The safe patient flow initiative: a collaborative quality improvement journey at Yale-New Haven Hospital.
Jt Comm J Qual Patient Saf
; 39(10): 447-59, 2013 Oct.
Article
em En
| MEDLINE
| ID: mdl-24195198
BACKGROUND: Yale-New Haven Hospital (YNHH) began a successful journey to achieve safe patient flow in fiscal year (FY) 2008 (October 1, 2007-September 30, 2008). The 966-bed (now 1,541-bed) academic medical center faced several challenges, including overcrowding in the Adult Emergency Department (ED); delays in the postanesthesia care unit, which affected the flow of patients through the operating rooms; pinched capacity during the central part of the day; and a lack of interdependent institutionwide coordination of patients. METHODS: The Safe Patient Flow Steering Committee oversaw improvement efforts, most of which were implemented in FY 2009 (October 2008-September 2009), through a cascade of operational meetings. Process changes were made in various departments, such as the Adult ED, Physicians/Providers, and the Bed Management Department. Organizationwide method changes involved standardizing the discharge process, using status boards for visual control, and improving accuracy and timeliness of data entry. RESULTS: Between FY 2008 and FY 2011, YNHH experienced an 84% improvement in discharges by 11:00 A.M. The average length of stay decreased from 5.23 to 5.05 days, thereby accommodating an additional 45 inpatients on a daily basis, contributing to YNHH's positive operating margin amid increasing volume and overall decreasing inpatient length of stay. CONCLUSIONS: YNHH improved clinical, operational, and financial outcomes by embracing five key components of demand capacity management: real-time communication, inter/intradepartmental and interdisciplinary collaboration, staff empowerment, standardization of best practices, and institutional memory.
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Base de dados:
MEDLINE
Assunto principal:
Avaliação de Processos em Cuidados de Saúde
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Eficiência Organizacional
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Centros Médicos Acadêmicos
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Melhoria de Qualidade
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Segurança do Paciente
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article