Hospital inefficiencies not only interfere with workflow, but also cost hospitals billions of dollars each year. A recent Ponemon Institute survey of more than 400 healthcare providers found that inadequate communication alone has an estimated annual economic impact of around $1.75 million per US hospital and more than $11 billion industry-wide.
Although many of the issues that lead to inefficiency may be complex, there are still some quick fixes that can add up to huge savings in both staff time and money. Here are some of the most common hospital inefficiencies and some simple strategies that can help to correct them:
1. Inadequate communication methods.
The results of the Ponemon Institute survey found that the primary reasons for communication challenges were the inefficiency of pagers, the inability to use text messaging and lack of Wi-Fi availability. Survey respondents agreed that the use of secure text messaging could increase productivity and minimize the economic loss by about 50%. This would amount to an annual savings of $875,000 per hospital.
2. Duplicate documentation requirements.
Eliminating inefficiencies in documentation methods allow clinicians to spend more time with patients and also helps with patient flow. The first step in eliminating inefficiencies might be to conduct a brief staff/provider survey aimed at identifying existing duplicate documentation requirements. If duplications exist within your EHR system, work with your EHR provider to eliminate them. If duplications are related to paper charts and/or the use of a combination of paper and electronic records, develop more streamlined standardized forms, omitting the duplicate requirements.
3. Poor patient flow.
Dealing with a large number of patients moving in and out of the hospital and from one department to another will inevitably lead to patient flow issues. To help hospitals address these issues, the Institute of Healthcare Improvement has developed a white paper titled Optimizing Patient Flow: Moving Patients Smoothly Through Acute Care Settings. According to the IHI, the key to improving flow is to redesign system-wide processes that impact flow. Some of the IHI's recommended strategies include evaluating patient flow by reviewing occupancy and 'parking' of patients, designating separate ORs for scheduled and unscheduled surgeries and providing a process for scheduling the date and time of patient discharge at least one day in advance.
4. Inappropriate hospital admissions and lengths of stay.
Practitioners sometimes admit patients to the hospital or keep them longer than necessary because they don't have an alternative place to send them. Providing practitioners with a list of resources (e.g., social workers, nursing homes, behavioral healthcare centers, skilled nursing centers, rehabilitation services) may help to reduce or eliminate this problem.
5. Incomplete medication reconciliation.
Inadequate or incomplete medication reconciliation can lead to medication errors. One of the reasons hospitals have difficulty with medication reconciliation is that patients are often poor historians when it comes to their medications, which makes it difficult to develop a complete 'entry' list. Asking the patient to bring his/her medication bottles to the hospital and contacting the patient’s primary care provider and pharmacy can help you to build a more accurate list. Another major barrier to medication reconciliation is lack of an adequate process for reconciling medications at each point of care. Developing standardized forms and adding hard stops to your EHR system can help to ensure that the medication list is being updated during each care transition.