Portion Control Opportunities: Real Time Gains for Hospital Patient Throughput (Trends‪)‬

Streamlining the discharge process to increase bed availability is an outcome measure of multidisciplinary efficiency and effectiveness; it signals that the hospital's systems, people, and processes are aligned to deliver the best patient care possible. Getting patients in and out of beds smoothly is one of the toughest challenges in running a hospital today. Capitalizing on precious resources, saving on construction of new beds, and maintaining or even reducing costs in a time when access to capital is difficult are clearly among the ultimate goals of hospital leadership (Goldberg and Petasnick 2010). Being fiscally responsible while improving the inpatient discharge process demonstrates to stakeholders (e.g., doctors, employees, patients, community) that the healthcare organization has their best interest at heart. Effective patient discharge is challenging. A problem in any one element (of the dozens involved) in the discharge process can cause delays in case management coordination and support services, the actual movement of the patient from the bed, follow-up care needs, and other next steps in care delivery. Many hospitals have streamlined the discharge process, assigning autocratic decision-making authority to bed "czars" to properly allocate in-demand resources to get the patient out and turn over beds to new patients coming from the operating room, the emergency department, or direct admission. This bed-czar system has helped, but it has not prevented lengths of stay from increasing, which has led to constructive criticism from stakeholders and reports of decreasing satisfaction from patients. This indicates that the facility's overall patient throughput requires re-examination. This can be best accomplished through an approach known as portion control opportunities (PCOs).