The ever-increasing demands on hospitals to provide more efficient care without sacrificing quality represent a formidable challenge. Adopting a more effective hospitalist staffing model is part of the solution. Hospitalists’ comprehensive understanding of inpatient care needs makes them invaluable assets in the quest to improve inpatient care continuity and facilitate hospital throughput.

This Open Source MD article dives into actionable strategies to optimize patient flow and revenue, all while maintaining—and even enhancing—the quality of care. 

Challenges in Hospital Throughput

What are the biggest challenges that prevent patients from moving through the hospital efficiently while getting quality care? 

Here are some common causes of suboptimal hospital throughputs:

Bottlenecks in Admissions and Discharges: 

It is not uncommon to have patients in emergency department beds waiting to be admitted because no inpatient beds are available. Admission delays also incapacitates the ED’s ability to take care of “treat-and-release” patients. And admission delays can also become a safety problem for patients as important medications or treatments could be missed during this period. 

This is very frustrating for the ER doctors and the patients. Providing inpatient care in an ED setting is not an ideal scenario for the patient nor the ED clinicians as an ED isn’t set up to care for inpatients like a medicine floor. By formally admitting patients, the hospitals can begin addressing all of a patient’s problems, not just their acute or presenting complaints in the ED.

Overcrowding can occur when hospitalists are not available onsite in the late afternoon through late evening hours to appropriately discharge inpatients, thus inpatient rooms don’t become available until the next morning when the hospitalist is back on-site to sign discharge orders.

Inefficient Communication 

Hospitalists should actively notify the emergency department when beds are becoming available. Also, when hospitalists are only on-site 8-9 hours of a 12 hour shift, this contributes to inconsistent handoff processes between physician shifts. This can contribute to incomplete documentation and missed verbal communication about the patients between physicians that may lead to delayed patient care.

Insurance Authorizations and Clinical Documentation Challenges

Waiting for inpatient admission and treatment authorizations from health insurance companies can be a major stumbling block. Success is often dependent on diagnosis focused clinical documentation by the physicians. Physicians must recognize that they are a critical part of the solution to these everyday challenges.

Patients with Complex Treatment Needs 

Patients with multiple comorbidities or non-medical factors that hinder recovery may require additional coordination and resources. When hospitalists work 16-hour shifts for 7 or more days consecutively, those physicians can provide unfragmented care for the entire patient’s stay (admission through discharge) in most cases. This physician-patient consistency improves care quality and effectiveness, and reduces length of stay.

How Hospitalists Improve Hospital Throughput

The Hospitalist Can Help Streamline Admissions

Hospitalists need to work with ED physicians to create better processes to facilitate quicker admissions. These two groups should meet on a regular basis to improve standardized key practices and procedures for qualifying when a patient is stable enough for inpatient status and improving inpatient admissions pathways.The goal is to reduce the time it takes to qualify for inpatient status and get patients admitted.

The Hospitalist Can Improve Communication

It is not uncommon for a hospitalist to get a pager/ text message with just a phone number and not much else. Consider using secure HIPAA-compliant two-way text messaging. Without more information, hospitalists have no way to know if the message is urgent regarding a patient, which patient, etc.. Setting a standard protocol for text pages is a common sense time saver. Sometimes just the basics can make all the difference. Consider making these items a minimum requirement: 

  • Patient;
  • Room number;
  • Urgency level;
  • Name of the sender;
  • Callback number;
  • Message; and
  • Whether or not a callback is needed.

For hospitals with a very busy ED, enabling ED staff to send hospitalists on shift a pager/text message that is specific for patients that are qualified candidates for admission could speed throughput.

The Hospitalist Can Help Support Authorizations and Reduce Denials 

Hospitalized patients often have multiple, co-existing health conditions, leading to more complex diagnoses. It is incumbent on hospitalists to provide complete and accurate documentation that clearly reflects the patient’s current condition, and supports each diagnosis and care plan. This documentation is essential to securing authorizations from health insurance companies, avoiding denials and maintaining compliance. Here are three steps to success:

  • Educate hospitalists on what is complete clinical documentation and why it is important.
  • Encourage hospitalists to complete clinical documentation that ‘tells a story’. 
  • Help Hospitalists understand what health insurance companies need for approvals.

Open Source MD: Innovative Physician Staffing Solutions

As experienced physicians who work in hospitals —- we have seen how the most efficient hospitals operate from both the physician-patient interaction level and from the senior executive level. What differentiates Open Source MD is our focus is on partnering with hospitals to deliver optimal performing hospitalist services. The result is better patient care, higher physician morale and meaningful improvements in many other key metrics. 

We don’t act as a middleman between the physician and the hospital. Our mission is connecting skilled physicians with exceptional hospitals. Our philosophy is informed by a collaborative, outcomes-driven approach to healthcare. 

Let’s discuss what we can achieve together.

 Call  336-997-9840 or contact us online to learn more.

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