Located in an area surrounded largely by private residences and small businesses, Northside Hospital’s mission is committed to the health and wellness of the community as well as becoming a regional leader in select medical specialties. The values to support this mission, are: Excellence, Compassion, Community, Service, Teamwork, Progress and Innovation. To align the culture within the organization with these goals, employee volunteerism and community service are promoted by the organization. Within the hospital units themselves, “we are committed to balancing clinical excellence with safe, high-quality, compassionate care for our patients” (www.northside.com, 2014). Like most hospitals, Northside actively seeks feedback through patient satisfaction surveys, conduct extensive quality and performance evaluations, and is continuing to grow its campuses as well as branches throughout the metro Atlanta area, demonstrating great financial stability.
To sustain this growth and success as an organization, many internal business processes must also be addressed on an ongoing basis. One such measure is a patient’s length of stay in the intensive care unit. Garland and Connors (2013), reported in a recent study that there is up to a 10% increase in mortality when transfer from and ICU to a medical-surgical area is delayed by 9-20 hours. This lapse in time and the associated poor outcomes must be improved in order for Northside Hospital to remain a regional leader within our community. Some objectives aimed to achieve this are, entering transfer orders in a timely manner, prioritizing rooms that need to be cleaned, inputting when rooms are ready efficiently, SBAR reporting processes, and multidisciplinary team rounding to improve communications and planning between team members.
Performance measures to track these activities have been developed. The three most widely used models to rate ICU performance on mortality are the Mortality Probability Model (MPM), the Acute Physiology and Chronic Health Evaluation (APACHE), and the Simplified Acute Physiology Score (SAPS) (Philip R. Lee Institute for Health Policy Studies, 2014). Recent literature indicates that the choice of model has little impact on hospital performance assessments (Afessa, 2006).
One strategy that was adopted on the unit to that will aid to sustain this initiative is the use of tele tracking; a system adopted by many hospitals in recent years to improve hospital patient flow and optimizing hospital operations. Through tele tracking, nurses and hospital staff on the unit are able to enter data for a patient transfer in a timely manner. Patient placement facilitators can also be placed on this tracking system, to assist with the prioritization of rooms to be cleaned. When ready, Environmental Services is able to input when the rooms are ready for occupancy (Brown and Kros, 2010). This is only one of several innovative initiatives that can be to connect organizational capacity, efficient business processes, customer value, stakeholder satisfaction, sustainability performance, and market and financial outcomes for Northside Hospital (Rohm and Montgomery, Balanced Scorecard Institute, 2011).
Afessa, B. (2006). Benchmark for intensive care unit length of stay: one step forward, several more to go. Critical Care Medicine. 34(10). 2674-2675.
Brown, E.C., Kros, J. (2010). Reducing room turnaround time at a regional hospital. Quality Management in Health Care. 19(1). 90-102
Garland, A., Connors, A.F. (2013). Optimal timing of transfer out of the intensive care unit. American Journal of Critical Care, 22(5), 390-397; doi: 10.4037/ajcc2013973
Philip R. Lee Institute for Health Policy Studies. ICU outcomes (mortality and length of stay) method and data. Retrieved from http://healthpolicy.ucsf.edu/content/icu-outcomes.
Rohm, H., Montgomery, D. (2011). Link sustainability to corporate strategy using the balanced scorecard. Balanced Scorecard Institute. Retreived from www.balancedscorecard.org