Patient Flow and Predicting Estimated Time of Patient Arrival to Decrease Unit Stress

Patient flow is an organization-wide initiative that helps us deliver a higher level of care and safety to our patients while also making our organization a better workplace for our employees and patients. This issue was a high priority for the senior vice president/chief nursing officer, patient care services organization in that it was a 2019 patient care services goal and objective as stated below:

The senior vice president/chief nursing officer, patient care services, is the co-leader of the executive safety walk rounds, which is focused solely on issues or trends regarding patient or employee safety. A key component of her leadership in this role is to conduct executive safety walk rounds, where she, along with the senior vice president, administration/chief operating officer, and the director of patient safety/regulatory compliance, meet with clinical nurses and other personnel in every department to inquire about safety issues or practices that impact the delivery of safe patient care and the creation of a safe work environment. One issue identified during the safety walk rounds on the inpatient units was that admitted and transferred patients were arriving at the same time increasing the workload of nurses and raising concerns

The Valley Hospital manages patient flow and throughput and nursing workforce staffing in a central patient care services office called the hospital operations resource center (HORC). The primary responsibilities of the HORC are bed management, creating hospital capacity, monitoring hospital operations, managing patient flow and throughput, and nurse staffing resource allocation for the inpatient units and the emergency department.

To accomplish the goal of managing patient arrival to the IP units, the HORC needed additional tools to manage and meet this objective. SurveyMonkey was used to get additional feedback from the IP managers, IP clinical shift supervisors, and the HORC team regarding patient flow and throughput and barriers to their workflow.

As a result, an interprofessional group comprised of business associates, information systems (IS) staff, inpatient nursing reps, and the HORC staff met to evaluate the current technological tools that are being used to guide decisions regarding patient flow.

The goal of the team was to improve patient flow by having the ability to predict estimated time of arrival (ETA) on all assigned and pending admissions, improve communication, and assign right bed first time.

Based on feedback from the HORC and interprofessional team, new dashboards for transport and the HORC were developed by IS to assist with patient flow. In order to monitor and manage the ability to manage patient flow and throughput a number of reports were created with near real time results that are reviewed daily/weekly, Action plans are developed to continually improve performance regarding managing patient flow to the units. Members of the IS team now attend a monthly meeting with the IP/ED/peri-op leadership team and the tools to manage and monitor patient flow have become a standing agenda item. 

Learning Outcome: After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.