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Discharge to Assess: “Flipping” Discharge Assessment from Hospital to Home

Discharge to Assess (D2A) (also referred to as "flipped discharge") is a redesign of the care process at Sheffield Teaching Hospitals in the UK that involves assessing a patient’s needs after discharge in the patient’s own home rather than in the hospital. Activities that traditionally happen at the end of a hospital admission are instead performed successfully and safely at home, thus enabling patients who are medically ready to go home earlier and spend less time in the acute care setting.

10 IHI Innovations to Improve Health and Health Care

This curated publication highlights 10 ideas that have emerged from IHI's systematic 90-day innovation approach, including reflections on the Triple Aim, the concept of a health care Campaign, the Breakthrough Series Collaborative model, and other frameworks and fresh thinking that have been replicated around the world.

Achieving Hospital-wide Patient Flow

This white paper guides health care leaders and quality improvement teams through an in-depth examination of a system-wide view of patient flow within (and outside) the hospital, including high-leverage strategies and interventions to achieve hospital-wide patient flow.

WIHI: The Right Care, Right Setting, and Right Time of Hospital Flow

March 9, 2017 | Making sure patients get the right care, in the right place, at the right time requires a number of underlying system improvements, including well-designed hospital flow.

Using Real-Time Demand Capacity Management to Improve Hospitalwide Patient Flow

This article reviews real-time demand capacity (RTDC) management as a promising approach to improving hospitalwide patient flow.

Passport Exclusive: Improving Patient Flow in the Emergency Department

In this video, Chuck Noon describes steps you can take to improve flow through your ED.

Passport Exclusive: Perfecting Emergency Department Patient Flow

In this video, Kirk Jensen discusses how to redesign a hospital emergency room that works better for your patients and your staff.

Real-Time Demand/Capacity Management to Improve Flow

Strategies for matching demand and capacity in real time can help hospital teams improve patient flow.

More patients, less payment: Increasing hospital efficiency in the aftermath of health reform

Large gains in hospital efficiency can be made through streamlining patient flow and redesigning care processes.

WIHI: All Hospitals in Favor of Saving Money: Say “Patient Flow!”

December 2, 2009 | A hospital CEO, a chief surgeon, and an operations management expert discuss how they applied the best improvement science available to address overcrowding in the emergency department, vacant operating rooms, a lackluster occupancy rate, stressed staff, and patients waiting around to be seen.

Improving Patient Flow: The Esther Project in Sweden

The community services, the primary care, and the department of internal medicine units in the area of Höglandet, Sweden, discovered a need, in cooperation with each other, to develop a more effective health care system, with better quality and flow for the elderly patients who need care and services from these units.

Improvement Report: Improving Flow of Patients

Bon Secours Venice Hospital (Venice, Florida, USA) has achieved improved patient throughput by decreasing patient disposition time, while assuring safety and satisfaction for both the patient and the health care provider.

Improving Patient Flow at Bon Secours Venice Hospital

Improvements in patient flow have led to greater efficiency and higher patient and staff satisfaction, as well as cost savings for the hospital.

Try Scheduling Hospital Discharges

Imagine the chaos that would ensue if airlines required all flights to depart by 11 AM — and yet, that's a good analogy for the patient discharge process in most hospitals today. IHI's work on improving "patient flow" includes a key innovation: scheduling a day and time for patient discharge.

Profiles in Improvement: Kevin Stange of Alaska Native Medical Center

Kevin Stange of Alaska Native Medical Center (Anchorage, Alaska, USA) shares how he's engaged in improving health care.

Improvement Report: Reducing Length of Stay in the Emergency Department for Psychiatric Patients

For psychiatric patients requiring admission to the emergency department (ED), a multidisciplinary team at Maine Medical Center (Portland, Maine, USA) decreased ED length of stay by over 40 percent — from over 10 hours on average to 6 hours — despite a steady increase in the overall number of patients requiring admission.

Improvement Report: Reduction in Nursing Documentation and Retrieval of Patient Information

A study of workflow on nursing units at Gundersen Lutheran estimates that a nurse on an inpatient unit spends 4 hours of an 8-hour shift documenting and retrieving patient information. It is hypothesized that improving documentation methods and freeing nurses from non-value added documentation and/or duplication of documentation, will provide them more time to directly interact with patients and families, to educate them about their disease process and associated plan of care.

Managing Patient Flow: Smoothing OR Schedule Can Ease Capacity Crunches, Researchers Say

This article explores how some organizations are scheduling elective surgery to better manage the flow of patients throughout the hospital.

Improving Patient Flow from the Post-Anesthesia Care Unit to Inpatient Bed: East Alabama Medical Center

East Alabama Medical Center (Opelika, Alabama, USA) reduces patient transfer time by as much as 80 percent through IHI Collaborative initiatives.

Reducing ED Diversions at Camden Clark Memorial Hospital

With a history of diverting patients away from the emergency department an average of 20 times each month, staff at Camden Clark Memorial Hospital (Parkersburg, West Virginia, USA) knew something had to change. Through careful analysis and the introduction of new protocols and policies, staff have improved the flow of patients into and out of the ED so much that they have gone on diversion only once in the past year.

Improvement Report: Eliminate Overcrowding in the Emergency Department

Baptist Memorial Hospital (Memphis, Tennessee, USA) has improved flow throughout acute care and improved efficiency in the Emergency Department while achieving record patient satisfaction.

Reducing Transfer Time from the Emergency Department to Inpatient Bed: Lee Memorial Hospital

Lee Memorial Hospital (Fort Myers, Florida, USA) reduces their ED to inpatient bed transfer time by 80 percent, using techniques learned in IHI's Improving Patient Flow Collaborative.

Improvement Report: Improving Flow Through the Acute Care Setting

Baptist Memorial Hospital (Collierville, Tennessee, USA), has reduced the median time in hours from the decision to admit a patient from the ED to placement in an inpatient bed from 3 hours and 45 minutes to 1 hour and 31 minutes.

Improving Surgical Flow at St. John’s Regional Health Center: A Leap of Faith

St. John's Regional Health Center (Springfield, Missouri, USA) improved patient flow by reducing the number of surgical hours and cases after 3 PM, while increasing revenue as well as patient and staff satisfaction.

Improving Outcomes in ICUs by Moving Long-Term Ventilator Patients Elsewhere

Learn how one ICU director saved a hospital system $18.5 million and weaned two-thirds of patients off ventilators by transferring them to a local nursing home.