1. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Daniel A. Nickerson Access & Special Projects Director, Willis Knighton Health System

2. Creating a Culture of Communication & Maximizing Efficiency in Patient Flow Introduction A Culture of Communication Communication in Healthcare Process vs. Culture Hindrances to Patient Flow How Poor Communication & Flow Affects Revenue Willis Knighton Health System Patient Flow Case Study Creating a Program & Process that Works for You!

3. A Culture of Communication Creating a Culture of Communication & Maximizing Efficiency in Patient Flow “The single biggest problem in communication is the illusion that it has taken place” -George Bernard Shaw “Communication works for those who work at it.” -John Powell

4. A Culture of Communication Process vs. Culture What happens in a culture of communication? Communication becomes: Automatic The Norm Easy Deviations are Identifiable Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

5. Poor Understanding Poor Communication Poor Visibility No Automation No Accountability Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

6. Patients Physicians Staffing Reputation Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

7. Patient Flow Case Study To create a culture of communication Automate the process A new level of accessibility Clear visuals Data driven decision making Decrease Wait Times & Increase Admits GOALS Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

8. Patient Flow Issues at WKHS Over 100% occupancy until 6pm Turning away 2-3 patients per day Avg. patient wait time exceeding 4 hours High diversion & LWBS Rate in the ER Excessive overtime & nurse agency use No clear visuals Finger pointing between departments Nurses hiding rooms or so we thought Patient & Physician complaints No communication Zero Accountability Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

9. Actions Taken for Improvement Morning Patient Flow Meetings Multidepartment Involvement Nurse Calls at the time of discharge Housekeeping calls from room New Communication Tools A new bed management system www.pasbedboard.org An “at a glance” dashboard of patient flow Automated reports, Alerts & Notifications A prioritization policy Nursing & Housekeeping Accountability Education Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

10.  Patient Wait Time decreased anywhere from 49-124 minutes at each facility after the first few months.  Rooms were discovered to be empty an average of 65 minutes faster.  An increase of 2,200 patients over the next 2 fiscal years. WK Pierremont increased by 600 admits the first year.  Overtime & Agency use reduced significantly, Emergency Room LWBS rate went down, & diversion is rare.  Fewer Complaints Impact from the New Program & Process Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

14. 3 of the 4 facilities have decreased their average wait times while increasing admits Average Room Turnover has decreased at all 4 facilities Pierremont had a record setting day with over 60 inpatient admits between 7am & 6pm. In February, Bossier decreased their room turnover time from 1:14 to 0:24 while having 30 more discharges as compared with the previous February. 2011 Improvements Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

15. ◦ 24/7 web based program ◦ Accessible from anywhere or any device (pc, phone, ipad, etc.) ◦ An “at a glance” Dashboard ◦ Patient Flow Gauge ◦ Automatic Alerts & Notifications (VIP, Confidential, Infection, etc.) ◦ Auto Generated Reports for any date or date range ◦ Integration capabilities with other departments Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

17. Reports For any date or date range For all departments Graphs & Trend Lines Stats by Individual Room Stats by Nurse Station or Wing Stats by bed type & location Hourly Stats Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

18. Lessons learned Regulation without Education will keep people from buying into the process. Checks and Balances keep individuals & individual departments from slacking or manipulating the process. Communicating results and having stats by department creates competition. Don’t just add to and revise an existing process, create something new and base it around the inefficiencies of your old process. Communicate success and be passionate! Creating a Culture of Communication & Maximizing Efficiency in Patient Flow

19. Thank You! Daniel A. Nickerson Asst. Director of Admissions & Special Projects dnickerso@wkhs.com (318) 212-3969 or (318) 453-6476 Creating a Culture of Communication & Maximizing Efficiency in Patient Flow