7:00 AM - 8:00 AM

Registration and Continental Breakfast

8:00 AM - 8:30 AM

Welcome, Introduction, and Table Discussion
Kirk Jensen, Roger Resar, and Kevin Nolan

This session introduces a framework for improving patient flow. Attendees will be asked to share their current work to improve hospital flow in their organizations. 

Materials:  Welcome

8:30 AM - 9:00 AM

Hospital Flow as a Strategic Initiative
Kirk Jensen and Kevin Nolan

To successfully improve hospital-wide patient flow, it must be a key priority in the organization. This session discusses a strategic execution framework, including sponsorship, oversight, and resources and responsibilities. Attendees will be asked to address the current relationship between patient flow and their organization’s strategic priorities.

Objective: Describe the framework and resources for implementing a flow execution strategy.

Materials:  Hospital Flow as a Strategic Initiative:  How Strong is Organizational Will

9:00 AM - 10:00 AM

Key Strategies for Improving Hospital Flow
Kirk Jensen

Patients and providers alike regard waits, delays, and cancellations as a normal part of getting and giving care. However, patient safety, hospital revenue, staff satisfaction, and patient satisfaction are all negatively affected when patients, information, and materials do not move through hospitals efficiently. This session introduces the following key strategies for improving patient flow: demand and capacity management, real-time monitoring of patient flow, forecasting, queuing theory, the theory of constraints, and managing variation.

Objective: Describe several key strategies for improving patient flow.

Materials:  Key Strategic Concepts for Improving Flow

10:00 AM - 10:30 AM

Break

10:30 AM – 11:15 AM

Understanding the Performance of Hospital-Wide Patient Flow
Kevin Nolan and Roger Resar

The common solution for busy units is simply adding beds. This session introduces several tools that will help identify wasted capacity and measure hospital performance. Useful metrics to gauge the impact of hospital flow improvement strategies will also be summarized. Faculty will lead a discussion on designing realistic aims and targets in your organization’s flow improvement efforts.

Objectives:

• Identify wasted capacity.
• Measure impact of hospital flow improvement strategies.
• Define realistic aims for your organization’s flow improvement efforts.

Materials:  Understanding the Performance of Patient Flow in a Hospital

11:15 AM – 12:00 PM

Introduction to Real-Time Demand Capacity Management
Roger Resar

This session lays the groundwork for designing a predictive tool for admissions and discharges that, when applied at a system level, will allow the redistribution of resources on a daily basis to maximize hospital throughput. Key predictions will involve short-term admissions and discharges connected to a daily unit status. Attendees will develop an understanding of how to achieve a useful level of reliability in their designs, and faculty will use examples of organizations currently employing these designs. The use of these predictions will be tied to a simple strategy for identifying bottlenecks and developing strategies to improve the flow. Lastly, the session will introduce the concept of “sequencing” in design.

Objectives:

• Design a predictive tool that is used for real-time demand-capacity management.
• Develop an understanding of how to achieve a useful level of reliability in designing a predictive tool.
• Use the predictive tool to identify bottlenecks and develop strategies to improve flow.
• Describe the concept of “sequencing” in design.

Materials:  Real-Time Capacity Management

12:00 PM - 1:00 PM

Lunch

1:00 PM – 4:00 PM

Real-Time Demand Capacity Management (Continued)

1. Overview of Key Components — Roger Resar

Objective: Summarize the main components of real-time demand capacity management.

Materials:  Real-Time Capacity Management

2. Focusing on Bottlenecks — Kirk Jensen
In order to improve hospital flow, organizations must identify, challenge, and intensely manage system constraints. Efforts spent improving a non-critical bottleneck will not improve the overall performance of a system. This session will review the concept of a bottleneck and its connection to real-time demand capacity management.

Objective: Describe the concept of a bottleneck and its connection to real-time demand capacity management.

Materials:  Focusing on Bottlenecks

3. Making Improvements — Kevin Nolan
Every system is perfectly designed to get exactly the results it gets. Therefore, in order to improve performance, organizations need to redesign their systems and processes. This session will introduce methods for redesign and will then apply them to the redesign of a real-time demand capacity management system.

