2.50
Hdl Handle:
http://hdl.handle.net/10755/162527
Type:
Presentation
Title:
Herding Cats: Creating a Centralized Admissions and Bed Coordination Center
Abstract:
Herding Cats: Creating a Centralized Admissions and Bed Coordination Center
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Holmes, Jennifer G., RN, BSN, MHSA, CEN
P.I. Institution Name:University of Michigan Health System
Title:Director, Emergency Department Operations
Contact Address:1500 E. Medical Center Drive TC B1 382U, Ann Arbor, MI, 48118, USA
Contact Telephone:734-657-7590
[Annual Conference] Clinical Topic: Delays and cancellations of transfers from outside hospitals, increased ED LWBS and boarding time, and third party payor payment denials were attributed to critical deficiencies in the management of unscheduled admissions to our Health System, an Academic Health Center that includes three hospitals, 913 licensed beds, and 44,000 inpatient admissions, 63% of which are unscheduled.

Implementation: A multidisciplinary lean team, lead by the ED Director of Operations, was established in March 2007 to redesign the current process, spread across multiple departments, to create a centralized 24/7 system. The result was implementation of the Admissions Bed Coordination Center (ABC) in May 2008.

The ABC provides financial and clinical screening, centralized queuing of all admissions, patient flow coordination, and Discharge Concierge services that expedite patient exit from the hospital once discharge orders are written. A Clinical Advisory Team of key medical, nursing, and administrative leaders provides oversight. FTE and operating expenses needed to implement ABC were extracted from departments previously involved in the admission process including the Transfer Center, Bed Management, and Utilization Management. A positive return on investment for the project will be generated by reduced payor denials, addition of at least one transfer per day, and a modest reduction in ED LWBS. Success will be measured tracking these metrics in addition to inpatient LOS, TAT from admission request to bed placement and use of surge capacity to manage patient flow.

Outcomes: Changes in process and flow have resulted in reduced boarding time in the ED and decreased hospital LOS for pilot units. Upfront screening for all admissions for clinical and financial requirements has reduced denials and eliminated rework.

Recommendations: Regulatory and clinical requirements for admission are increasing and complex. Centralizing admitting functions and standardizing processes in both the sending (ED) and receiving units (inpatient floors) has been shown to improve financial outcomes, ED throughput, efficiency and accuracy at ours and other institutions who have taken these steps. Use of lean methodology to redesign these processes is an effective way to bring together medical, nursing, and key ancillary services to tackle longstanding problems and change the culture, replacing ineffective operating procedures and relationships with productive system changing strategies.

Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHerding Cats: Creating a Centralized Admissions and Bed Coordination Centeren_GB
dc.identifier.urihttp://hdl.handle.net/10755/162527-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Herding Cats: Creating a Centralized Admissions and Bed Coordination Center</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Holmes, Jennifer G., RN, BSN, MHSA, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Michigan Health System</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director, Emergency Department Operations</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1500 E. Medical Center Drive TC B1 382U, Ann Arbor, MI, 48118, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">734-657-7590</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jgholmes@med.umich.edu</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: Delays and cancellations of transfers from outside hospitals, increased ED LWBS and boarding time, and third party payor payment denials were attributed to critical deficiencies in the management of unscheduled admissions to our Health System, an Academic Health Center that includes three hospitals, 913 licensed beds, and 44,000 inpatient admissions, 63% of which are unscheduled.<br/><br/>Implementation: A multidisciplinary lean team, lead by the ED Director of Operations, was established in March 2007 to redesign the current process, spread across multiple departments, to create a centralized 24/7 system. The result was implementation of the Admissions Bed Coordination Center (ABC) in May 2008. <br/><br/>The ABC provides financial and clinical screening, centralized queuing of all admissions, patient flow coordination, and Discharge Concierge services that expedite patient exit from the hospital once discharge orders are written. A Clinical Advisory Team of key medical, nursing, and administrative leaders provides oversight. FTE and operating expenses needed to implement ABC were extracted from departments previously involved in the admission process including the Transfer Center, Bed Management, and Utilization Management. A positive return on investment for the project will be generated by reduced payor denials, addition of at least one transfer per day, and a modest reduction in ED LWBS. Success will be measured tracking these metrics in addition to inpatient LOS, TAT from admission request to bed placement and use of surge capacity to manage patient flow.<br/><br/>Outcomes: Changes in process and flow have resulted in reduced boarding time in the ED and decreased hospital LOS for pilot units. Upfront screening for all admissions for clinical and financial requirements has reduced denials and eliminated rework. <br/><br/>Recommendations: Regulatory and clinical requirements for admission are increasing and complex. Centralizing admitting functions and standardizing processes in both the sending (ED) and receiving units (inpatient floors) has been shown to improve financial outcomes, ED throughput, efficiency and accuracy at ours and other institutions who have taken these steps. Use of lean methodology to redesign these processes is an effective way to bring together medical, nursing, and key ancillary services to tackle longstanding problems and change the culture, replacing ineffective operating procedures and relationships with productive system changing strategies.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:42Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:42Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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