Creating a Culture of Communication & Maximizing Efficiency in Patient FlowDaniel A. NickersonAccess & Special Projects Director,Willis Knighton Health System

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

• Introduction

• A Culture of Communication• Communication in Healthcare

• Process vs. Culture• Hindrances to Patient Flow

• How Poor Communication & Flow Affects Revenue

• Willis Knighton Health System Patient Flow Case Study

• Creating a Program & Process that Works for You!

A Culture of Communication

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

“The single biggest problem in communication is the illusion that it has taken place”

-George Bernard Shaw

“Communication works for those who work at it.”

-John Powell

A Culture of Communication

• Process vs. Culture

• What happens in a culture of communication?• Communication becomes:

• Automatic• The Norm• Easy• Deviations are Identifiable

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

• Poor Understanding

• Poor Communication

• Poor Visibility

• No Automation

• No Accountability

Hindrances to Patient Flow

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

• Patients

• Physicians

• Staffing

• Reputation

How Revenue is Affected

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Patient Flow Case Study

• To create a culture of communication• Automate the process• A new level of accessibility • Clear visuals• Data driven decision making• Decrease Wait Times & Increase Admits

GOALS

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Patient Flow Issues at WKHS• Over 100% occupancy until 6pm• Turning away 2-3 patients per day• Avg. patient wait time exceeding 4 hours• High diversion & LWBS Rate in the ER• Excessive overtime & nurse agency use• No clear visuals• Finger pointing between departments• Nurses hiding rooms or so we thought• Patient & Physician complaints• No communication• Zero Accountability

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Actions Taken for Improvement• Morning Patient Flow Meetings• Multidepartment Involvement• Nurse Calls at the time of discharge• Housekeeping calls from room• New Communication Tools• A new bed management system

www.pasbedboard.org• An “at a glance” dashboard of patient flow• Automated reports, Alerts & Notifications• A prioritization policy• Nursing & Housekeeping Accountability• Education

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Patient Wait Time decreased anywhere from 49-124 minutes at each facility after the first few months.

Rooms were discovered to be empty an average of 65 minutes faster.

An increase of 2,200 patients over the next 2 fiscal years. WK Pierremont increased by 600 admits the first year.

Overtime & Agency use reduced significantly, Emergency Room LWBS rate went down, & diversion is rare.

Fewer Complaints

Impact from the New Program & Process

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

• 3 of the 4 facilities have decreased their average wait times while increasing admits

• Average Room Turnover has decreased at all 4 facilities

• Pierremont had a record setting day with over 60 inpatient admits between 7am & 6pm.

• In February, Bossier decreased their room turnover time from 1:14 to 0:24 while having 30 more discharges as compared with the previous February.

2011 Improvements

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

◦ 24/7 web based program◦ Accessible from anywhere or any device (pc, phone, ipad, etc.)◦ An “at a glance” Dashboard◦ Patient Flow Gauge◦ Automatic Alerts & Notifications (VIP, Confidential, Infection, etc.)◦ Auto Generated Reports for any date or date range◦ Integration capabilities with other departments

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Reports• For any date or date range

• For all departments

• Graphs & Trend Lines

• Stats by Individual Room

• Stats by Nurse Station or Wing

• Stats by bed type & location

• Hourly Stats

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Lessons learned• Regulation without Education will keep people from buying into the

process.

• Checks and Balances keep individuals & individual departments from slacking or manipulating the process.

• Communicating results and having stats by department creates competition.

• Don’t just add to and revise an existing process, create something new and base it around the inefficiencies of your old process.

• Communicate success and be passionate!

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

Thank You!

Daniel A. NickersonAsst. Director of Admissions & Special Projectsdnickerso@wkhs.com(318) 212-3969 or (318) 453-6476

Creating a Culture of Communication & Maximizing Efficiency in Patient Flow