The purpose of this innovative patient throughput strategy was to investigate the potential impact of the nursing workforce's proactive discharge management and improved communication efforts on obstetrical inpatient length of stay and bed capacity.
Significance:
Capacity constraints strain hospital resources and adversely impact healthcare operations. Effective resource allocation and capacity management are contigent upon patient throughput and the nursing workforce's engagement in throughput initiatives.
Strategy and Implementation:
Engagement of the nursing workforce at a women's specialty hospital assisted with identifying the need for innovative changes to care for obstetrical patients within the physical restraints of the facility.
The hospital contracted a management-engineering firm to assist with evaluating their current processes. Process mapping, time studies, and data analyses of the inpatient obstetrical areas revealed that peak obstetrical delivery and discharge times overlapped. Process mapping also unveiled that many activities took place on the day of discharge that could occur sooner during the hospital stay in order to improve efficiencies.
Consistency with the times for completion of key performance indicator (KPI) activities has improved process flows, efficiencies, and the continuity of care by setting expectations for the patient and the nursing workforce; thereby fostering improvements in the NDNQI nurse satisfaction indicator.
Evaluation:
Expediting patient throughput has improved organizational operations by decreasing lengths of stay, maximizing bed capacity, minimizing obstetrical patients overflowing to less desirable locations, reducing nursing staff overtime, and improving financial performance while sustaining quality care.
Implications for Practice:
Throughput has gained attention in the emergency and clinic arenas. One hospital has proven how many of these principles can be applied to obstetrical areas to improve throughput. While a disparity in the setting exists, expediting obstetrical inpatient throughput yields many positive results.