3 Ways to Take Control Over Patient Flow, Staffing

Alexandra Wilson Pecci, for HealthLeaders Media , August 6, 2013

"The nursing staff was really onboard. They weren't rushed with their patient," Mensik says of the change. "The staff nurses loved it." And although one particular hospitalist proved "problematic" because he only wanted to discharge patients in the evening, other physicians worked with nurses to change their rounding patterns.

2. Don't forget about PAs and NPs: "They're still very, very underutilized," Mensik says, adding that nurses don't have to wait for the physician come around at discharge; the PA or NP can discharge patients. Nurse leaders can work with PAs and NPs ahead of time to establish discharge plans with the interdisciplinary team.

3. Revamp the surgical schedule: "Your surgical schedule is artificial," Mensik says, and it can be manipulated to maximize staffing. Mensik says she sees hospitals that can be at 100% capacity on Tuesdays and Wednesdays and at 25% capacity on Saturday night.

"We're burning out the nurses in the middle of the week while at the same time providing the minimum amount of nurses on the weekend," she says, simply to accommodate these "artificial" surgical schedules. "Healthcare is a 24/7 business," Mensik says. She acknowledges that some surgeons have a lot of influence; they like to do certain procedures on certain floors and usually they get their way. "Sit down with those physicians and see what can be done about smoothing that surgery schedule," she says.

Ask them whether they really need to do all surgeries on Monday, Tuesday, and Wednesday. And remind them that errors are more common when hospitals go over capacity.

Alexandra Wilson Pecci is a managing editor for HealthLeaders Media.

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