Addressing Hospital Challenges: Elective Admissions and Patient Flow Management (Full Transcript)

Speaker 1: Where should we start? Unfortunately, the hospitals have a lot of problems. Starting from medieval crowding, stress stuff, many of them are under red ink in anticipation of Affordable Care Act being in action starting January 1st. They are trying to improve it and they don't know where to start. You are absolutely right. So what they do, they start at the places where they see the consequence. So if for example you are a patient and you have a headache due to your blood pressure, it's impossible to cure your continuing headache until you address the cause, the blood pressure. The same is with what the hospitals see. The hospitals are being penalized for example for readmission and it has been documented in a study at Hopkins and others that the readmissions increase by the factor of five during the time when the patient flow peaks. So that's a real problem. We cannot resolve readmission when it increases by 500% by some other actions. I'm not saying that other interventions are not necessary. They are, but they are not sufficient as long as we put the hospitals under stress. So where are those artificial peaks coming from? From elective admission. So what are the sources of elective admission? Mostly it is operating room, catheterization lab, some of the transfers. Those are sources of elective admission. Surprisingly we found that against common sense that those admissions, the volume of those admissions is more variable than admissions through the emergency department, which is against common sense. It means that our mother nature is more predictable than our ways of managing patient flow. So those units where you have elective admission, operating room first and catheterization lab second, those are the starting points.