The Man in the Arena
I want to begin April by saying thank you. Thanks to your hard work, we saw some movement in the right direction for Length of Stay (LOS) at both ministries and came in better than predicted at St. Peter and Centralia hospitals. Thank you for being part of the solution by participating in our initiatives, and for taking exceptional care of our patients. Thank you for modeling professional, courteous behavior for our care teams who look to you for leadership. An often-cited quote from Theodore Roosevelt reminds me that, “The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood,” and each of you are the man (or woman, or person) in the arena.
- Length of Stay – Improved at both ministries! Our Financial Length of Stay (FLOS) at PSPH improved from 6.8 in February to 6.51 in March (projected) and at PCH from 5.4 to 4.85 (projected). Our target will become harder to reach in the coming months, requiring continued efforts with documenting Medically Ready for Discharge date (MRD) and weekend and Monday discharges.
- Epic Medically Ready for Discharge (MRD) date – Epic will add a Medically Ready for Discharge or MRD date by 15 April (see this flier information from clinical informatics, or at the Epic Learning Website (https://epiclearning.providence.org/Content/Learn/Applications/InPatient%20Provider/Expected-DC-and-Medically-Ready-for-DC.htm?Highlight=medically%20ready%20for%20discharge).
The provider will be responsible for populating the date when a patient is expected to be medically ready for discharge. The Expected Discharge Date (EDD) will belong to care managers and nursing teams. We aim for patients to discharge when they are medically ready, meaning the MRD and EDD should be the same in most cases. This functionality will allow better awareness and tracking of discharge delays once patients are medically ready to discharge. Please help us plan for discharges by ensuring that all your patients have an estimated date when they will be medically ready for discharge.
- Weekend and Monday Discharges – Saturday through Monday we admit more patients than we discharge on average. Thank you for your flexibility as we added Discharge Rounds (MPDRs) on weekends, to facilitate communication between our case managers, hospitalists, and nursing leaders. The intent for this process is to better prepare for weekend discharges and to better understand failed weekend discharges. Additionally, we know that our hospitalist teams account for many but not all our discharges. We are working on how to add other teams to our discharge planning processes (or get them access to the information) to improve efficiency and throughput so that every patient needing a bed can get one within 2 hours of admission.
