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

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Vanderbilt University Hospital implemented the Patient-Centered Teams (PaCT) initiative to address a capacity crisis and improve patient flow through geographic localization of Hospital Medicine teams. A multidisciplinary group designed Phase 1 of PaCT by placing five HM teams on five nursing units (69 beds total) and creating two ED boarding teams. Bed management workflows were also redesigned so patients could be assigned to appropriate ED boarding teams until inpatient beds were available.<br /><br />The study evaluated throughput using several metrics, including resource length of stay (RLOS), case-mix-adjusted RLOS, early discharges by 11 a.m., roomed-when-ready turnaround time, and ED boarding times. After implementation, PaCT teams showed a reduction in average RLOS of 0.73 days, or 17.5 hours. The number of bed days created on PaCT units increased by 1,665, which is roughly equivalent to capacity for about 300 additional patients. Average daily team census also decreased, which may have contributed to improved throughput.<br /><br />However, there was no significant change in early discharges, roomed-when-ready time, or median ED boarding times. Geographic localization was highly successful operationally, with teams correctly localized 97% of the time. PaCT units and teams represented about two-thirds of HM teams and patients after implementation, and average RLOS decreased in four of the five units.<br /><br />Overall, the initiative was associated with improved throughput primarily through shorter length of stay, while other patient flow measures remained unchanged. Further optimization of provider and bed management workflows is ongoing.

Asset Subtitle

Allison L. Schwall

Meta Tag

Author List Allison L. Schwall, Kaitlyn Anderson, Kelly E. Cunningham, Russell Ledford, Ryan Starnes

Category Innovations

Concept Localization

Concept Throughput

Concept Length of Stay

Concept Patient-Centered Teams

Concept Relative Length of Stay

Distinguished Non-Finalist

Presenter Organization Vanderbilt University Medical Center

Presenting Author Allison L. Schwall

Track Value in Hospital Medicine

Keywords

Vanderbilt University Hospital

Patient-Centered Teams

PaCT initiative

hospital medicine

geographic localization

patient flow

capacity crisis

length of stay

ED boarding

throughput improvement

Localization

Throughput

Length of Stay

Patient-Centered Teams

Relative Length of Stay