To reduce the bottleneck, Sharp compared staffing patterns against patient flow and found the two didn’t line up, so that was corrected. Another initiative looked at bed turnover in the hospital to try to understand why it took more than an hour to move patients from the ED up to the units once an admit order was given.
“It was taking housekeeping 40 minutes to make a bed because people were saying it wasn’t their job. We started the ‘Everyone is a bed-maker’ campaign, and we got that down to eight minutes,” Stone says.
Another inconvenience to patients and a time-waster, Stone says, was that patients were repeating their information at least four times to different staff members (admission staff, multiple nurses, and the physician) from the time they arrived.
“Now we go in as a team and ask all the questions together so everyone gets the same message and information,” she says. Staff also began making follow-up calls with patients to see if they had questions about their treatment and, when appropriate, to see if the patient had been taking the next steps in the treatment plan.
“We found if we made anything less than 1,000 calls a month, our patient satisfaction scores would drop,” she says.
As its ED wait time decreased from 5.1 hours to 3.8 hours for inpatient care (2.8 hours for outpatient), Sharp saw its patient satisfaction scores go from the 30% range to 93%. Volume also increased—from 150 patients a day to 205—which Stone says represents new patients and market-share growth, not readmissions.
As with Sharp Hospital, Griffin Hospital credits its patient-centered approach to seeing declines in readmission rates for heart patients—from 13.2% in 2010 to 9.2% in 2011.