Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

1. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Daniel A. Nickerson Access & Special Projects Director, Willis Knighton Health System

2. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow • Introduction • A Culture of Communication • Communication in Healthcare • Process vs. Culture • Hindrances to Patient Flow • How Poor Communication & Flow Affects Revenue • Willis Knighton Health System Patient Flow Case Study • Creating a Program & Process that Works for You!

3. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow A Culture of Communication “The single biggest problem in communication is the illusion that it has taken place” -George Bernard Shaw “Communication works for those who work at it.” -John Powell

4. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow A Culture of Communication • Process vs. Culture • What happens in a culture of communication? • Communication becomes: • Automatic • The Norm • Easy • Deviations are Identifiable

5. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Hindrances to Patient Flow • Poor Understanding • Poor Communication • Poor Visibility • No Automation • No Accountability

6. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow How Revenue is Affected • Patients • Physicians • Staffing • Reputation

7. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Patient Flow Case Study • To create a culture of communication • Automate the process • A new level of accessibility • Clear visuals • Data driven decision making • Decrease Wait Times & Increase Admits GOALS

8. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Patient Flow Issues at WKHS • Over 100% occupancy until 6pm • Turning away 2-3 patients per day • Avg. patient wait time exceeding 4 hours • High diversion & LWBS Rate in the ER • Excessive overtime & nurse agency use • No clear visuals • Finger pointing between departments • Nurses hiding rooms or so we thought • Patient & Physician complaints • No communication • Zero Accountability

9. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Actions Taken for Improvement • Morning Patient Flow Meetings • Multidepartment Involvement • Nurse Calls at the time of discharge • Housekeeping calls from room • New Communication Tools • A new bed management system • www.pasbedboard.org • An “at a glance” dashboard of patient flow • Automated reports, Alerts & Notifications • A prioritization policy • Nursing & Housekeeping Accountability • Education

10. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Impact from the New Program & Process • Patient Wait Time decreased anywhere from 49-124 minutes at each facility after the first few months. • Rooms were discovered to be empty an average of 65 minutes faster. • An increase of 2,200 patients over the next 2 fiscal years. WK Pierremont increased by 600 admits the first year. • Overtime & Agency use reduced significantly, Emergency Room LWBS rate went down, & diversion is rare. • Fewer Complaints

11. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

12. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

13. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

14. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow 2011 Improvements • 3 of the 4 facilities have decreased their average wait times while increasing admits • Average Room Turnover has decreased at all 4 facilities • Pierremont had a record setting day with over 60 inpatient admits between 7am & 6pm. • In February, Bossier decreased their room turnover time from 1:14 to 0:24 while having 30 more discharges as compared with the previous February.

15. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow • 24/7 web based program • Accessible from anywhere or any device (pc, phone, ipad, etc.) • An “at a glance” Dashboard • Patient Flow Gauge • Automatic Alerts & Notifications (VIP, Confidential, Infection, etc.) • Auto Generated Reports for any date or date range • Integration capabilities with other departments

16. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

17. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Reports • For any date or date range • For all departments • Graphs & Trend Lines • Stats by Individual Room • Stats by Nurse Station or Wing • Stats by bed type & location • Hourly Stats

18. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Lessons learned • Regulation without Education will keep people from buying into the process. • Checks and Balances keep individuals & individual departments from slacking or manipulating the process. • Communicating results and having stats by department creates competition. • Don’t just add to and revise an existing process, create something new and base it around the inefficiencies of your old process. • Communicate success and be passionate!

19. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Thank You! Daniel A. Nickerson Asst. Director of Admissions & Special Projects dnickerso@wkhs.com (318) 212-3969 or (318) 453-6476