Leaders at Lafayette General Medical Center (LGMC) in Lafayette, Louisiana set out to improve patient capacity challenges and improve patient satisfaction with wait times. To do so, they decreased the amount of time for staff to respond to and complete transport requests, while also streamlining the patient discharge process.
“Our goal was not only to address throughput issues within our four walls, but also to serve our community better,” said Renee Delahoussaye, MBA, BSN, RN, assistant chief nursing officer. “When our emergency department is saturated, we can’t serve the community.”
After embarking on a hospital-wide flow initiative — including patient flow technology implementation, identifying barriers to earlier patient discharge and updating workflows — Lafayette staff decreased their discharge transport times from 26 minutes, 48 seconds to 19 minutes, 51 seconds — a 25.9% decrease.1
In August 2017, LGMC staff implemented CareAware Capacity Management®, a bed management and patient tracking technology allowing them to improve transport operations and automate bed management workflows through electronic health record documentation. As part of their patient flow initiative, staff now identify potential barriers to discharge patients earlier and communicate interventions to the care team. A multidisciplinary team meets twice daily to discuss these barriers and identify at least two patients to discharge per unit by 10 a.m., noon and 4 p.m. They indicate these patients with high priority in Capacity Management, allowing them to triage treatment timing based on the patients identified for discharge.
“Before Capacity Management, we weren’t able to see transport data and make changes,” said Noel Bourgeois, RRT, clinical analyst. “Now, we actually can make these changes to discharge patients faster.”
This initiative helped increase the number of discharges completed by noon from 19.9% in September 2017 to 25% in September 2018. LGMC staff also realized improvements in patient transportation, cutting median transport time from 15 minutes to six minutes since beginning the patient flow initiative.2
“We now have more time with our patients, and they reach their destinations quicker,” said Delahoussaye. “This improvement has changed the perception and feel of the flow, being able to get patients in and out more quickly.”
This initiative also helped staff improve operations and throughput reporting. By implementing technology to track patients and beds in near-real time, operations leadership can view when a patient departs the facility, allowing for more accurate reporting and appropriate staffing levels. Data available through Capacity Management provided LGMC leaders better visibility to transport needs, resulting in reallocating an additional full-time employee to support overnight transport demand.
“With Capacity Management reports, I can review trends in transfer requests and staff my transport team accordingly,” said Amado Aguayo, transport services manager. “Now, the staffing process runs smoother and more efficiently.”
1 Comparing October 2017, the second month post-implementation, to September 2018
2 From June 2017 – June 2018