Improving ED Communication & Patient Throughput

Improving ED Communication & Patient Throughput

Among the many Affordable Care Act initiatives rumbling through the healthcare industry, the introduction of 30 to 40 million new patients is certain to create additional stress to an already overburdened healthcare system. As a result, hospitals must find ways to increase their patient throughput and operational efficiency. Unfortunately, inefficient inpatient discharge practices continue to create unnecessarily long hospital stays. Patient throughput in the ED impacts the rest of the hospital system. ED lengths of stay generally increase when hospital occupancy levels exceed 90%, so enhanced communication and patient throughput are vital throughout the acute care setting. Although many factors can hinder patient flow, nearly 70% of clinicians cite communication as the most challenging cause of patient throughput delays. EDs: The Communication Ground Zero Communication in the ED sets the course for patient flow throughout the hospital. Safe, efficient, quality care in the ED requires frequent and effective communication. Nearly half of EDs report operating at or above capacity, and wait times and patient visits have risen steadily for the last 20 years. Initial communication with ED patients must be a top priority. As soon as patients register at the ED, they must be clearly informed of their anticipated treatment. Early communication about details, such as estimated wait times, anticipated discharge times, and availability of immediate treatments for minor symptoms, can smooth transitions of care.  Intricacies are sometimes forgotten but have a tremendous impact on patient throughput. The physical design of individual patient rooms can greatly affect throughput. When rooms are well-designed and provide optimum flexibility, patients can receive faster, more efficient care. In order to save space for...

Post-Acute Care for Medicare Beneficiaries

The quality of care coordination is important to the United States healthcare system as hospital readmission rates are being further scrutinized. When hospital readmission rates are high, it is often the result of poorly coordinated care across the full continuum of care settings, from EDs and ICUs to primary care and outpatient settings. As care is better coordinated, it is more likely that these rates will be reduced. “Improving the coordination of care for patients is also important to Medicare and to hospitals,” says David C. Goodman, MD, MS. “Medicare patients who return to hospitals shortly after they’ve been discharged add substantial costs to Medicare that could be avoided with better post-discharge care.” CMS estimates that the cost of avoidable readmissions is more than $17 billion per year. In the coming months, there are plans in place to reduce Medicare payments for readmissions if hospitals have higher-than-expected 30-day readmission rates for patients with acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia. In 2013, hospitals face a penalty equal to 1% of their total Medicare billings if an excessive number of patients are readmitted. The penalty rises to 2% in 2014 and 3% in 2015. Hospitals Currently Struggling In September 2011, the Dartmouth Institute for Health Policy & Clinical Practice released the Dartmouth Atlas report, which analyzed readmission rates among Medicare patients for AMI, CHF, pneumonia, and other hospital discharges between 2003 and 2009. Researchers examined the records of 10.7 million Medicare patient hospital discharges and found little progress during the study period. Patients hospitalized for CHF, pneumonia, surgery, hip fractures, or other medical conditions had 2009 readmission...