More staff and more beds are not the answer. To prevent overcrowding in the emergency department this flu season, start with challenging accepted practices, bolstering leaders, and promoting a culture of efficiency.
Let's face it: resources are limited. You can only hire so many surgeons and so many nurses. Your hospital has only so many rooms, and so many beds. And, of course, there are only so many hours in every day.
During flu season, this is not something hospital management wants to hear—and neither do the sick, scared and feverish patients waiting in your emergency room. Especially this year.
With the recent Ebola hysteria still fresh in the public's mind, waiting rooms will be more crowded than ever this flu season, predicts Eugene Litvak, PhD, president and CEO of the Newton, MA-based Institute for Healthcare Optimization.
"We anticipate a spike in patients seeking emergency treatment—that always happens during the flu season—but it will be even worse with the current Ebola fears," says Litvak. He predicts unprecedented demand followed by unprecedented mismanagement of capacity in the coming months.
But with some organizational changes, it's possible to minimize the backups, he says.
1. Improve Patient Flow
A common cause of backed up emergency departments is inefficiently scheduled surgeries. Certain times of the day or week are popular with surgeons, and it's not uncommon for two surgeries by different surgeons to be scheduled back-to-back. The problem arises when one runs over, causing multiple employees' and patients' schedules to run behind.
This practice also causes more beds, rooms, doctors, and nurses to be occupied by post-surgery patients, all at the same time—which wouldn't be an issue, except that during busy times, patients don't stop coming through the emergency department door.
But there is a strategy that can get the peaks and valleys of demand under control.
"It's much easier to admit patients through improved scheduling—it puts your organization in a better position to meet increased demand. This is how to prepare [to have the] capacity for increased demand," says Litvak.
Litvak uses the example of Cincinnati Children's Hospital, which was able to streamline its patient flow through improved scheduling practices. The organization has since been able to increase surgeries performed by 7%—but there was an even more important effect.
Due to the reduction in congestion, surgeons, ED staff, and nurses experienced a 57% drop in extended hours worked, improving work/life balance. The improved efficiency allowed the hospital to save $115 million yearly, says Litvak.
2. Hire Strong Leaders
"Improved efficiency is good for patients, hospital finances, surgeons, and any other physicians," says Litvak. "The only group it is not good for is leaders who do not have the necessary leadership skills or commitment to do what is necessary."
While it's easy for hospital leaders to talk the talk about improved efficiency, it isn't quite as easy to put into practice. Getting back to the scheduled surgeries example, there is a fear, says Litvak, that medical staff will leave the organization, or physicians who have admitting privileges at multiple facilities will admit their patients elsewhere if they can't schedule surgeries at the time they want them—or perpetuate other equally inefficient practices.
The way to deal with this is to be firm, suggests Litvak. "If you're a real healthcare leader, [you] would talk to this [physician] and tell them why [their current scheduling practices are unacceptable]…. If [you] are not a real leader, [you] will bow to physician's demand," he says.
HR can help create and maintain strong leadership by backing up leaders who take a stand for the greater good of the hospital's staff and patients and by spreading the word about the benefits of improved efficiency.
Make sure the offenders know that they're slowing everyone down through their inefficient scheduling practices. It's possible they are simply unaware as to why proper timing of surgeries—and other efficient practices—matter.
3. Promote a Culture of Efficiency
Beyond taking a stand for those who push efficiency, make it clear that running your organization in an efficient way is a priority.
While some employees may not initially like this approach, they may change their minds when they realize that efficient policies mean decreased overtime, improved morale, and better employee satisfaction—not to mention an improved patient experience.
Additionally, inefficient practices in hospitals have been shown to decrease quality of care and, in some cases, increase rates of infection, says Litvak. Furthermore, higher rates of infection can negatively affect Medicare reimbursements and quality scores. Armed with this knowledge, you should be able to win over most members of your staff.
"Every clinician wants to do the best for the patient-- They're just not always aware of the solutions," says Litvak.
Lena J. Weiner is an associate editor at HealthLeaders Media.