ABSTRACT
Does My Department/Facility Have a Patient Flow Problem? ...................................................... 350 An Overview of Patient Flow......................................................................................................... 350 Organizing Your Patient Flow Efforts ............................................................................................ 351
Case Management/Admissions/Bed Placement ........................................................................ 351 Emergency Department ............................................................................................................. 351 Better ED LOS in 5 Steps ......................................................................................................... 352
Step One: Better Bedding ..................................................................................................... 352 Step Two: Scheduling ........................................................................................................... 352 Step 3: Diagnostic Testing ................................................................................................... 352 Step Four: Noti›cation ......................................................................................................... 353 Step Five: Troubleshooting................................................................................................... 353
Better Prep, Execution, and Discharge in the Operating Room ................................................ 353 Preoperative .......................................................................................................................... 353 Holding Area or Not? ........................................................................................................... 353 Operative .............................................................................................................................. 353
Postoperative ............................................................................................................................. 354 PACU Overload, Dealing with Inpatients ............................................................................ 354 Protocols for Discharge and LOS ......................................................................................... 354
Inpatient Unit Bed Management ............................................................................................... 354 Patient Flow Variability in Critical Care Units .......................................................................... 355
Institutional ........................................................................................................................... 355 Medical Factors .................................................................................................................... 355
Social Factors ............................................................................................................................ 355 New Admits and Discharges ................................................................................................ 355
Support Departments/Ancillary Departments ................................................................................ 356 A Closer Look at Laboratory/Radiology ....................................................................................... 357 A Glimpse at Equipment and Materials Handling ......................................................................... 357
With two-thirds of all U.S. hospitals looking for ways to improve the functionality and quality of their organizations, it is imperative that hospital leadership addresses these ef›ciency challenges and work to prioritize and systematically reduce weaknesses. Like exercise, process improvement is a discipline and a habit. Day-to-day time limitations often sidetrack managers from reviewing clinical and administrative processes, but improvement is crucial for long-term viability. New thinking about employee productivity, case management, lean processes, and policies can dramatically affect patient ³ow in a health care facility. With some guidance, hospital leaders can make over their organizations into leaner, faster, and overall better organizations with sustainable improvements.
