It is important to track three types of measures when you are working to improve the flow of patients through the acute care setting:
Outcome Measures
These measures tell you whether changes are actually leading to improvement—that is, helping to achieve the overall aim of improving the efficient flow of patients through the acute care setting. Examples include the following:
- Time from the decision to admit a patient from the emergency department to placement of the patient in an inpatient bed
- Time from when the patient is deemed ready to transfer from the intensive care unit to placement of the patient in an inpatient bed
- Time from the decision to transfer a patient to long-term care to placement of the patient in a long-term care facility
Process Measures
To affect the outcome measure of improving flow, you will make changes to improve many core processes, including the processes for triage, discharge, the use of protocols, and the scheduling of elective surgical cases, as well as changes to improve the culture as it relates to improving flow. Measuring the results of these process changes will tell you if the changes are leading to an improved, more efficient system. Examples include the following:
- Percentage of patients seen in the "fast track" process for patients with urgent conditions that can be treated relatively quickly
- Percentage of patients with a discharge appointment
- Percentage of patients on protocols
- Number of elective surgical procedures each day
Balancing Measures
Use balancing measures to ensure that changes made to improve the timeliness of the flow of patients through the inpatient setting do not adversely affect other quality indicators, such as unanticipated returns to the operating room, returns to the intensive care unit, readmissions to the hospital, or decreased patient and/or staff satisfaction.
