Emergency Department Physicians

Insufficient numbers of inpatient beds is the main reason for ED boarding, overcrowding and diversion, right? Wrong. Despite this common belief, our research in hospital patient flow systems has shown that the chief problem is neither the number of inpatient beds nor the inefficiency of ED internal processes. The problem is that a bed is not available when it is needed.

The right bed is usually not available at the right time because of competition for resources between patients admitted from the ED and elective admissions. This competition is a result of artificial variability in patient flow, which in turn is driven by inappropriate scheduling of elective patients. Better management of the flow of elective admissions provides a sustainable solution for your intractable ED overcrowding and boarding problems.

Aside from boarding and overcrowding issues, ED operations are complicated by the broad array of services provided for a wide range of patient types. At its core, an ED’s challenge is to service variable demand with fixed capacity. How various care processes and resources are organized can have a significant impact on the overall efficiency of an ED. The science of operations management offers some of the best tools, such as queuing models, separation of homogenous patient streams, and the critical path method, for determining ED workflow design and resource allocation.

Brent R. Asplin, MD., Chair of the Emergency Medicine Department at Mayo Clinic, Rochester, MN

Cost reduction through optimal patient Flow Variability Management Healthcare Cost Corner

Hospital costs can be decreased by millions of dollars annually by adopting the Institute for Healthcare Optimization’s approach to managing variability in healthcare delivery.

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Case Study

See how Cincinnati Children’s Hospital increased annual revenue by $137M, and avoided $100M in cost, while improving quality of care.

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Resources

Book Cover Mock - Optimizing Patient Flow

Joint Commission Resources Book

The IHO’s approach to managing variability in healthcare delivery is the central theme of Joint Commission Resources’ new book.

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IOM Report: Transforming Health Care Scheduling and Access

The Institute of Medicine (IOM) recommended IHO Variability Methodology as one of the six principles to address the compelling issue of access to healthcare.

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Keep up on the latest IHO NewsWhat's New

A key step on the road to health equity: improving patient flow

BY EUGENE LITVAK, MARK D. SMITH, HARVEY V. FINEBERG, OPINION CONTRIBUTORS

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With Canada’s health-care system “in crisis” as described by many front-line workers, there is a renewed push towards leaning on private facilities to ease the pressure on public hospitals.

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By Laura Osman. The Canadian Press

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Litvak, Eugene PhD; Keshavjee, Shaf MD, MSc, FRCSC, FACS; Gewertz, Bruce L. MD; Fineberg, Harvey V. MD, PhD

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How surgical smoothing could help ease the medical backlog created by COVID-19

Surgical smoothing eliminates conflicts and adds granularity to medical-decision making.
Colin Butler – CBC News

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Peter S. Antkowiak, MD; Michael N. Cocchi, MD; David T. Chiu, MD, MPH; and Leon D. Sanchez, MD, MPH

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Jason Hanna, CNN

Opinion: This math-trained Harvard professor is helping hospitals cope with a potential second wave of Covid-19

Mark Taylor, MarketWatch

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Mark Taylor, MarketWatch

Another election cycle, another health-care debate

National adoption of patient flow optimization practices has the potential to reduce total U.S. per capita spending “by 4-5%”, which amounts to $140 to $180 billion a year.

Emergency Rooms Shouldn’t Be Parking Lots For Patients

Smoothing out surgical scheduling to improve efficiency is much less expensive than building a new hospital wing, and has been shown to yield major improvements.

To Solve Hospital Overcrowding, Think Like a Mathematician

An operations management specialist is applying lessons from statistics to help free up hospital beds. It’s working.

The way out of the nurse staffing impasse

Unresolved nurse burnout at hospitals globally leads to legislative initiatives such as Massachusetts’ ballot Question 1. In the face of financial constraints and workforce shortages, the only solution is to smooth variability in healthcare operations.