Universal Patient Floor Increases Flow, Decreases Handoffs

Heather Comak, for HealthLeaders Media , August 27, 2009

In 2007, Cedars-Sinai Medical Center in Los Angeles rolled out a "universal floor" during an expansion project. In the time that has passed, Cedars-Sinai's innovation has lowered wait times for patients being admitted from the ED and elsewhere, reduced the number of patient safety events, and increased staff member satisfaction.

A universal floor is one on which most patient consultations can take place. Rooms are created with multiple types of patient care in mind and staff members are trained in many specialties to facilitate patients' needs on the one floor. This reduces the need for patients to travel throughout the hospital.

The idea for developing a universal floor came at a time when the hospital was designing a new critical care tower. Staff members decided to trial the idea after hearing of the success of a universal floor at Methodist Hospital of Clarian Health in Indiana.

"We thought we could have a unit where we could ensure that all of the staff were capable of providing the levels of care that included a step down unit as well as a general medical unit and a tele-unit," says Linda Burnes Bolton, Dr.Ph, RN, FAAN, vice president and chief nursing officer at Cedars-Sinai Medical Center. "Second, in terms of the construction of the unit, [it] would facilitate idealized design…about creating units where you minimize the amount of time staff are out of the patient's room and maximize the amount of staff are in direct care with the patient."

A growing body of data show that increasing the amount of time nurses are in direct contact with patients leads to the best patient outcomes. Nurses are better able to rescue patients and prevent harm from occurring, says Burnes Bolton.


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