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The Challenge: In order to prepare for an anticipated increase in patient volume at this client hospital, the EmCare hospitalist team worked collaboratively with the emergency medicine physicians as well as case management and others to improve patient flow system-wide.

The Solution:One goal for the hospitalist team was to increase the focus on improving flow by coordinating early morning discharges for patients who are ready to leave the hospital. Early morning discharges reduce average lengths of stay (ALOS) when medically indicated, increase patient satisfaction and allow for new admissions from the E.D. or direct admits. Better flow from the E.D. effectively increases E.D. capacity.

Over a six month period, EmCare provided the following tools and resources:

  • Lean facilitation and coaching on Studer Group tactics
  • Training on early morning discharge process
  • Implementation of Rapid Admission Process & Gap Orders™ with Rounding Charge Capture (RAP&GO™/RCC), EmCare’s proprietary software for patient flow

The Results:Using our rounding and charge capture system, the hospitalist team and case managers identify patients throughout the day who need to be discharged the next morning. They use the software to generate a priority list. The result was an increase from 23 percent of discharges occurring before 11 a.m. to about 70 percent.

Studies show the sooner the patient gets to the inpatient bed, the better the outcome. EmCare has built a model around the close integration of emergency and hospital medicine to achieve that goal. The program is referred to as EmCare’s Door-To-Discharge™ (D2D™). With D2D, when patients are ready to be moved from the E.D. to the inpatient units, the shared processes and RAP&GO technology help ensure there will be beds open and ready for them.

The benefits of this approach include:

  • Reducing ALOS, when medically indicated – which can result in significant cost-savings
  • Opening inpatients beds for new admissions, reducing boarding in the E.D. and decreasing E.D. wait times
  • Improving the patient experience - better management of the process helps expedite the patient’s discharge, improving the patient’s satisfaction