This story originally appeared in IHI's 2007 Annual Progress Report.
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 suboptimize another,” says Andrea Werner, MSW, Officer of Innovation for Bellin Health in Green Bay, Wisconsin. Improving the pre-surgical flow of patients and smoothing the surgical schedule has significantly improved the efficiency for the surgical patient across the continuum. In the GI suite, for example, capacity increased by a third without adding new staff or space.
“Our surgeons can practically turn and scrub and go right into the next procedure,” says Werner. Similar improvements in the Emergency Department decreased patients’ average “door-to-doctor” time from 57 minutes to 22 minutes. “But these improvements meant we also had to make sure we weren’t creating a bottleneck to the nursing units where those patients end up,” she says.
Chief Nursing Officer Laura Hieb, RN, BSN, MBA, says that the factors that contribute to Bellin’s success at improving flow include strong support from leadership, accountability, sharing of data with staff, and someone — in this case, Andrea Werner — championing the process at the macro level. Another key is teamwork: the “flow group” — including leaders and front-line staff — meets regularly to review and plan flow activities.