Internal Patient Transportation: A Critical Link to Patient Flow Optimization
By Diane McCullough
A lot has changed for hospitals in the last 30 years. The economy has created financial and operational stress. Aging baby boomers on Medicare have stretched bed capacity. Pay-for-performance and more informed patients demand faster and better service. The increased volume and adverse conditions have shifted the main point of entry from admissions to the Emergency Department (ED).
Yet, positive first impressions and overall patient experience continue to be critical to ensure high HCAHPS scores, patient loyalty, and increased revenue. Hospitals today must find new and cost-efficient ways to handle the growing patient volumes without sacrificing patient care or satisfaction.
With margins stretched thin and bed capacity at a premium, expansion and adding more beds can be expensive and is often not a realistic option. So rather than increasing physical capacity, administrators look more and more at patient flow optimization.
Go with the Flow
Patient flow optimization -- or patient throughput -- allows hospitals to increase their service capacity by improving their ability to move patients internally through the care process. A centralized and efficient flow of patients through the treatment system can significantly reduce delays and wait times, reduce complaints, and use staff time and hospital resources much more effectively, easing bed capacity issues and making them simpler to manage.
While patient tracking and other real-time location technologies are important components of patient flow optimization, administrators should not overlook the value of a centralized patient transportation department; professional transporters; and non-clinical support staff, systems, and processes in facilitating throughput efficiency and maximizing bed capacity.
Hidden Value of Patient Transportation
Patient transportation sounds simple -- just get patients from Point A to Point B, right? In reality, all patient flows in a hospital are interconnected, making transport the hub of patient movement and an essential ingredient to efficient and cost-effective patient flow and bed capacity optimization.
Inefficient movement of patients throughout the facility, especially in the ED, causes bottlenecks and crowding, compromises care and trust, and is costly. Centralized patient transportation provides a one-stop solution for coordinating, dispatching, and delivering efficient patient movement. It automates, streamlines, manages, and simplifies the admission, transfer, and discharge processes for hospitals and patients.
Patient transportation, however, is more than just technology. A key component of patient transportation is the human element. In this world of HCAHPS and pay for performance, patient experience is everything. By the nature of their job, patient transporters serve as ambassadors for the hospital, often creating the first -- and most lasting -- impression your patients might get of your hospital.
Dedicated patient transporters not only optimize patient flow, they also provide non-clinical support for an overburdened and diminishing nursing population. Departments such as nursing and medical imaging, who often have their own staff transporting patients, may believe this structure reduces patient wait times. However, since transportation is not their core competency, patient flow management and productivity are not always properly managed and can actually be negatively impacted.
Patients who are waiting to be transported to a test or are being discharged need to wait until their nurse or nursing assistant completes care to another patient -- which is their first priority. This creates unnecessary wait times, while bed space remains unavailable to other patients.
A lot of hospitals have mission statements that talk about operational efficiency, high quality and safety, and the desire for hope and to heal. Patient transporters can be a direct link to helping them meet these mission goals.
ED Capacity Challenges
ED capacity and patient transportation are also intimately connected. In the past, most patients entered the hospital through the admitting department. But today the percentage of patients being admitted to hospitals from the ED has increased significantly. In just a few decades, the figures have ballooned to more than 50 percent and higher.
This means the patient’s first impression of a hospital’s performance is now based on the efficiency of the ED. How long did they wait to be triaged? How long did it take to be seen? How long did it take to go to Radiology? How long have they been on this stretcher in the hallway? When will they get to their room?
Inefficient movement of patients within the ED can cause costly crowding and complaints. Without dedicated tracking and transport staff throughout the facility to mitigate crowding and facilitate patient flow and throughput, care quality, patient trust, HCAHPS scores, and bed capacity optimization will all be compromised.
The Role of Integrated Support Services
Hospital administrators should also note the important role non-clinical staff and support services can play in facilitating throughput and capacity efficiency. When these services are siloed, hospitals can miss efficiencies because of decentralized flows of people and information.
When you synchronize patient transportation with other support functions such as Environmental Services, you can handle admissions and discharges more efficiently, and expedite bed turnaround times even further. Systems, processes, and communications are seamlessly integrated.
Schedules can be synced so staff can be scheduled to handle admissions and discharges during peak times so as soon as a patient is discharged and transported which results in an automatic, electronic discharge clean request to Environmental Services removing the task from nursing personnel and expediting the patient flow process.. Wait and hold times for patient rooms are decreased, complaints are reduced, bed capacity optimization is improved, and HCAHPS scores are enhanced.
As you can see, patient transportation can be the critical piece to helping solve the patient flow puzzle. With an integrated, hospital-wide patient transportation program that combines the right people, training, and technology, you can decrease delays and wait times, preserve the effective use of hospital staff and resources, and ensure maximum occupancy and capacity. Ultimately, this translates to better care, better patient satisfaction, and better business.
Diane McCullough is Vice President of Patient Transportation and Observation Services, ABM Healthcare Support Services.