Improving Patient Flow at a Non-Academic Hospital

Emergency department admitted patients used to wait an average of 24 hours for an inpatient bed at Mercy Medical Center. The functional capacity of the ED for 'treat and release' patients was impaired, post-anesthesia recovery room flow was adversely affected, and patient and staff satisfaction suffered. Mercy Medical Center began an organization-wide root-cause analysis to develop an improvement strategy. It revealed physician practice patterns for complex geriatric patients were associated with a mean length of stay in excess of ten days, lifting the hospital's overall LOS to 7.6 days. These practice patterns far exceeded national norms. The solution was to develop a 'geriatric care best practice program' and a unique contractualarrangement with physicians.