Efficient clinical operations within an acute inpatient setting require effective management of patient length of stay. The limitations of the human mind to multitask are well documented, and studies confirm the inefficiencies that exist in switching between various complexities of tasks.
This limitation limits the efficiency of managing heterogeneous populations of patient severity, leading to additional treatment and stays beyond typical standards of care. A comprehensive analysis identified patients with simpler diagnostic conditions that, when treated as a cohort, allow for more efficient clinical operations and a lower length of stay.
Tool: Voice of Customer, Process Map, Regression Modeling
Problem: Hospital length of stay was exceeding national benchmarks in patients with lower complexity conditions. The hospital structured general care wards according to diagnostic conditions without taking the complexity of care (excluding intensive/intermediate care wards). Data analysis found this heterogeneous patient severity placement process contributed to excessive time in the hospital
Tool Selection: Lean Six Sigma toolkit was selected as a methodology and approach to designing the work. The proven methods give a pathway to designing new processes and evaluating process and outcome measures. The design was coupled with best practice standards and protocol methods for the treatment of a targeted population of patients
Usage: Voice of Customer evaluated internal & external stakeholder feedback on performance. The process Mapping tool is powerful to lay out the design of the future state. Regression Modeling is used for statistical analysis and projection
Results: Mann-Whitney U Test was performed and the median ALOS fell 50% from 2 days to 1 day (p<0.001). Significant reduction in hospital Average Daily Census during this time from 377 to 366 (p=0.009). This improvement lowers the cost of care, reduces staff stress, and creates capacity for regional referrals
