Accreditation

Learn how a model hospital maximized throughput

Briefings on Accreditation and Quality, January 1, 2005

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The JCAHO's new patient flow standard, LD.3.15, takes effect this month, and JCAHO president Dennis O'Leary is pointing to Boston Medical Center (BMC) as a model system for improving throughput.

In 2003 more than 117,000 patients visited BMC's emergency department (ED), home of the largest 24-hour level I trauma center in New England. The hospital admits more than 27,500 patients annually and employs more than 1,300 nurses.

Even though it's one of the state's busiest hospitals, the 547-bed BMC has successfully overhauled multiple hospital systems to improve throughput and maximize productivity, including a 3%-4% increase in the medical/surgical volume.

"Anybody who comes to me and says, 'I can't do this,' I'm going to send them to [BMC]," Leary told the Boston Globe in a July 8 article.

Eugene Litvak, PhD, professor of healthcare and operations management at Boston University and director of the program for management of variability in healthcare delivery (MVP), worked with John Chessare, MD, chief medical officer at BMC, to secure a grant from the Robert Wood Johnson Foundation, an organization dedicated to improving the health and healthcare of all Americans. With this grant, the team tested Litvak's theory that flow problems in the ED stem from a lack of available hospital resources, including inpatient beds. To fix the ED's problem, the hospital must improve its other systems, Litvak told BOJ.

Note: The approach Litvak and Chessare took at BMC is universal, but organizations need to customize how they carry out the changes to meet their individual needs, says Litvak.

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