Health First is a central Florida nonprofit health care system of more than 900 beds in four hospitals, with the county’s only Level II trauma center.
Streamlining and automating the patient discharge process is a major goal to gain efficiency among hospitals. Health First is no different, having struggled to manage patient flow and manual discharge processes at its four hospitals.
Manual discharge processes, dependent on written records and ad hoc verbal communication, have resulted in silos of information between different care teams, creating bottlenecks in the flow of patients and delays in discharge. This obscured the visibility of staff in getting the latest status updates and identifying existing barriers to discharging patients.
“For example, we had several systems in which back-up services relied on EHR mapping, but they couldn’t tell what was outstanding or what was complete,” said Patti Canitano, director of the EHR division. patient flow at Health First. “All discharge documents were on paper, and these documents had to be reviewed as a group or shared with other care teams via scan, email or fax to ensure timely communication.”
Supervisors created 20-30 page patient lists daily that healthcare teams used to see who was discharged and when. However, the data quickly became outdated and inaccurate. Support services were unsure of when to expect admissions or when discharges were underway, leading to a shortage of staff struggling to support the flow of patients.
“We needed to automate this process to get real-time insight and create a significant impact by reducing avoidable days and lengths of stay,” Canitano said. “These inefficiencies came to a head during COVID-19. Accurate, timely and proactive operations were more critical than ever. We needed to optimize length of stay management to better plan for capacity constraints, avoid capacity expansion, and track our COVID patients against the normal population. “
Health First did not have the digital means or the transparency of data to complete this in a timely manner or operate with patient care processes at the level of efficiency demanded by COVID, she added.
Hospital IQ is a provider of predictive hospital operations software. Health First opted for the company system, which offers a way to streamline leave management. The system uses artificial intelligence to drive the action of healthcare teams in real time by providing situational awareness to future capacity constraints, identifying and orchestrating exit activities and communicating actionable information from obstacles to the exit to bottlenecks.
“The solution’s prescriptive recommendations and AI-enabled workflows would help our hospital staff speed up the discharge process, reducing unnecessarily long patient stays and avoidable days,” Canitano explained. “By integrating AI and machine learning-based forecasting with our own data collected from our four hospitals, Hospital IQ predicts future patient demand while automatically prioritizing specific patients for discharge. “
“Our success to date proves that the use of an advanced analytics platform can play a huge role in helping hospitals move from a reactive approach to a proactive one that prevents patient flow issues before. that they do not occur. “
Patti Canitano, Health first
By predicting and prioritizing discharges, care teams could quickly align with high-priority patients and have the information they need to manage throughput and address capacity issues before they arise, she added. .
In addition, the provider presented us with its regional COVID-19 forecast dashboard tool, which is currently helping other hospitals plan for upcoming patient increases, ”she said.
“Finally, to best meet our specific COVID-related data tracking and reporting needs, the vendor created a COVID command center specifically designed for our healthcare system in just days – putting the proof of the supplier’s promise of technological agility and marking the start. of our growing partnership. “
TRY THE CHALLENGE
Vendor and vendor organizations implemented the platform and focused on streamlining and automating inpatient operations.
“We have converted manual processes to digital processes through intelligent automation – using technology that streamlines standard operating practices while using AI to detect risks and guide actions in real time,” said Canitano. “In this way, our multifunctional teams, which traditionally operate independently, have become easily connected to streamlined workflows for enhanced collaboration to accelerate patient treatment processes.
“The implementation was easy and transparent,” she continued. “The discharge automation-focused rollout began with our patient flow administrators, or house supervisors, who used Hospital IQ on rounds to identify patients ready to discharge.
“Some associates were initially reluctant to adopt this new tool,” she added. “But after about a week, the team has reached a level of confidence in their use of the digital solution, which has completely abandoned their paper and fax processes.”
As use of the tool increased, Health First worked with the vendor to integrate additional data sources from across their IT infrastructure. The result provides teams with a consolidated view of each patient that they might not otherwise be able to get, she said.
“To meet the timely monitoring and reporting needs brought about by the COVID-19 pandemic, Hospital IQ has also provided automated tracking of our COVID-19 patients,” she noted. “The platform combines dozens of datasets to power our COVID-19 command center with a centralized, real-time and predictive view of operations. “
Through a single source, Health First has immediate access to patient population data and insight into bed availability, which is necessary to successfully manage patient inflows, while maintaining efficient throughput. The COVID-19 command center is also able to meet state and federal government reporting requirements due to this data information.
AI-powered technology is changing the way Health First works, from delayed data analysis and siled improvement initiatives to digitized and more coordinated efforts.
“In the first 90 days of implementation, we exchanged over 15,000 notes between clinical care teams that previously relied on paper-based processes and phone calls,” Canitano said. “In the two years since implementing Hospital IQ solutions, we have eliminated 517 avoidable days per month, reduced length of stay by an average of six hours per patient, and eliminated 200 hours of data collection per week.
By developing a digital transfer of information on all staff and teams, Health First saved more than an hour per person and per team, by prioritizing patient discharges, and generated two additional discharges per day , on average.
“Our success to date proves that the use of an advanced analytics platform can play a huge role in helping hospitals move from a reactive to a proactive approach that prevents patient flow issues before. they don’t happen, ”she said.
TIPS FOR OTHERS
Understand that you cannot improve what you cannot measure, advised Canitano.
“Assess all the paper-based processes currently in place and the timeframe required to complete and collect the data,” she suggested. “Then look at when that data is being used and for what. We saw that we would start collecting data on our discharge patients and outstanding issues by 7am which usually happened overnight, and that information was used by our 8:30 am. am caucus and 10 o’clock round. “
Staff found there was a huge data gap.
“Our ancillary services were missing the most up-to-date discharge list and were performing morning labs, physiotherapy, and diagnostics on patients no longer awaiting discharge, or were missing patients added to the discharge list. during this period, “she noted. “There was no reliable source of data review or a single source of truth.”
Start small, she added, by identifying the biggest manual opportunity for improvement and tackling it. Don’t try to take care of everything at once.
“As you start to get your first few gains and your team’s comfort level and product knowledge increases, and your support team grows, start brainstorming to eventually form a team. interdisciplinary approach that proactively identifies any remaining hurdles for leave management, communication between teams, and data metrics collection for continuous optimization, ”she said.
“Collaboration between sites is essential to optimize deployment. “
Finally, put training processes in place to ensure that the pilot site is fully capable of training other hospitals or sites as were its staff, she said.
“One way to do this is to choose a technology champion to oversee the deployment across your business,” she concluded. “Internal Champions make adoption more successful not only by ensuring that the appropriate training is completed, but by championing the benefits and value of the technology as seen so far on the pilot site.”