I had other plans for the blog today – but given the dramatic way my suggestions about issues in the public hospital sector exploded into the news today – I could not but pass this article on!
http://www.healthleadersmedia.com/view_feature.cfm?content_id=92600
The Key to Improving Patient Throughput
Marybeth Regan, PhD, for HealthLeaders News, Sep 26, 2007
Healthcare needs a transformation--hospitals can no longer afford to take a business-as-usual approach. Substantial dollars are at stake, whether it's absorbing the cost of poor efficiency or foregoing revenue opportunities because of poor capacity management.
Consider the movement and experience of a typical patient in today's hospital. The average patient will be in the hospital for about five and a half days. During that stay, he/she will encounter a multitude of providers, staff and departments. How this hospital stay is managed and how the patient is moved between hospital areas dictates the "experience," and has a significant impact on the hospital's performance.
While the clinical outcome of the patient stay is the most critical component of a patent's experience, the other is the process by which the patient moves through the hospital. Regardless of how capable the clinician or advanced the medical technology, patients will perceive their care to be substandard when delays and awkward interdepartmental handoffs occur. For a patient and their family, inefficient handoffs are sometimes the most visible aspect of a patient's hospital stay.
Patient care is the business of the hospital, and when care processes are inefficient, the business is inefficient. In short, a hospital's ability to optimize capacity and maximize profitability is largely determined by how efficiently their processes, and ultimately their operations, are managed.
In order to address these challenges, the following five approaches are required:
System-wide process improvement and integration of the separate departments--not isolated silos.
Process visibility and accountability through metrics.
Communication with all the stakeholders; the patient, their family, the physician(s) and hospital employees.
Identification of key patient indicators to assist patient throughput and enhance communication to deliver accurate, real-time information to all in the patient care process.
Application of a technology solution used for bed tracking and real-time patient flow logistics for workflow intelligence, and capacity management for sustainable improvement.
Hospitals have certainly attempted to improve patient flow. For the most part, however, these solutions have fallen short because they a) address only part of the problem or address it as a departmental issue; b) lack any reliable mechanism for measuring or sustaining performance improvements, and c) lack any IT tools to support the process. And of course, let's not forget lack of communication.
….. (see the rest of the long article at the URL above)
A careful read, followed by development of plans along these lines are the only way to avoid headlines like this in the longer term.
A small sample:
http://www.smh.com.au/news/national/its-third-world-care/2007/09/26/1190486395840.html
Birth in toilet in hospital without care
Kate Benson and Alexandra Smith
September 27, 2007
…..(see URL above for full article)
And
Health Minister Meagher under scrutiny
September 26, 2007 - 7:29PM
The NSW Opposition has slammed state Health Minister Reba Meagher's performance as appalling.
…..(see URL above for full article)
And
http://www.news.com.au/story/0,23599,22487166-421,00.html
Royal North Shore undestaffed and underfunded
September 27, 2007 05:19am
Article from: The Daily Telegraph
THE NSW Government has been plunged into its worst health crisis since the Campbelltown and Camden hospitals outrage, with revelations that Royal North Shore Hospital is chronically understaffed, underfunded and mismanaged.
…..(see URL above for full article)
http://www.news.com.au/story/0,23599,22488582-421,00.html
Parents' anger at miscarriage
September 27, 2007 01:00am
Article from: The Daily Telegraph
- Ordeal was humiliating, say parents
- Nurses 'just walked by' couple
- 'Too scared' to try another pregnancy
A DEVASTATED Jana Horska has revealed her fears of falling pregnant again following her "humiliating" ordeal of miscarrying in the emergency room toilet at one of Sydney's top hospitals after being denied medical treatment.
…..(see URL above for full article)
Not a good look and awfully sad for the couple in the midst of what is an obvious system failure. All the politicians and bureaucrats (State and Federal) responsible for bringing the system to this state should hang their heads in shame for 10 minutes before starting to earn their huge salaries, getting off their backsides and fixing it. The blog a few days ago and this article offer some useful thoughts to start off with.
Normal service will resume Monday!
David.
A timely article indeed. However the use of the language of process rather than systems improvement again inadvertently fosters piecemeal silo approaches that merely shift the block around. We need to understand and manage the dynamic interaction between services supplied and patient demand.
ReplyDeleteI certainly feel sorry for the lady who lost her baby in the toilet, but it doesn't stop there. Fifteen years ago, feeling unwell, I went to a local Doctor, who questioned me, examined me, and told me he believed I had appendicitis. He sent me with a letter of referral to the RNS. The Triage Nurse took my letter of referral, and without even looking at it, or asking me what was wrong, informed me: "There's a two and a half hour wait, will you sit down over there ". And wait I did.
ReplyDeleteAs it turned out, the original Doctor was right.