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IHI.org has two types of Improvement Stories:
- IHI.org Stories that describe the changes and results in specific organizations.
- Improvement Project Reports from IHI.org users that describe improvement projects in their organizations.
We all learn from others' experiences testing and implementing changes in real settings — who should be on the team; what measures were tracked; which changes worked best or didn't work at all; and what lessons were learned.
Improvement Project Reports, submitted by IHI.org users, accelerate our learning. In the spirit of "all teach, all learn," we encourage you to share your Improvement Report with the IHI.org community. Please click the Submit an Improvement Report button below.
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Patient First: Efficient Patient Flow Management Impact on the ED
Memorial Regional Hospital (Hollywood, Florida, USA) improves care and service in the adult emergency department by focusing on key operational, clinical, and service improvement strategies.
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Early Discharge Program for Premature Infants
Singapore General Hospital’s Neonatal Intensive Care Unit (Singapore) reduced the length of hospital stay for premature infants by 59.8 percent, primarily by implementing processes to improve discharge planning and revise discharge guidelines.
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Better Patient Flow Means Breaking Down the Silos
Patients who worry that their hospital’s emergency department (ED) is too busy to reliably deliver prompt care are in good company. A majority of hospital leaders worry about this, too.
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Working Together to Improve the Patient Journey
North Hampshire Hospital NHS Trust (Basingstoke, Hampshire, UK) improved the process of patient discharge to dramatically reduce the "delayed discharges" and reduce the patients’ length of stay, which has resulted in a reduced need for acute beds.
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Hackensack University Medical Center Decreases Wasted Capacity in the ED from 23 to 10 Percent
With 778 beds, more than 70,000 inpatient admissions and more than 59,000 emergency/trauma department visits a year, Hackensack University Medical Center (HUMC) in Hackensack, NJ, is one of the nation’s busiest hospitals. “We often say we are the victim of our own success,” says Regina Berman, RN, MA, HUMC’s Director of Performance Improvement.
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Shawnee Mission Medical Center Decreases the Average Ambulance Diversion Time in the ED From 82 to 6 Hours Per Month
Putting together a multidisciplinary team from the hospital’s key bottleneck areas was one of the first steps that Shawnee Mission Medical Center (Shawnee Mission, Kansas, USA) took to improve patient flow. The team tested and implemented changes to improve throughput, including faxing reports between units, improving compliance with bed tracking, and scheduling discharge appointments.
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Bellin Health Services Reduces the Average Time from ED Arrival to an Inpatient Bed to Less Than Three Hours
Health care professionals who work to improve the flow of patients through the hospital learn one thing very quickly: the improvement team must focus simultaneously on the micro- and the macro-level system. “If you don’t focus on both, you can optimize one area and sub-optimize another,” says Andrea Werner, MSW, Officer of Innovation for Bellin Health in Green Bay, WI. Improving the pre-surgical flow of patients and smoothing the surgical schedule has significantly improved the efficiency for the surgical patient across the continuum.
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Leading Improvements in Emergency Flow
The Emergency Services Collaborative (ESC) was a pan-England programme run by the National Health Service Modernisation Agency (London, UK) to achieve a 98 percent operational standard by December 2004 for patients to be seen, treated, discharged or admitted within four hours of arrival at Accident and Emergency departments.
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A Pragmatic Approach to Improving Patient Efficiency Throughput
Carondelet St. Mary’s Hospital (Tucson, Arizona, USA) and the Ascension Health Operations Resource Group worked collaboratively to improve hospital flow and increase access to care, reducing the Emergency Center (EC) length of stay by 7 percent, increasing the EC monthly volume by 5 percent, increasing the inpatient daily census by 20 percent, and improving the hospital net operating margin by 1.3 percent above budget.
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Changing Patient Flow Improves Pneumonia Care
Mission Hospitals (Asheville, North Carolina, USA) achieved the 2nd decile ranking in the CMS Hospital Quality Incentive project and improved quality of care for pneumonia patients by implementing a clinical pathway, evidenced-based order set, and a new admission process flow.
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