Keep It Flowing

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Like many sprawling healthcare systems, Lehigh Valley Hospital had a problem accommodating patient demand. Based in Allentown, Pa., the three-hospital integrated delivery system was hounded by emergency department diversions. The Level I trauma center system saw all trauma and burn patients, but sometimes had to turn to other facilities for other incoming critical care patients. Even moving patients from the operating room to recovery rooms was slow, given the difficulty in monitoring 850 beds available across three facilities, recalls Lisa M. Romano, administrator of patient logistics and access. “We had wasted capacity all over the place,” she recalls.

So in 2003, Lehigh Valley turned to an automated patient tracking system from Pittsburgh-based Tele-Tracking Technologies to help manage its capacity. Interfaced to the hospital’s admission-discharge-transfer system from Burlington, Vt.-based IDX Systems Corp., the tracking system serves as a command and control center over bed status and availability. Now, rather than calling nursing stations to see whether rooms have been cleaned, Romano’s staff members look at graphical displays on two 50-inch plasma screens. Colored icons shift from brown (dirty) to yellow (being cleaned) to green (ready for patient). Housekeeping staff feed the information to the system through a telephone response system.

For patients admitted through the ED, Romano does a bed search that shows pending and confirmed discharges across the three hospitals. When Romano assigns a patient to a bed, the system sends a text page alerting both the sending and receiving nurses, who can access the bed availability tracking system at local workstations. Patient transporters let the system know they have moved or discharged a patient by entering data through their cell phones.

The real-time information has been a boost to patient flow, Romano says, citing an 8 percent jump in admissions in 2005. The time elapsed from discharge to cleaning has fallen from more than four hours to about one hour, she says. “Discharge notification had been a huge problem,” she says. “We had to rely on the nursing staff to tell us a patient had gone home. Now we bypass that.”

Lehigh Valley rents the software for about $10,000 monthly, Romano says. The installation was fairly simple, she adds, but changing the staff culture around patient flow took time. Once the system was installed, it generated reports that showed where bottlenecks occurred and where staff were underperforming. “We thought patients stayed in the ED because they did not have a bed, but we found out sometimes they were not being moved in a timely manner,” she says. “Some staff were dawdling.” Rather than take a punitive approach, Lehigh Valley devised a financial incentive plan for housekeeping staff based on productivity.

—Gary Baldwin




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