When the leadership team of a Wilmington, Delaware, hospital sought to improve operational performance of its observation unit, they called upon its trusted hospitalist partner TeamHealth to prioritize, study and improve the situation.
The Challenge
With a commitment to results-oriented partner collaboration, TeamHealth’s clinical leaders drew upon decades of experience in performance improvement. Once it became clear that multiple operational and procedural factors contributed to high length of stay (LOS), TeamHealth hospitalists structured a multi-pronged plan to quickly achieve the desired results for the 146-bed acute care facility.
Challenges ranged from absence of vital fields in the electronic medical record (EMR) and patient lists, to the need for improved discharge procedures and patient observations. For example, staff lacked the ability to accurately identify observation patients in the hospital’s patient list and the hospitalist team’s daily assignments. The patient list lacked fields to denote patient status, thus making the hospital staff take an extra step by adding status into the individual patient chart. Additionally, nurses and clinicians in various departments needed targeted education regarding prioritization of observation discharges over critical patients. When only a few were observation patients, immediate discharge could take second place to a critical inpatient or patients with complex conditions.
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