Optimizing Patient Flow with Increased Observation Beds

Blaine Stringer, MSN, RN, CEN, NE-BC, Jill Ehrendreich, BSN, RN, CMSRN, and Cara Jagodzinski, BSN, RN-BC

Cara Jagodzinski, Blaine Stringer, and Jill EhrendreichCara Jagodzinski, Blaine Stringer, and Jill Ehrendreich

On Dec. 4, 2017, the Adult Observation Unit at Rush University Medical Center (RUMC) was relocated from 5 Kellogg to 9 Kellogg. This effort was a result of months of planning and strategizing within the organization to meet the growing needs of the observation patient population.

This move allowed the organization to expand from 12 to 23 beds capable of caring for both outpatient and inpatient populations.

In FY18, the organization had 1,542 observation patients admitted to the general medical floors decreasing their bed availability for inpatient capacity. As of January 2019, only 292 observation patients were admitted to a regular medical bed, projecting a 62 percent increase in capacity for the general medical floors for FY19.

This strategic decision will add to the organization’s effort to reduce wait times for inpatient beds, decrease the declinations for transfers outside of RUMC, and create a service line that is dedicated to the special needs of this patient population.

Members of the 5K Unit Advisory Committee (UAC) were actively involved in planning the move. The members participated by creating the model used to design the budget for staffing and helped create a list of equipment that would be needed on the unit and in each room.

Staffing increased by 50 percent with the bed expansion; UAC members were engaged in the recruitment process by actively participating in the interviews. Staff involvement in the move and unit expansion helped to develop the cohesive team that exists today.

The nursing team is now collaborating with the medical team to establish clinical pathways to help standardize care and increase efficiencies. In the unit’s short tenure, the team has been able to accomplish many of their goals, such as a successful rollout of the Daily Management System (DMS). The length of stay has been below the goal consistently, even with the growing census for the unit.

Optimizing Patient Flow
Structural Empowerment