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Patient throughput: Determine the severity of your problem and identify realistic solutions for your facility

Patient Access Weekly Advisor, August 22, 2007

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Overcrowding directly results in diversion. It also frustrates referring physicians, hospital staff members, and patients and their families, said Susan Werthem, RN, consulting manager for revenue management at IMA Consulting in Chadds Ford, PA. To a patient access professional, this is old news. However, there are new best-practice approaches, such as admissions units, that can help you relieve this gridlock.

The first step is to measure key performance indicators (KPI) to determine the severity of the problem within your organization. Werthem suggested that you take a long, hard look at the hours that your facility is on diversion.

Examine diversion by hour of day and day of week. Perhaps your facility is on diversion more often at a certain time of day. "See if you can find a trend," Werthem said. Then calculate the ramifications of that trend.

Not only is it important to compile this information to fuel any process change, The Joint Commission also requires you to track patient throughput data (Joint Commission standard LD3.15.10). "You need to demonstrate that you're reviewing the data and discussing it on a regular basis, resulting in quality improvement," said Werthem.

The financial impact of diversion is not just from the loss of ED patients. The loss of revenue is also seen through the potential loss of ED admissions and market share.

"Determine the average ED revenue generated," Werthem said. "Then multiply that times the potential number of lost ED patients due to diversion to determine the financial impact."

You can also calculate the same for potential ED admissions, she added.

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