Patient Census Dashboard Drives Workflow and Documentation Improvements
Background, Opportunities & Challenges
Founded in 1926, UPMC Pinnacle Hanover and Hanover Medical Group – along with the Hanover Apothecary and Hanover SurgiCenter – provide an extensive array of services throughout York and Adams Counties in Hanover, Littlestown, New Oxford, Gettysburg, Spring Grove, and McSherrystown. The not-for-profit UPMC Pinnacle Hanover has 93 licensed beds and offers a full range of care and treatment options. On September 1, 2017, Hanover Hospital and its network of outpatient services and physician offices (Hanover HealthCare PLUS) became a member of the UPMC Pinnacle family.
Tracking patient census throughout the hospital entailed numerous manual processes and the resulting reports were not always accurate due to workflow issues. For example, clinical documentation took 12 hours to complete after a patient left the emergency department (ED). In addition, the hospital’s registration system may show that the patient has been moved from the ED, but the patient was often still in an ED bed. In many cases, hospital staff resorted to manually counting ED patients to get an accurate census. Although patient census reports were delivered to the hospital’s quality department three to four times per day, the information was often out of date by the time the report was delivered.
“The daily census dashboard created by team members from MIS and Quality Improvement has greatly helped bring “situational awareness” to all staff at UPMC Pinnacle Hanover. This up-todate dashboard provides information on current ED bed status, ED wait times, hospital census, bed availability by unit, pending admissions and a “snapshot” of the previous 24 hours. It has been immensely helpful in fine-tuning our ‘surge plan’ that is based on a frequently updated ED saturation score that is now available for all to see.”Michael Ader, MD | VP Medical Affairs, UPMC Pinnacle Hanover
Over a two-month period, Huntzinger collaborated with Hanover’s LEAN Quality Analyst and ED team to define workflows, improve documentation and change behaviors. These efforts included identifying business rules and matching them to consistent data entry. Data feeds were established with Hanover’s registration system, as well as the ED clinical documentation and inpatient documentation systems. What started as a dashboard evolved into data being displayed on strategically located flat-screen monitors for the staff to view real-time patient census data.
The dashboard is now available on the internet, which makes it convenient for the satellite facilities and affiliates to check census before referring patients to ensure they are accommodated in a timely manner. A series of automated workflows and clinical documentation improvements have increased consistency, which improves the accuracy of the dashboard, expedites processes and provides for a standardized patient handoff between the ED and other departments. ED documentation that used to take 12 hours is now done in real time when the patient leaves the ED. A total of 48 patient volume statistics are maintained by the solution, and they can be searched for retrospective analysis.
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