Literature Review : High Census Improvement Essay

In order to eliminate the inefficiencies witnessed in many public and private hospitals that serve a number of patients, an integrated approach to handling the daily workload is necessary. There is need for all departments within the hospital to work closely together in ensuring more effective and efficient service deliveries. In this paper, a planned change is going to be carried out involving designing a new system that incorporates all the departments within the hospital. This includes the surgery department, pediatrics department, dentistry department, nursing department, pharmacy departments, laboratory and testing department, X-ray and Physiotherapy departments, Equipment maintenance and Engineering department, Information Technology

To improve the performance, there need to be upgrades with the systems that the hospital uses to keep track of the patients information. I recommend using Epic as a tool to help keep all of the patient’s information confidential and easy to access with a click of a button. This will allow for every department to have access to a certain patient’s file whether to be from a doctor entering notes about the patient’s visit, to health insurance billing department making sure that copays and such are being paid and their accounts are kept up-to-date. The hospital governance plays an important role because of the need for funds to help keep the hospital. By providing more outside events to raise money for the hospital will be a great start to being able to fully provide for each patient that comes through Middlefield Hospital doors.

The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload.

Our one hundred bed hospital is in need of updating from paper charting to computerized health records. In doing this, we will meet our goal of compliance with meaningful use legislation. We assembled a team of members to assist with this task and together we have narrowed the search to two health care systems. Those two systems are EPIC and Meditech and we will now discuss the advantages and disadvantages of each, with a final recommendation for our new healthcare system.

In terms of resources and finances, inpatient care is the most costly form of healthcare. It not only requires the medical supplies, but basic care supplies such as food, bedding, etc. It requires more practical resources in terms of electricity and other services, as well as more human resources, as the patients require round the clock care and availability. Hospitals and centers providing inpatient care therefore need a minimum of two shifts, and possibly three in order to avoid unnecessary and costly mistakes due to the workers’ exhaustion.

Rio Grande Medical Center is a full service not-for-profit acute care hospital with 325 beds. Most of the hospital’s facilities are devoted to inpatient care and emergency services, but a 100,000-square-foot section of the hospital is devoted to outpatient (OP) services. Of the 100,000-square-foot OP section, the OP Clinic uses 80%/80,000-square-feet, and the remaining 20%/20,000-square-feet are used by the Dialysis Center. Increased patient volume at the OP Clinic has created a need for 25% more space than it is currently assigned. Due to its large size and patients’ need to access other departments the decision has been made to move the Dialysis Center to another location, and allow the OP Clinic to

Throughout this course I have learned about the various challenges that impede productivity and efficiency at today’s hospitals. These issues facing the modern healthcare organization come in varying forms from technological, staffing, and financial to name a few. There are no limits to what hospitals can face in these modern technologically savvy times. Below are the major issues that today’s hospitals are facing, though there are many facets to these topics it will be described as best as possible to meet overall challenges:

When a patient becomes hospitalized, it is important to ensure patient safety and satisfaction. A process known as hourly rounding has been implemented in many hospitals as a way to achieve this increase in patient satisfaction. The hourly rounding process consists of four concepts that are covered with each hourly round. When these concepts are implemented, the nurse will anticipate the needs of the patient and prevent unnecessary and untimely call lights. Hospital implementation of this process may receive some resistance but with the proper training and education this process can increase patient safety and patient

When overcrowding occurs, patients are placed in the hallway waiting for room to be transferred to. Any time overcrowding occurs most ambulances divert away from the closest hospital to the patients and in this situation hospitals lose a lot of revenue. Data published in the US Department of Health and Human Services (HHS) in 2004 report national hospital ambulatory medical care survey on ED summary depicted that ED in United State are approaching a boiling point in terms of increasing patient demand and shrinking bed capacity, Levin et al (Fall,2006). According to the Institute of Healthcare Improvement, a recent survey conducted by the American College of Emergency physician of about 200 hospital administrators, majority pointed at overcrowding as their major constraint and about 60% said overcrowding in their facility forces the diversion of patients with urgent need

The health care industry continues to be challenged by daily patient turnover due to the number of admissions, transfers, and discharges (Spader, 2008). The increase in number of admissions, in turn, puts a high demand on nurses in keeping up with the pace resulting in nurse frustration and dissatisfaction. According to Lane (2009), a thorough and comprehensive admission process is critical in providing quality patient care. Completing the admission process in a timely, efficient, and comprehensive manner has

Health care systems across the world are facing a number of challenges, which include changing patterns of diseases, a shortage of health care professionals, inaccessibility of services, and insufficient resources. Given that an increasing population creates a greater demand for healthcare services, the shortage of hospital beds due to high admission rates and increased length of stay are some of the challenges that the healthcare system of Saudi Arabia is struggling to overcome. The Saudi Arabian government funds 244 hospitals that have a capacity of 33,277 beds (Almalki, Fitzgerald, & Clark, 2011). However, there was a forecast of bed capacity shows that, by 2013, the healthcare system in Saudi Arabia will require about 14,700 additional beds to meet the increasing demand for healthcare services (RNCOS, 2011). The shortage of beds implies that the healthcare system needs to formulate ways of increasing hospital bed capacity. The problem being investigated is the Saudi Arabian hospital bed shortage due to increased length of stay in hospitals by patients with chronic illnesses, the elderly, and the disabled. The purposes of the proposed study are to describe the post-acute care needs and also the need for effective discharge planning.

The Computerized Provider Order Entry is effective program to help organization improve quality measures and financial margins. The CPOE is effective program; which monitors a hospitals current performance and calculates methods of improvement. For example, Trinity Hospital a leader in clinical intelligence to track and report across it members hospitals on systems wide quality measures (Balgrosky, 2015). The Clinical Provider Order Entry will help patients compare programs graded by the Center for Medicare & Medicaid and Hospital Quality Assurance. This program will further enhance the patient-centric model because patients will have comprehensive comparison of hospitals to make informed medical decision as to where they would like to receive treatment. The quality measures monitor readmission, complications, patient’s experience surveys and other categories. Patients are interested in receiving health care in top-notched care facilities that address their needs. Consumer needs are very important because translating into referrals by word-of-mouth or rankings. Technology plays a major role in an organization's success with supports Judy Murphy idea of enhancing patient’s health information technology

The hospital is currently utilizing 71.43% of their beds, this is actually an ideal operating point. To increase its rate of utilization might decrease the service quality.

The cost of the health care industry has always been rising since the early 1980s. It has been a growing concern in both the industry and society. Massachusetts General Hospital (MGH) is no exception. Even though the average length of stay (LOS) for the patients in MGH has been declining (Exhibit 10), it is still the highest compared to their competitors (Exhibit 6). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital. MGH lacks communication and coordination between the facilities.

Middletown Hospital is a 200-bed, not-for-profit-general hospital that has an emergency department with 20 emergency beds. The emergency department handles on an average 100 patients per day. The hospital’s CEO has authorized the Six Sigma Team (SST) to address complaints received from patients seeking treatment between 6:00 p.m. and 10:00 p.m. The complaints are centered on waiting times and poor service. During this time the data indicates that approximately 70% of the department’s admissions occur (University of Phoenix, 2009, Course Syllabus).