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Improving Patient Throughput in the Emergency Department

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Improving Patient Throughput in the Emergency Department
Improving Patient Throughput
In the Emergency Department

Introduction
St. Vincent’s Medical Center, a 501 bed facility located in Jacksonville, Florida, provides general medical and surgical care to the North Florida Region. St. Vincent’s admits over 26,000 patients annually. The average occupancy rate is approximately 84% with the Emergency Department (ED) peeking at 100% for approximately 4-12 hours daily. The hospital is struggling with availability of bed space. This shortage of available beds creates a bottleneck in the ED on high census days. Bottlenecks are created in the ED when there is a shortage of inpatient beds to place admitted ED patients. Thus, patient flow, or throughput, is becoming more and more important.
Like all healthcare facilities, the chief goal of the organization is to serve patients and the community. With this in mind, few people equate a hospital with being a service business that competes for customers and resources. With the healthcare industry becoming more and more competitive, the importance of service cannot be overstated. Improved patient flow would serve two purposes: provide better service and to attain financial goals. If the hospital cannot provide adequate service, then business will suffer. Moreover, financial reimbursement from Medicaid is now based in part on the “pay for performance” concept, giving patients more choices where to receive their medical care. Improved patient flow will increase revenue, reduce costs and waste, and improve service (Mayer & Jensen, 2009). Thus, the business case for improving patient flow is intriguing.
The hospital relies on admissions from the emergency department. The ED is a strong contributor to the net operating income of the hospital. Each patient admitted into the hospital through the ED brings approximately $7,500 in revenue. Approximately 33% of all patients admitted to this hospital are admitted through the ED. Maintaining an efficient flow of patients



References: Bazzoli, G. J.,Brewster, L.R., Liu, G. & Kuo, S. (November 2003). Does U.S. hospital capacity need to be expanded? Health Affairs. Retrieved from http://content.healthaffairs.org/content/22/6/40.full Healthcare Financial Management Association (2012). Unclogging patient flow in the ED and beyond. Retrieved from http://www.hfma.org/Publications/Leadership-Publication/Archives/Special-Reports/Spring-2012/Unclogging-Patient-Flow-in-the-ED-and-Beyond/ Mayer, T. & Jensen, K. (2009). Hardwiring flow: systems and processes for seamless patient care. Gulf Breeze, FL: Fire Starter Publishing. Walrath, J. M., Tomallo-Bowman, R., & Maguire, J. M. (2004). Emergency department: Improving patient satisfaction. Nursing Economics, 22(2), 71-4, 55. Retrieved from http://ezproxy.ju.edu:2048/login?url=http://search.proquest.com/docview/236936193?accountid=28468

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