What the hospital is struggling with is the improper management of patient flow. The flow is important in ensuring that the patients receive the care they need, when they need it and where they need it. This problem is also occurring in other health facilities across the country. When patients come to the hospitals, they lack beds, and therefore they cannot receive care as per their expectation. This causes a situation where they suffer delayed care, protracted suffering, anxiety and health risk.
The major areas/ CFS that need to be looked at in order to improve the outflow of patients and availability of beds include:
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Flows of patient, hospital staffs and supplies.
Patient and hospital staffs ‘satisfaction
Inventory turnover
Motion
Communication
Information delivery
Data collection and analysis
The quality of Service and System
Utilization of resources
Error rates related to resource use
Match measure between on duty staff and demand of patient
Time management (Scheduling time, evaluate time, register time, cycle time and wait time etc.)
Length of stay
Organizational processes
Demand forecasting
Means to find equilibrium of hospital beds needs and shortage
Expanding the wards and increase bed capacity -If there are no enough beds in the wards, it means there will be delayed care and patients will suffer. Therefore there is a need to expand the wards in bid to reduce congestion in the hospital. Expanding the wards will allow for increased bed capacity and this will allow for more admission of the patients.
Improve patient discharge process - The discharge process would be more efficient if the officers in charge had better attention to details. If they were familiar with the patient’s details they would be able to make prediction of how the discharge process will go, including the number of people that will be discharged. It is important to integrate a care plan where the patients manage the discharge process at home.
Reduce emergency room evaluation time- it is apparent that the long wait in the ER and turnaround time causes lowered quality and poor patient satisfaction. If patients were served more swiftly in the emergency rooms it would serve to reduce the congestion. If people start to show improvement they should be transferred to the wards to allow for more patients to be served in the emergency room.
Reduce patient registration time and reduce extra processing- During registration, it is estimated that people spend much time waiting for care and filling out forms. If people spend more time during registration it means the hospital losses on resources. The registration process would be streamlined to reduce congestion in the hospital and making the process more efficient
Increase bed turnover rate- This could be done if there was better coordination and communication. Some health institutions have integrated a multidisciplinary program to implement electronic beds to help improve bed turnover.
Improving the quality of a system and maximize the utility of the whole system and resource- Improving the quality of a healthcare should be done by introducing models that improve the primary care and quality emergency services. The resources should be well utilized including the available beds. Therefore admission should follow a well thought out plan.
To facilitate communication between departments- More frequent meetings should be held between various departments to ensure they are informed of how admission and utilization of beds is progressing. Each department will also have an opportunity in reducing the congestion in the hospital.
Optimize the movement of patients and materials- if the movement was improved , it means there would be reduced waiting time. This would also reduce the longer clinic appointments. The corridor and access routes should also be clear to ensure there is smooth movement of patients and staff. The beds should be made in such a way they can be moved from one point to the other more easily.
Optimize the schedules – Better discharge, operation and admission schedules would help to reduce patient retention and wait time. If scheduling was done in an improved manner, it means that there would be no waste of time and this would reduce overcrowding in hospitals.
Improve the efficiency and effectiveness of information delivery- information sharing between the departments should be improved. For instance, nurses should practice better reporting approaches like the details on the patients who are expected to be discharged and describe if patients are improving. If there is such information, it would be easy to plan on how discharge will be done.
Improve the accuracy of forecasting demand in the future- predicting the future would help to know how many people are to be discharged and how many patients will be admitted. Forecasting will also help to plan the hospital resources and their utilization.
Improve the ability of the triage nurse to group and count to identify the accumulate demand on a given resource for each patient- Having working groups will reduce nurses burnouts and will be a good way to improve care this will in turn reduce the wait time and make care more efficient and effective. Patients who need specific care will be identified and there will be better allocation of resources for such care. Therefore there will be no delay and this will reduce overcrowding in the wards.
Flexibility of duty hours improve the match rate of on duty staff match demand of patient-with better planning and scheduling it will be possible to match the on duty staff with the patients demand. This increases flexibility and serves to bring equilibrium.
Using Technology and Data- The use of technology can be used to do better scheduling and forecasting. This will be done with the consideration of the available resources, such as beds. Therefore this could be used to achieve equilibrium.
Adjust and distribute the number of beds as needed between different sub departments- The distribution should be done in such a way that the most active department will get more beds. For instance, the emergency department needs to be allocated more beds.
