MEDITECH and Forward Advantage Boost Greenwich Hospital's Bed Turnover Rates
(8/20/2008)

Hospitals with both inpatient and outpatient care settings are asked to perform a constant juggling act—making beds available for scheduled inpatient procedures, while also accommodating the influx of patients coming into the ER. If one of the balls in the air gets dropped, the consequences are severe: longer wait times, decreased revenues, limited patient census numbers, low patient satisfaction scores, and perhaps most devastating, the dangerous situation of patients leaving the ER without receiving the necessary care.

Greenwich Hospital (Greenwich, CT) confronted these challenges by implementing MEDITECH's Bed Board and Forward Advantage's Bed Stat™ solutions. Bed Board, a dashboard screen used to manage all functions of bed placement, and Bed Stat, a telephony interface, have automated Greenwich's bed management processes, enabling the hospital to maximize bed utilization and ultimately improve patient satisfaction.

The organization went LIVE with Bed Board in December 2007 and with Bed Stat in January of 2008. In just a short time, Greenwich began to reap the benefits of its automated bed management system—and has kept its eye on the balls ever since. "We've seen a decrease in patient waiting times, between coming into the ER, being admitted as an inpatient, and securing a bed," says Trish Babcock, manager of case management and patient throughput at Greenwich. "In less than six months, with the assistance of Bed Board, we were able to further refine our average time by 30 minutes, and achieve our goal time of 270 minutes."

Out With the Old: Manual Processes, Miscommunication, Lack of Data
Prior to their Bed Board and Bed Stat implementations, Greenwich managed its bed placement process manually, often relying on verbal communication. This often led to inaccurate assessments of bed availability throughout the hospital. Reliance on verbal cues especially posed problems for the housekeeping staff, whose messages were often not communicated effectively.

"Before Bed Stat, our housecleaning staff told the unit secretaries as soon as a bed was clean and available. This information was not always passed along to the bed placement coordinator, leading several of our units to have unoccupied beds," says Rosario Simone, environmental service manager at Greenwich. "At the same time, Admissions and the ER were not aware which of our rooms were clean and ready for patients."

A lack of communication across the units was a recurring problem at Greenwich, facilitated by the absence of an automated system to keep everyone on the same page in terms of bed availability. "When a patient was discharged from a room, the housekeeping staff would clean the room; however, with a busy nursing staff, the discharge would not be entered into the system until long after the discharge had taken place. Although the room was clean, the bed was still listed as dirty to Admissions and the ER," explains Babcock.

"But with Bed Board in place, Environmental Services can verify whether a bed status has not been updated properly, prompting an inquiry into the timelessness of discharges. Now, with all bed statuses displayed across the hospital units, we have created a more transparent bed management environment, resulting in discharges being processed quicker."

In with the New: Bed Board Integrates Across All Hospital Units
The lack of an automated bed management process led Greenwich to search for a solution, with the paramount concern being integration with their MEDITECH Health Care Information System. The search quickly ended after learning MEDITECH's Bed Board solution was part of Greenwich's most recent MEDITECH update.

"Before implementing Bed Board, we looked at several other third party products," says Jim Weeks, Greenwich's chief information officer. "We were thrilled to learn MEDITECH offered a free bed management solution with our update. Not only did it offer the functionality we were looking for, but we immediately saw the benefits of seamless integration between Bed Board and our other MEDITECH solutions. If we had selected another vendor, it would have required its own interface and dedicated server, and another set of authentication and upgrades."

Bed Board's accessibility has proven to be an invaluable asset for all the staff at Greenwich, but especially for the bed placement coordinator, who is responsible for managing patients' bed placement. Every morning, the bed placement team has a meeting to discuss bed coordination for the day, and the bed placement coordinator brings her tablet PC to the meeting, allowing her to place patients in beds, even when she is away from the hospital floor. "We have immediately noticed our bed placement has been expedited due to Bed Board's accessibility throughout the hospital," says Quinton Friesen, senior vice president and chief operating officer at Greenwich.

