bed availability Key Performance Indicators (KPI)
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- This topic has 17 replies, 11 voices, and was last updated 14 years, 8 months ago by
Kaushik.
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February 15, 2006 at 5:19 pm #25271
Hi,
Just wondering if any of you has have some experience that wouln’t mind sharing defining KPIs for bed availability or pacient flow.
Much appreciated,
Victor0February 20, 2006 at 2:17 pm #60790ED diversion hours, Time of day of discharge, Bed assigned to bed placement, Bed cleaning time, LOS in ED.
0February 20, 2006 at 11:00 pm #60791Thank you very much
0February 21, 2006 at 7:05 pm #60792Victor,
There is another site that may be of benefit. Check out http://www.ihi.org. It has more detail on patient flow.
Sheri0February 21, 2006 at 7:23 pm #60793Thank you Sheri!,
Victor0February 21, 2006 at 8:57 pm #60794Heath,
What does ED and LOS stand for? Thx!
I can guess LOS is length of stay? But I’m not sure and have no clue what ED is…0February 22, 2006 at 12:46 pm #60795
J D ColeParticipant@J-D-ColeInclude @J-D-Cole in your post and this person will
be notified via email.ED is short for Emergency Department…expanded version of the ER, Emergency Room, or EC, Emergency Center…the same place, just different terminology, and sometimes indicating the size or scope of the facility
0February 27, 2006 at 11:53 am #60798You can also look at Bed Occupancy Rate, and Bed through Put / Bed Turnover Rate……
Vivek
0March 8, 2006 at 8:32 pm #60807Do you have any information on automating the bed availability from an analog system that uses a white board, to a computer based system that updates in realtime and sends notifications.
0March 8, 2006 at 9:14 pm #60808M Jay,
We use Teletracking in our organization for bed management, facilities (room cleaning), and transport so everything is in one system (realtime) and notifications are sent. I would be happy to talk with you about your current process to see if I can offer up any assistance. Please provide your contact information if you would like.
Sheri0March 8, 2006 at 9:58 pm #60809Thank you Sherri, my contact info is Michael Jay Spearman -1708 756 1000 ext 6173 Ofc – or you can page me @ 1708 242 0986.
Thank you again, and hope to hear from you soon.0July 27, 2006 at 7:30 pm #61017checkout http://www.premiseusa.com
0July 27, 2006 at 7:57 pm #61018
Dave WilsonParticipant@Dave-WilsonInclude @Dave-Wilson in your post and this person will
be notified via email.All,
I am in the implementation phase of a kaizen event regarding bed flow here at Oregon Health & Sciences University (OHSU). I would be happy to share any information I have with you if you think it would help.
About me, I also come from the Manufacturing/Hi-Tech industry and have worked for RCA, IBM, GE etc. Now in healthcare, I’m tasked with setting-up a Six Sigma/Lean program here at OHSU. We have already had many successes including ED Billing, Pharmacy move to JIT, Scheduled and Unscheduled Admissions, Bed Flow etc. If I can be of any help, please fell free to contact me…I’m willing to share!
Dave Wilson
Process Improvement Analyst
Oregon Health & Sciences University
[email protected]
503-494-6079
0July 28, 2006 at 5:14 pm #61019Hi,
I just want to ask a ‘stupid’ question – why is bed availability a key performance index?
I mean .. to draw an analogy it a bit like saying the availablity of seats in a theatre is a key performance indicator – which is clearly wrong! I don’t want to go and see a show that no one else wants to see …
I beleive the real indicator is all the seats are full ..!!!
Surely we want all beds in hospitals to be occupied and we certainly want enough hospitals – or spare capacity in case it rains and there is a flurry of car accidents.
Now patient throughput is entirely a different matter – we want a first time ‘yield’ of cured patients – meaning we don’t want any of them coming back (reworks); and if this means they have to stay in hospital an extra day – so be it. The point of all this is there should be a standard time for each procedure – including a recovery time; but there ought to be a little flexibility for complicated case, where patient’s have unexpected pathology or take longer to recover.
In manufacturing – TPS style – any ‘patient’ who needs more than a ‘standard time’ sets off an Andom alarm and is pulled off the line and examined elsewhere.
I hope you don’t mind my ignorance; I just felt strongly that bed availability is not a reasonable metric! (Muri.)
Cheers,
Andy0July 28, 2006 at 8:53 pm #61020You certainly aren’t being ignorant – you make a good point on why beds availability as a KPI shouldn’t be used. One problem with your scenario (bear with me – I’m a bit long winded):
The point of all this is there should be a standard time for each procedure – including a recovery time; but there ought to be a little flexibility for complicated case, where patient’s have unexpected pathology or take longer to recover.
In manufacturing – TPS style – any ‘patient’ who needs more than a ‘standard time’ sets off an Andom alarm and is pulled off the line and examined elsewhere.
We can calculate average standard times for procedures in areas like surgery. We can also calculate average standard times for different DRGs. However the difference in standard deviationis tremendous between the 2. For example, I can know with relative certainty that a specific cath procedure will take 45 minutes, have 1.5 hour of cath recovery, and 5 hours of CVICU recovery time. If someone comes in complaining of shortness of breath, possibly a COPD issue, but not sure, the LOS std deviation is amazing. So, finding a standard time for that process is a little unreasonable – that is where one part of the problem lies. It’s actually the less acute patients that have the greater variability in treatment time – on average. There is much more variation in a person’s care than in making a widget. I’ve worked in both environments and can attest to it. That is why Lean 6 sigma is so needed in healthcare.
Now – as for beds being available as a KPI. I wouldn’t use that either. There are some other variables that go with that. Nurse:Patient ratio is one. Your bed capacity may change daily based on your staffing. I think bed turns, bed utilization (in place of a full bed measure), bed turnover times, intent to discharge vs discharge (i.e., the difference in time), discharge time of day, ED to Floor time after disposition, diversion hours, transport response time, are all better measures of throughput than beds full. Last problem – other than clinical data, most hospitals are data poor in terms of throughput. Only since 1999 or so has there been a huge effort for throughput as an improvement issue. Baby boomers, financial issues, etc. have caused this, in my opinion. I wished they had looked at it sooner.0July 29, 2006 at 7:52 am #61021Brit,
Thank you for responding …
I’m happy to concede the points you’ve made. My interest is based on my daughter’s experience – not my own!
One of the point she made was the ‘multi-disciplinary team ‘roughly’ knows the expected time for surgery and rehab. – she mentioned four days in rehab. Apparently, some hospitals in the NHS do have ‘special’ beds for patients in a rehab ward – the problem is there are not enough rehab beds, which puts a tremendous strain on wards by increasing the prospect of ‘infections’ and ‘bed-blocking.’
As you point out staffing levels is now a serious concern especially since the NHS has wasted vast sums of money paying doctors unnecessary bonusses and using ‘contract’ staff – who work from agencies ‘owned’ by NHS hiring managers – an old Admiralty trick for fleecing the public purse.
Cheers,
Andy0July 31, 2006 at 1:08 pm #61022Good insight. I think we are on the same page, as usual.
0December 7, 2007 at 10:56 am #61796Dear All,
Can any one help me out in figuring out the KPIs’ for Business Development in an hospital setup?
Thanks in advance.
Regards,
Arun0 -
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