With hospitals receiving set payments for providing care, getting patients into the most appropriate care as soon as possible is crucial. Every day a patient spends in a setting that provides more care than necessary adds unnecessary cost.
Two Florida hospitals are looking to automation to help them in what has traditionally been a difficult step – discharging a patient to a setting that provides the most appropriate care. In the busiest months of the year for hospitals, automation can be of even greater help.
"As we are entering our busy season, the ability to place patients quickly becomes even more important," said Chuck Cleaver, assistant vice president of finance at Stuart, Fla.-based Martin Memorial Hospital.
"From November through March, we can find ourselves in the position of having to turn patients away as beds are not available," Cleaver said.
Westside Regional Hospital, part of Hospital Corp. of America, has decreased its length of stay by at least one day by automating the patient discharge process.
"We saw an opportunity to reduce cost when placing our patients (in post-acute care facilities) and increasing the throughput to deal with bottlenecks in case management," said Michael Houston, CFO at Westside Regional. "The discharge technology cuts down on time and manual labor. It shortens the length of stay."
Because hospitals get fixed reimbursement for patient care, a facility loses money when a patient’s stay is prolonged while waiting to be placed in a post-acute care facility. "If you shorten length of stay by a day, you can reduce cost and increase your margin," Houston said.
Cleaver says the two-hospital network receives fixed reimbursement for 80 percent of its cases.
"At 80 percent, it is very important to give the appropriate care to the patients and then get them out," he said.
After implementing this technology in 2001, Martin Memorial reconfigured staffing assignments and was able to reduce staff time previously spent calling post-acute care facilities.
"We redirected staff to spend time on more appropriate duties," Cleaver said.
The hospital also arranged meetings with local post-acute care facilities to talk about the value and efficiency of automating the process, eventually persuading them to participate in the Extended Care Information Network. Martin Memorial now uses ECIN for making 98 percent of all referrals.
Cleaver said Martin Memorial has taken advantage of other steps – such as control of beds, advances in medicine, staffing organization and an increase in short stays – to reduce the average length of stay for patients.
More hospitals are finding ways to smooth their patient flow by adding beds, better organizing staff or implementing IT.
"Patient flow hasn’t been a big focus of management in the past," said Kathleen Fuda, data analysis manager at Boston University’s Health Policy Institute who studies the management of variability in a healthcare environment.
"Many hospital information systems aren’t designed to help monitor patient flow, but hospitals are starting to understand the reasons behind ED overcrowding," she said.