Even more impressive, Bed Board's accessibility is not restricted to the confines of the hospital. "Not only can Bed Board be run from anywhere throughout the hospital, it's also accessible from home, as long as there is a staff member at the hospital to monitor the system," says John Hegarty, manager of patient access at Greenwich. "We are able to maximize bed placement with Bed Board's seamless integration inside and outside the walls of the hospital."

Bed Stat's automated telephony interface automatically updates the MEDITECH system as soon as a bed is cleaned, or is in the process of being cleaned. The phone interface has been well-received among all housekeeping staff, particularly for its minimal user-training requirements.

"By using a phone to update the status of beds, Bed Stat offers an interface everyone is familiar with," says Darla Rigg, vice president of marketing and product management at Forward Advantage. "The housekeeping staff does not need to be trained to use the hospital's MEDITECH system, which has proven to be a win-win for everyone involved in the bed management processes at Greenwich."

Immediate Improvements in Admissions, Transfers, and Discharges
Once the site went LIVE, Greenwich noticed immediate improvements. Whether a patient is being admitted, transferred, or discharged, the up-to-date information is always available for accurate bed placement.

"Bed Board and Bed Stat have created transparency in our bed management efforts," says Simone. "Using the Bed Board tracker, housekeeping is notified immediately once a bed is ready to be cleaned. With the tracker, there are no hidden beds, as everyone is on the same page as to what is available, being cleaned, or currently occupied by a patient."

The Bed Board tracker also provides real-time status of all beds, including any beds which have pending discharges. "The Bed Board tracker provides our staff with a snapshot of the bed placement activity throughout the hospital. For example, bed placement for patients from the Operating Room can be pre-assigned using the reservation feature, which notifies the units of their upcoming patient intake," says Terry Azzara, RN, bed control manager at Greenwich.

Babcock further explains how Greenwich is able to proactively increase bed turnover rates. "Bed Board's 'Big Board' provides a visual dashboard of all pending discharges. As most discharges are in the morning, bed reservations can be made for the occupied beds the morning of the discharge."

Bed Board Aids in Infection Control
While improving the bed turnover rate was one of Greenwich's most noticeable improvements, their Bed Board solution has also armed them with improved awareness about infection control. As the quality standards established by The Joint Commission and other industry organizations continue to become more stringent, hospitals must look to all avenues which will aid in the improvement of care quality delivered to patients. With infection control being a top priority for all hospitals, especially in terms of isolation beds, Bed Board ensures these specialty rooms are managed and treated properly.

"Bed Board alerts our housekeeping staff if a bed is an isolation bed, ensuring the proper precautions are taken so these beds are cleaned with the proper products," says Azzara. "Prior to Bed Board, this information was not always made available on a consistent basis."

Faster Turnaround Time Increases Patient Satisfaction
With this new, enhanced bed management process, it is no wonder Greenwich has seen record numbers of patients coming through the door this year. "Between October 1 of last year and March 31 of this year, our hospital census has been the highest it has ever been in the 15 years I have been here," says Friesen. "Bed Board provides our staff with the tools necessary to significantly cut the time it takes for patients to be admitted, treated, and released."

Even with this surge in patient census, Greenwich has not found it necessary to add staff to its bed placement group. "By using Bed Board and Bed Stat, our bed placement team is operating with more efficiency; therefore we have seen no need to hire additional staff," says Babcock.

Faster turnaround times have also translated into increased patient satisfaction. "We have seen a direct correlation to patient satisfaction survey results from Press Ganey based on the decrease in wait times in the ER," says Babcock. "Bed Board enables our staff to handle higher patient volumes, while at the same time decreasing the amount of time patients wait for a bed. I cannot see how we would be able to manage this surging census without the help from Bed Board and Bed Stat."

 

MEDITECH
Medical Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com