Is Patient Progression Management MIA in Your Patient Flow Strategy?
By Bob Gleason-Moore RN, MN
Everyone was banking on it… We were going to move the needle on length of stay. We would finally meet the goal corporate had set for our hospital.
We had changed our processes. We had tools in place. We were ready!
Soon, we found we could move patients around like we never had before. We felt efficient. We were good at it.
So, what about our length of stay?
It barely budged!
Sure, there were improvements, but we expected more for all our efforts. We didn’t meet our own goals, much less those of corporate.
Does this story sound familiar to you? It does to a lot of my peers I talk to. Even a well-executed patient flow initiative may not yield the results you’d hoped for.
Patient Progression Missing in Patient Flow Initiatives
The New England Journal of Medicine defines “patient flow” as “the movement of patients through a healthcare facility.”1 From EHRs to bed management systems to operational command centers to consultants, hospitals use a variety of tools to optimize patient flow.
The challenge is that patient flow tools and initiatives often focus on the entire patient population. With this high-level, general view of flow, we end up losing focus on the progression of the individual patient. Opportunities to maximize patient throughput and flow are left on the table.
How do we prevent this?
That’s where an effective patient progression program can help.
Patient Progression is the advancement of the hospitalized patient through the required care events, actions and processes to achieve a health status where the patient can be safely and appropriately transitioned to a lower level of care. Patient progression is patient centered and is directed by the physician order according to hospital policies and procedures.
Without effective patient progression working in conjunction with your patient flow strategy, patient flow improvements cannot reach their full potential. For example, we can successfully and efficiently move patients from the ED into appropriate beds, have on-time transport to and from the unit, and little to no waiting for the diagnostic testing they need, only to have a barrier such as a delayed physician consult or discharge placement issue prevent a timely a transition.
So, how do you find out if patient progression is missing from your patient flow initiatives? Ask yourself the following questions:
Does the care team know the clinical goal and desired outcome for each patient?
Do you have condition-specific plans that guide the care teams each day?
Are length of stay goals aligned with reimbursement?
Do you have a mechanism to identify barriers to patient progression and a way to resolve them?
Is accountability for patient progression clearly defined among your care team members?
If you answer “no” to 2 or more of these questions, your patient flow is probably not achieving the results it could. Don’t leave opportunity on the table. The time is now to add a new focus on patient progression to your patient flow initiative.