Does your facility employ a “push” or “pull” approach when it comes to patient placement in hospitals in order to increase hospital efficiency?

That was the subject of the 4th session in our webinar series entitled: “7 Ways to Master Operational Efficiencies in Your Hospital” hosted by Maria Romano, Clinical Product Consultant at TeleTracking.

Pull vs. Push and the Effect on Patient Placement in Hospitals

The notion of pull vs. push is an important concept when it comes to hospital efficiency and effectively placing patients — and in order to understand the concept, one must first know the difference of the definitions.

1. Push: to exert force on something or someone, typically with one’s hand, in order to move them away from oneself or the origin of the force (e.g., shove, press, thrust, force)
2. Pull: to exert force on something or someone, typically by taking hold of them, to move towards oneself (e.g., to draw, tug, attract)

So why are these definitions important? The pull methodology significantly improves patient flow through the system and is based on principles of “lean methodology“, whereas the push methodology detracts from it. The pull methodology focuses on the following principles:

• Customer value
• Value-stream analysis
• Everyday improvement
• Flow
• Perfection

This type of methodology begins and ends with the patient who best defines and determines the value of care. To create value for patients, it’s important for hospitals to focus on improving patient flow, applying pull and striving for perfection in hospital efficiency.

The following chart outlines how pull vs. push affects patient placement:

We asked the audience to identify the main cause of issues with patient placement in hospitals as well as the reason why their patients remain in beds after they’ve been discharged. The responses were split 50/50 between physician orders and “don’t know — can’t track it.” What roadblocks does your hospital face when discharging your patients?

How to Overcome Pull vs. Push Patient Placement Roadblocks

Romano stressed the need to set goals for the organization discharge process in order to overcome patient flow barriers and increase hospital efficiency. New patient admissions should begin with discharges, and hospitals should utilize a centralized process to ensure that patients are discharged in Real-Time.

Also, all portals of entry need to use the “Ready to Move Timer” to hold employees accountable. Once a bed is cleaned and assigned, and the patient is clinically “ready to move,” the actual transfer into the bed is completely controlled by the organization and not dependent upon occupancy. If confirmed discharge beds are assigned, the time from bed assignment should not exceed 30 minutes and SWAT teams should be deployed to ensure efficient room turnover. Furthermore, the recommended goal is less than 60 minutes for a clean bed to assignment to transfer.

So how does the pull methodology relate to patient flow and patient placement in your hospital?

• “Pull” is a workflow process borrowed from LEAN methodology
• “Pull” in a healthcare setting requires some adaptation, but the concept of anticipating the next unit of work and preparing accordingly is the same as any business setting
• In the hospital setting, the “unit of work” is a patient admission which requires transfer to an assigned bed
• Overcrowding resulting from capacity challenges can delay a bed assignment
• Patients being pulled are smoothly transitioned in their care

Maria presented two success stories of TeleTracking clients who embraced the pull methodology for patient placement:

• Advocate Lutheran General places 92% of all ED patients within the hour

• Lakeland Regional Medical Center has seen an 80% improvement in patient placement delay times as a result of EVS turnaround times decreasing from more than 60 minutes to 40 minutes

Maria’s 6 Key Takeaways for Patient Placement in Hospitals, Pull vs. Push and Overall Hospital Efficiency

To end her session, Maria outlined 6 key takeaways in regards to patient placement and the importance of employing a “pull” vs. “push” methodology:

1. Implement a precision placement strategy (assign your beds in real-time)

2. Institute an “open-door” unit policy for all admissions and transfers at any time of day

3. Implement a ‘No Delay Nurse Report’ to streamline the admission process

4. Minimize bed changes by nurses — monitor frequently and report

5. Set a 60-minute target from patient bed request to bed placement

6. Hold accountability with two reports: Processing Time Analysis and Ready to Move

MORE INFO 

Patient Care Efficiencies

Introduction

The healthcare industry is facing a lot of challenges. A huge issue is inadequate patient care, which causes inefficiency, loss of money and unnecessary deaths.

Improve patient safety

One of the best ways to improve patient safety is to reduce the number of patient safety incidents. The more you can do this, the better your results will be. To do this, you need to look at how you’re performing in each area and identify where improvements are needed.

For example: Your facility has had an increase in patients requiring care due to injuries sustained from falls or motor vehicle accidents. You’ve also noticed that some of these injuries were caused by faulty equipment (such as poorly maintained wheelchairs) or poor maintenance practices (such as not securing equipment properly). These issues could lead directly back into harm’s way if not addressed immediately–so what can you do?

• Improve patient experience: This means making sure that all aspects of what goes into caring for a patient are done correctly so there aren’t any surprises down road once they leave your care center with their new mobility device attached securely under their arm….

Improve productivity

• Improve productivity

• Increase patient satisfaction

• Reduce costs

• Increase revenue and profits for your business

Increase satisfaction

Patient satisfaction is an important indicator of a hospital’s quality. Patients are more likely to come back, recommend the hospital and give it positive ratings on review sites if they are satisfied with the care they receive at your hospital.

In order to increase patient satisfaction, you can do the following:

• Make sure that staff members are friendly and helpful when dealing with patients. They should always be available for questions or concerns about their care or treatment options; this will help them feel like part of a team instead of just another number on an appointment sheet.

• Make sure that all appointments run smoothly by keeping track of important dates (such as insurance claims) so that no one misses something else important due to over-scheduling themselves into rooms too early in advance – which could cause problems later down line where staff members need those same resources most desperately!

The healthcare industry is facing a lot of challenges. A huge issue is inadequate patient care, which causes inefficiency, loss of money and unnecessary deaths.

The healthcare industry is facing a lot of challenges. A huge issue is inadequate patient care, which causes inefficiency, loss of money and unnecessary deaths. Improving patient care will help the healthcare industry to become more efficient and productive.

There are many different ways that you can improve patient care by using technology:

• You can create an app that would allow doctors to share information about their patients with each other or with other medical workers (e.g., nurses). This way they can get updates about what’s going on with each patient’s condition as well as any changes in treatment plans over time. The apps could also send messages directly from one doctor’s phone screen into another person’s phone screen so they could see exactly how an operation went down during surgery; this would allow them better communication between doctors across all departments within hospitals/hospitals’ practices overall instead of having just one person talking directly with another person who already knows everything there is know about said issue(s) being discussed here today!