SHM Converge Scientific Abstract ePoster Gallery-The Impact of Geographic Localization on Hospital Throughput

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This process improvement study examined whether geographic localization of hospital medicine teams could improve hospital throughput at a 700-bed academic hospital in Texas. The hospital had 16 inpatient hospital medicine teams, including 5 teaching teams, and before July 2022 these teams were spread across 11 units in 3 towers.<br /><br />The project used a series of PDSA interventions. In PDSA 1, each team was assigned a designated unit, creating a “bed before team” model for direct care teams. PDSA 2 refined this by adding an ED-based team to manage patients until floor transfer. PDSA 3 further improved the model by assigning specific beds to each team and using active bed planning for assignments.<br /><br />The results showed that geographic localization significantly improved average length of stay (ALOS) and reduced ED departure times for admitted patients, without harming key balancing measures. The strongest improvements occurred during PDSA 3, when localization reached 79% and daily census averaged 286. During that period, ED visit volume also increased from a baseline of 5662.5 to 6177.5 patients per month (p=0.06).<br /><br />Importantly, there were no significant differences in risk-adjusted readmission rates, mortality, or patient satisfaction. The observed-to-expected readmission ratio was 0.71 versus 0.75 at baseline (p=0.59), and mortality was 0.37 versus 0.36 (p=0.95). HCAHPS communication-with-providers scores also did not significantly change.<br /><br />Overall, the study suggests that geographic localization can improve hospital throughput and ED flow while maintaining safety and patient experience.

Asset Subtitle

Soniya Abraham

Meta Tag

Author List Ankur Segon, Christopher R. Sandles, Nathan Sevigny, Saket Kottewar, Soniya Abraham, Ting-Wei Lu, Zoe Bullock

Category Research

Concept Geographic Localization

Concept Throughput

Concept Emergency Department Crowding

Concept PDSA Cycle

Concept Bed Assignment

Distinguished Non-Finalist

Presenter Organization Uthscsa

Presenting Author Soniya Abraham

Track Quality Improvement

Keywords

geographic localization

hospital medicine teams

hospital throughput

average length of stay

PDSA interventions

emergency department flow

bed planning

readmission rates

mortality

patient satisfaction

Geographic Localization

Throughput

Emergency Department Crowding

PDSA Cycle

Bed Assignment