The implementation of a new electronic health record presented Lehigh Valley Health Network in Pennsylvania with an opportunity to kick patient throughput efforts up a notch. Lehigh leaders in August 2015 launched a real-time dashboard populated with key throughput metrics pulled from the EHR, helping earn it a Most Wired Innovator Award from Hospitals & Health Networks and the American Hospital Association.
Every weekday, 30 to 40 people from a variety of departments at the system’s two acute care hospitals huddle quickly to review the digital dashboard to plan for the day and review performance from the day before.
Before the electronic dashboard’s creation in collaboration with Epic Systems Corp., throughput data were gathered manually and written on a white board for the daily huddle. By the time leaders gathered, much of the information no longer reflected what was happening inside the hospital, says Richard Kerr, administrator of clinical and revenue cycle software applications management in information services for Lehigh.
Now the dashboard collates easily digested tables and graphs of key throughput indicators, including overall hospital and emergency department census and anticipated operating room and post-anesthesia care unit volume for the day. The dashboard also displays discharge orders before 11 a.m., average transport times and room cleaning times from the day before.
Participants in the huddle are the leaders who can effect change, Kerr notes. The group includes the directors of all the clinical units, hospitalists, and representatives from pharmacy, respiratory, nursing, the ED, perioperative areas, environmental services, transport, and administrative and physician leadership.
“The huddle gives you the pulse of the hospital in that moment and what to focus on today,” says Emily McCormick, manager of access applications on the Epic implementation team. “In 15 minutes you get that picture, and you’re ready to go.”
The team tries to anticipate potential problems, and everyone in the huddle rallies around the appropriate department to figure out what they can do to solve the issue, says Janice Wilson, R.N., chief nursing information officer.
Metrics motivate performance improvement, especially if the previous day’s metrics indicate that goals haven’t been met, Wilson says. Leaders use the data to identify the cause of the slowdown and to propose solutions to prevent it in the future.
The use of real-time throughput metrics enables the team to act on them immediately. For example, the dashboard has already helped the system reach one of its main goals: eliminating ED diversion.
It has also led to permanent changes. For example, an analysis of environmental services and transfer times led to a reallocation of environmental and transport staff during peak discharge hours to speed room turnaround time.
Beyond improving patient care by reducing wait times and care delays, the dashboard fosters staff engagement. “I feel more connected to the hospital and understand why I’m important to what we do,” McCormick says.
The Most Wired Innovator Award honors hospitals that apply technology in innovative ways, finding creative solutions to serve their patients, staff and communities. A panel of chief information officers and others evaluate submissions on a variety of criteria, including universality and achievement of business objectives, creativity and uniqueness of concept, impact on the organization, scope of the solution, state of implementation, and technical creativity.