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In-patient bed management

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Viewing 10 posts - 1 through 10 (of 10 total)
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  • #25293

    Ram
    Participant

    Hi,
    Has anyone looked into bed management, census points, stafffing issues related to patient placement?
    I am trying to figure out something in relation to develop a strategy with regards to patient placement taking into consideration, diagnosis, appropriate unit/area and at the same time Physician concern. Has anyone worked in the same lines as I am thinking?
    Please allow me gain as much as information I can and anything if anyone of you out-there has worked?
    Thanks!

    0
    #60864

    Dr. Eugene Jacquescoley
    Participant

     
    Ram,
    You’re going to have to be more specific. What is the scope of your project specifically?
    E
     

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    #60874

    Ram
    Participant

    Dr.Eugene,
    What I am trying to do is to come up with a bed anagement policy which could work/consider all the hospital wide issues. I am just trying to buy in everybody to think of a productive way of handling admissions and also consider staffing levels when admitting a patient to an in-patient unit.
    Since the hospital I work with does not have a patient dependency classsification system it is a choas through out all the in-patient units and it’s confusing too for everybody to plan their shift by shift staffing issues.
    Any help or comments on this will be much appreciated!
    Rp

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    #60875

    Dr. Eugene Jacquescoley
    Participant

    Ram,Okay. It appears that your organization (like many others hospitals and medical centers) is hauted by ineffeciency. So, let’s get to the meat and potatoes. Gaps in a hospital’s admission and discharge process may lead to a number of organizational ineffiencies, that can create a drain on financial and human resources. Before we can consider applying DMAIC, Kaizen or Lean Six to this particular complex process, you must truly identify root cause analysis of this particular issue. 1. Time to beef up your census reporting mechanism(s) and subsequent processes. How often do you receive a descriptive summary of ER visits, surgeries (in-patient and ambulatory, in-patient day calculations, etc?
    2. What Level trauma center is your hospital? This is extremely important in applying your DMAIC. Once you have this information, you can attempt “forecasting” methods, turnaround times…depending on how many counties or municipalities your hospital covers.
    3.Cross-functional team synergies are a must. In order to do your job Ram, you must have the appropriate synergy with other departments (e.g., ER, Admitting, Nurse Leadership). Once this synergy has been established, you can begin to get buy in from leadership concerning improvement methodologies.
    4. While I’m on this particular subject of team synergies…Here are some additional steps you can implement immediately.
    A. Eliminate outdated policies that prohibit housekeeping staff from removing sheets, which may slow turnaround time.
    B. Add a dedicated nurse with admission, discharge, and transfer duties to your respective unit.
    C. Create a transitional care unit for patients who no longer require acute care (ACHE, 2005).
    D. Post approximate discharge times on patient doors (JAMA, 2001; ACHE 2005).
    E. Create a discharge lounge for your patients, to increase patient flow. As a result of these efforts, some hospitals and medical centers have slashed turnaround bed times within two years. Moreover, patient wait times for available beds have increased significantly (p>.05). .05). .05). Hopefully Ram, when you’re beginning to put your DMAIC together or Lean Six, consider these improvement steps before making contingency plans, allocating resources and setting project scopes and charters.Kind regards,Eugene
    E.

    0
    #60876

    Dr. Eugene Jacquescoley
    Participant

    Ram,Okay. It appears that your organization (like many others hospitals and medical centers) is hauted by ineffeciency. So, let’s get to the meat and potatoes. Gaps in a hospital’s admission and discharge process may lead to a number of organizational ineffiencies, that can create a drain on financial and human resources. Before we can consider applying DMAIC, Kaizen or Lean Six to this particular complex process, you must truly identify root cause analysis of this particular issue. 1. Time to beef up your census reporting mechanism(s) and subsequent processes. How often do you receive a descriptive summary of ER visits, surgeries (in-patient and ambulatory, in-patient day calculations, etc?
    2. What Level trauma center is your hospital? This is extremely important in applying your DMAIC. Once you have this information, you can attempt “forecasting” methods, turnaround times…depending on how many counties or municipalities your hospital covers.
    3.Cross-functional team synergies are a must. In order to do your job Ram, you must have the appropriate synergy with other departments (e.g., ER, Admitting, Nurse Leadership). Once this synergy has been established, you can begin to get buy in from leadership concerning improvement methodologies.
    4. While I’m on this particular subject of team synergies…Here are some additional steps you can implement immediately.
    A. Eliminate outdated policies that prohibit housekeeping staff from removing sheets, which may slow turnaround time.
    B. Add a dedicated nurse with admission, discharge, and transfer duties to your respective unit.
    C. Create a transitional care unit for patients who no longer require acute care (ACHE, 2005).
    D. Post approximate discharge times on patient doors (JAMA, 2001; ACHE 2005).
    E. Create a discharge lounge for your patients, to increase patient flow. As a result of these efforts, some hospitals and medical centers have slashed turnaround bed times within two years. Moreover, patient wait times for available beds have increased significantly (p>.05)..05)..05).Hopefully Ram, when you’re begin to put your DMAIC together or Lean Six, consider these improvement steps before making contingency plans, allocating resources and setting project scopes and charters.Kind regards,Eugene

    0
    #60877

    Ken Feldman
    Participant

    Out of curiousity, you signed this post Eugene E.
    What does the E stand for?

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    #60878

    Ken Feldman
    Participant

    I got it….this time you leave off the E. but post the same response. Certainly twice as effective that way. Gene, you need to change the meds.

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    #60879

    Dr. Eugene Jacquescoley
    Participant

    D,You’re out of control. Have a good weekend.
    E

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    #60880

    Ken Feldman
    Participant

    E,
    Statistically speaking or clinically speaking???  Have a good Cinco de Mayo….time to go see my friend Don J.

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    #60884

    Ram
    Participant

    I am trying to do a internal check on our reporting w.r.t census points and all. So once I have some of the info I can certainly bring it in so we can have a better idea of what I am trying to accomplish.
    About clinical or statistical, what I am trying to do is I am trying to tie in clinical at the same I want to consider statistics too so will it be a possibility?

    0
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