When the hospital is over 85 percent capacity, as it often is in the winter months, efficiency decreases and patient satisfaction may suffer. Matt Van Vranken, COO, and Andy Whittemore, MD, CMO, with the assistance of Nursing, the Admitting Department, and physicians, have reviewed and implemented a plan to better manage bed occupancy during these times.
The plan calls for information to be sent to clinical leaders from Admitting when more than 85percent of beds are occupied. This will occur early in the day. Robert Goldszer of Internal Medicine, Patrick O'Gara of Cardiology, David Brooks of Surgery, and Lawrence Schulman of Oncology will receive lists of patients pending discharge. These clinicians, nurse managers, and administration colleagues will work with the nurses and specific attendings to try to expedite discharges. Faulkner Hospital will be notified of possible admissions and transfers, and teams will report back to Dr. Whittemoreís office by noon.
Currently, most discharges occur by 2 p.m. A major goal of the Brigham and Womenís Clinical Improvement Teams is to move discharge times earlier in the day in order to open up beds earlier.
To expedite the discharge process, it is helpful to:
Speak with patients and family a day or two prior to discharge so they are prepared.
Speak with housestaff, Nursing, Care Coordination, and Physical Therapy at least a day prior to
pending discharge so preparations can be made in advance.
Write prescriptions and pending discharge order the night prior to discharge.
Do discharge teaching the night prior to tentative discharge.
Evaluate what tests are needed on the day of discharge so that patients are not
delayed.