Objective: Apply methods for redesign to a real-time demand capacity management system.

Materials:  Making Improvements

4. Case Discussion — Deb Kaczynski, UPMC Shadyside
During this session, attendees will have the opportunity to participate in a discussion based on one hospital’s success. Attendees will also have time to reflect on the sequence of steps used by the hospitals to redesign their real-time demand capacity management system.

Objective: Examine the sequence of steps used by the case study hospital to redesign their real-time demand capacity management system.

Materials:  A Day in the Life:  Real-Time Demand Capacity Management in Action at UPMC Shadyside 

4:00 PM - 4:45 PM

Managing Variability in Patient Flow
Marilyn Rudolph

This session introduces variability methodology and demonstrates the effect of variability on access to care, nurse staffing, cost, and quality of care. Key measures and real-life examples of managing variability to improve patient flow will be presented.

Objectives:

• Identify the effects of variability on patient safety and quality of care.
• Describe key considerations in managing variability to help improve patient flow.

Materials:  Managing Variability in Patient Flow

 4:45 PM - 5:00 PM

Final Questions and Summary

 5:00 PM - 6:00 PM 

Networking Cocktail Reception (optional)

7:00 AM - 8:00 AM

Continental Breakfast
*IHI Marketing Representatives will be available at the registration desk from 7:30 AM – 8:00 AM for questions regarding IHI and IHI’s programs.

8:00 AM - 8:30 AM

Introduction to Day 2
Kirk Jensen, Kevin Nolan, Roger Resar

8:30 AM - 9:30 AM

Improving Flow in Surgery
Marilyn Rudolph

Most hospitals experience daily challenges in effectively managing perioperative flow. This session will focus on strategies and tactics that describe how to improve efficiencies and throughput in the perioperative setting.

Objectives:

• Explain the relationship of surgery and perioperative efficiencies to overall patient flow.
• Identify tips for gaining efficiencies in surgery to facilitate patient flow.

Materials:  Improving Flow in Surgery

9:30 AM - 9:45 AM

Break

9:45 AM - 11:15 AM

Improving Flow in the Emergency Department
Kirk Jensen

Acute care settings are plagued with waits, delays, and diversions and hospitals are increasingly challenged to address these problems. This session outlines and defines key challenges, opportunities, and constraints within the emergency department. Key strategies and successful approaches, drawn from operations and service management, to breaking down typical barriers and optimizing patient flow will be shared.

Objective: Describe several successful strategies that can be used to address key challenges and constraints within the emergency department.

Materials:  Improving Flow in Your Emergency Department

11:15 AM -12:00 PM

Improving Discharges and Transitions
Roger Resar

This session focuses on poorly designed discharges and transitions either within the hospital or to locations outside the hospital. The identification of bottlenecks defined by key flow metrics on identified “bad” days will be used to determine these effects. The session includes the concepts of discharge appointments and transition slots in the design for these discharge and transition strategies.

Objective: Apply strategies to identify and mitigate bottlenecks that occur during discharge and transition of patients

Materials:  Improving Discharges and Transitions

12:00 PM – 1:00 PM

Lunch

1:00 PM - 1:45 PM

Extending the Chain: Collaborating with Extended Care Facilities
Marilyn Rudolph

Hospitals often feel buffeted by forces beyond their control. Events occurring outside of the hospital are often some of the chief determinants of the flow within the hospital. Whether or not they own the geography, hospitals end up owning the problem. This session focuses on the development of creative solutions and collaborative partnerships that grow out of mutual regard, shared benefit, and, most importantly, patient need.

Objective: Depict strategies to effectively partner with facilities and resources outside of the acute care setting to improve patient throughput.

Materials:  Extending the Chain: Collaborating with Extended Care Facilities

1:45 PM - 2:30 PM

Execution: Project Management and Change Management
Kirk Jensen and Kevin Nolan

Organizations can have good ideas and the will to make changes but fail in their improvement efforts due to the lack of skilled execution. Two important components of executing projects will be discussed in this final session.

Objective: Identify strategies for project management and change management.

Materials:  Execution: Project Management and Change Management

2:30 PM - 3:00 PM

Summary and Adjourn