... Real Time Demand Capacity (RTDC) Approach. Months: Shift/Add Capacity to Address Large Mismatches

Transcription

1 Real Time Demand Capacity (RTDC) Approach Months: Real-Time Matching of Capacity to Demand Shift/Add Capacity to Address Large Mismatches Identify Barriers to Accomplishing Plans Focused Improvements on Barriers.... Larger Improvement Projects Copyright 2012 Institute for Healthcare Improvement

2 This presenter has nothing to disclose. Hospital Bed Meeting: Its Role in Real Time Demand Capacity Management October 23, 2014

3 Session Objectives Describe the key components of a hospital-wide bed meeting Make comparisons to participants existing bed meetings

4 UPMC Then: Hospital Bed Meeting Surgical Unit I am not going to fit I need 2NA/1RN for E Bed Czar keeper of the beds

5 This Bed Meeting Format Led To: Increase ED border hours Long PACU stays PACU holding post-op patients overnight Off-service patients on every unit But most of all, this process led to.

6 6

7 Sharing About Your Bed Meeting Sharing Prework At your tables, briefly describe your daily hospital-wide bed meeting. (Include start time, length, participants, objectives, and, in general, the format.). What are the weaknesses?

8 Let s take a look at a hospital (Gundersen Health System) that took the leap After watching the video, let s discuss: What recommendations you would make to improve their bed meeting?

9 UPMC Now: Hospital Bed Meeting A mandatory house-wide, interdisciplinary meeting held each morning to assess the status of capacity and demand by unit and develop plans when there is a mismatch. The meeting focuses especially on the next 6hrs. It s not about staffing Key Participants at Bed Meeting Inpatient Units Case Management Emergency Dept PACU /CCL Infection Control Nursing Leadership AOD Transport Cardiology EVS

10 Recipe for Success

11 Standing start time that does not vary Consistent room, large enough to hold the entire group

12 Entire room must be able to visualize each unit s huddle outcomes

13 Prior to start of bed meeting..units have informal discussions about pending transfers

14 Each nursing unit must report the outcome of their unit huddle (to measure demand / capacity for the day) and any informal discussions This information is entered onto a screen for all to see

15 Attendance at the bed meeting is not optional Calling information in, texting or ing information is not acceptable

16 Ancillary support departments attendance is equally important and expected daily Problems can be solved on the spot with ancillary partners present

17 Consistent leadership presence is essential Hospital bed meeting should be chaired by nursing leadership (Director level and above) and Care Management leadership (Director)

18 Once all units have reported the outcomes of their unit huddles meeting should begin Important that everyone in the room can visualize the spreadsheet with outcomes and easily see where the issues will be

19 Unit Available Beds DC's Transfers off Unit DC /Tsfs by 2pm AdmissionS: ED, ORs, CCL, DIRECTS, etc Transfers from other Units Admits by 2pm Status at 2pm PLANS 12E E E E

20 12E you are are at a minus 2 You have predicted 8 discharges for today but only 3 of them leaving by 2pm Of the 5 discharges leaving after 2pm are there any opportunities to put a plan into place to move 2 of those discharges earlier?

21 10E you are at a minus 1 You predicted 6 discharges for today, but only 1 leaving by 2pm. Is there any opportunity to put a plan in place to move any of the other 5 discharges up to a time before 2pm?

22 We have 17 discharges and transfers predicted to occur by 2pm and plans in place to try to get an additional 3. It is important that the moment you incur any kind of barrier in getting your predicted discharges out, you need to escalate that barrier to the proper person If we can get our 20 discharges by 2pm, the ED and the PACU should not have anyone waiting for beds.

23 Do any of the ancillary departments have any issues that we need to be aware of that might affect our patient flow today? Let s look at yesterday s results.

24 Summary 24 The hospital-wide bed meeting is a key structure for RTDC Most hospitals will need to make changes to the objectives and format of their existing bed meeting when implementing RTDC Observing your bed meeting with the steps of RTDC in mind is a good learning exercise

25 Exercise Identify and discuss at your tables two things you would do differently in your bed meeting.