Hospital Workflow Redesign Could Save Lives

On the outpatient side of primary care, attention recently has focused on the use of the medical home to provide ongoing, quality care. So what would happen if that concept were moved to an acute-care inpatient setting?

According to a study from Geisinger researchers, organizing multidiscipline teams of providers to deliver timely, coordinated, and even personalized care in a hospital—using this concept—could save thousands of patient lives a year.

In a large prospective study headed by Thanjavur Ravikumar, MD, Geisinger's director of surgical innovation, the team realized that the medical home model held answers for its continuum of care study conducted last year at the 242-bed Geisinger Wyoming Valley Medical Center in Wilkes-Barre, PA.

In essence, they say in this month's Annals of Surgery, their continuum of care study—which first looked at surgical patients and then at the medical/surgical population—borrowed tenets from the medical home model that could be used to provide patient-centered care in an inpatient setting:

• Continuity through different transition points in the hospital,
• Proactive interventions to prevent complications,
• Early recognition of patient deterioration to provide a "timely rescue",
• Multi-member team performance and quality-based rounding, and
• Use of electronic health records (EHRs) for real-time information sharing.

The pilot—which was building on earlier research obtained from two New York hospitals over the past decade—sought to "improve the efficiency of the hospital workflow," while reducing hospital mortality and keeping down costs, Ravikumar said.