This presentation will show how Increasing occupancy and declining reimbursement rates threaten the viability of hospitals across the country, especially in the East Tennessee region. In fact, recently a downtown hospital in our area closed its doors. The hospitals in our system are being challenged to increase patient volumes while decreasing length of stay, improve core measure compliance, prepare for RAC reviews, and maintain our tight budgets. With the increasing focus on the quality of patient care and efficiency of healthcare services, in 2008, the Covenant Health System hospitals embarked down a road for creating teamwork and ownership in bed capacity management.

Method:

Involve a multidisciplinary team to review, assess, and implement change in our bed flow process by implementing “Huddles” in the Bed Capacity Management Office, Nursing Units, and Case Management staff.

• Bed Capacity Management Huddle


• House supervisors


• Bed Board staff


• Admitting Case Manager


• Manager of Case Management


• Charge Nurse/Shift Leader, including ED, Surgery, Cath lab


• Nursing Units


• Nurse Manager


• Nurse Educator


• Charge Nurse/Shift Leader


• Case Manager


• Social Worker


• PT/OT staff


• Case Management


• Manager of Case Management


• Unit Case Managers


• ED Case Manager


• Admitting Case Manager

Results:

• Demonstrate decrease in Medicare Length of Stay and overall Length of Stay.


• Improve bed flow process to increase turnaround time for acute care bed.


• Decrease time in the ED, Surgery, and Cath lab of patients waiting for a bed.


• Improve physician satisfaction.


• Improve customer satisfaction.


• Operate within or below budget.

Conclusions and Recommendations:

Capacity Management requires collaboration between all disciplines to drive the flow from admission to discharge. Teamwork is essential to achieve timeliness of patient flow, patient/staff/Physician satisfaction, and meet hospital goals.