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Bottleneck breakdown: Resolve your discharge process first

Case Management Weekly, September 4, 2007

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People often point to long wait times in the ED as the source of bottlenecks in the patient access process. However, the problems do not always originate at the beginning of a hospital visit; instead, the end of the process - the discharge - is often to blame.

Lehigh Valley Hospital in Allentown, PA, learned this lesson during a three-year period.

In 2001, the hospital administration made it a priority to solve this growing problem. The hospital held a retreat with leadership from every department in the hospital.

Modeled after similar programs at Southwest Airlines, the group identified where it thought the problems began. Terry Capuano, RN, MSN, MBA, senior vice president of clinical services, formed teams to look at each problem. Between 2003 and 2005, the hospital took on 17 projects aimed at reducing bottlenecks.

As a result of these early projects, Lehigh adopted many changes to improve the discharge process and reduce bottlenecks; the most important areas of focus include a patient logistic system, improved ancillary services, modified rounds, and physician extenders.

Source: Patient Access Weekly Advisor, August, HCPro, Inc.

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