1) Communication and Feedback: It’s hard to believe that it is already August! I hope you have enjoyed some sunshine during one of my favorite times in this area, the Pacific Northwest summer! Please be sure to take time for yourself whenever possible and to enjoy time with your family. With your persistence, we have made it through some difficult weeks. I wanted to start with some good news/highlights first!
2) Good News!
a) Providence St. Peter Hospital has been named a top hospital in the Olympic Peninsula Region, #13 in Washington by US News and World Report, and rated high performing in 9 adult procedures! Providence Centralia Hospital was recognized as high performing for pneumonia. Congratulations and thank you to our physicians and APCs and all of our care teams who work tirelessly to ensure the highest quality of care for our patients!
b) Productive OIG/QRO visit! Thanks to all who participated in our recent visit from the Office of the Inspector General (OIG) as a part of our Corporate Integrity Agreement (CIA). Have you completed your training yet? This training is annual, mandatory, and due to be completed by Friday, Aug. 18 and CME is available for completion! See story below in the newsletter for more information.
c) Christmas in the Forest Gala is our Providence Southwest Washington Foundation’s largest fundraising event. This year’s Fund A Need benefits our No One Dies Alone (NODA) program, focusing on the needs of those nearing end of life without a friend or family member at their side. This event is a fantastic opportunity for physicians to meet with our Foundation board members, to socialize, and to support this program. I hope to see you there Dec. 1! Gala Registration can be found at: Gala Registration - Providence Christmas Forest (provforest.org); Donations can be made at: Providence St. Peter Hospital - Christmas in the Forest - Donation Form - Southwest Washington
3) What to watch: Emergency Center Boarders, Discharge Efficiency and LOS
a) Emergency Center Boarders are a key marker for patient flow inefficiencies through our hospitals. Did you know that while boarding hours are down, we continue to have 50% or more of our ED beds occupied by patients waiting for an inpatient bed? Once this bottleneck starts, it impacts the entirety of the ED workflow. ED boarder numbers are shared every day at Tier 2 (8 a.m. at St. Peter, 9:30 a.m. at Centralia Hospital) and Tier 4 (10:05 a.m.) huddles. I want to make you aware of this high acuity demand at our front door each day! Pay attention to our boarders as a demand signal to improve the flow of patients moving through our facility; how many ED patients are boarding right now?
b) Discharge efficiency is the percent of our total census we discharge each day. Our goal is to turnover 20-25% of our beds daily to make room for patients being admitted. Many days when our discharge efficiency is lowest (8-10%) our boarders remain high in the ED (30-40+ patients); when we discharge a larger percentage of our census (22% on May 27 and July 26!) our boarded patients fall drastically … occasionally as low as the teens or single digits!
c) Improving patient flow will decrease Length of Stay (LOS)! This work is directly tied to ensuring patients get the right disposition to the right place at the right time. Efficient use of the discharge ward (operating on most days now), having discharge planning conversations early, and having coordinating conversations with the care team (nursing, care management, therapies, etc.) are critical to continued success. We have implemented additional huddles after Tier 4 and multidisciplinary discharge/progression to discharge rounds (MDR/PDR) to talk patient by patient to create capacity each day. Geometric Mean Length of Stay Observed to Expected (GMLOS O:E) at St. Peter is down for the first time since April to 1.59 and LOS improved slightly, while both were up at Centralia Hospital. We will continue to work on all aspects of patient flow to drive down LOS at both ministries.