accolades

• 2005 SJMC ED received the 1st Maryland Star of
  Life Award for a hospital from MIEMSS for EMS
  Access
• First hospital in the state to use an Electronic
  Bed board.
• National Recognition for throughput in
  Healthcare Financial Management April 2005

21
Questions?

• Karen Starks, RN
• Manager Nursing Supervisors/Clinical Placement
• 410-337-4429
• karenstarks_at_chi-east.org
• Ida Singer,RN
• Clinical Placement Nurse
• 410-337-1155
• idasinger_at_chi-east.org
• updated 8/06
• 02/23/06