Frontline staff members on the bed flow value stream

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frontline staff members on the Bed Flow Value Stream project at Hospital 2 reported how exciting it was to receive recognition from other departments and from the corporate office for their cultural transformation initiative. Efficiency. Nearly half of interviewees reported on efficiency gains on the Bed Flow Value Stream project. At Hospital 4, frontline staff and hospital executives reported that the average time a patient had to wait in the ED after the order for admission was written until he/she was transferred to an available bed decreased by 28 minutes, down from 194 minutes. Further, at Hospital 4, beds are now required to be cleaned within 30 minutes. At Hospital 1, with the exception of a few cases (e.g., isolation rooms), beds were cleaned within 45 minutes. Hospital 3 reported that they initially had a patient cycle time of 278 minutes. The team saved 46 minutes discharging inpatients; time from discharge instruction to patient departure is now 10 minutes instead of 56 minutes. Hospital 3 saved 32 minutes (from 87 minutes to 55 minutes) by reducing the time between bed assignments and getting a new patient into the room. An additional 25 minutes was saved (from 45 to 20 minutes) by reducing delays in assigning patients to available beds. At Hospitals 2 and 4, two frontline staff and two hospital executives reported fewer calls being made to nurses about the availability of rooms; staff at Hospital 4 quantified the reduction at 50 percent. Finally, one environmental staff person noted that the automated system allowed for faster response times and identification of delays and other issues. Clinical process assessments. Little information on clinical process assessments was available; however, one frontline staff member stated that patients were less likely to be left unattended in the ED because of the improved patient flow. A negative outcome of the faster transfer of patients from the ED to the inpatient floors became apparent over time at Hospital 3. Because of the format and length of the written report from the ED, inpatient nurses weren’t able to find and read the clinical information describing the patient’s status before the patient was transferred to the inpatient unit. A new process was implemented to share vital information about the patient sooner, using oral reports. In addition, the nurses worked to streamline the written report. Patient experience. The improved discharge process as a result of the Bed Flow Value Stream projects had a direct impact on patient experience scores. The Press Ganey patient satisfaction
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39 survey m asks specifically about how the inpatient discharge process went. At Hospital 3, patient satisfaction for this measure was around the 16th percentile before the Bed Flow project, and after the project, it was around the 97th percentile. At Hospital 1, a management engineer noted that although the patient volume is ever-increasing, they are able to maintain the patient satisfaction score at 95 percent.
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