Localizing Patients for Hospitalist Services on Dedicated Nursing Units

1Cleveland Clinic, Cleveland, OH

Meeting: Hospital Medicine 2007, May 23-25, Dallas, Texas

Abstract number: 68

Background:

Admission to the general internal medicine (GIM) service at our 1100‐bed tertiary‐care hospital occurs randomly, with bed assignments determined on a first come, first served basis. Consequently, patients are dispersed to geographically disparate nursing floors, with resulting inefficiencies in hospital throughput. We sought to investigate whether geographically localized units (GLUs) may resolve this problem. GLUs may improve hospital throughput and be associated with better patient and physician satisfaction, as well as improved nursing‐physician collaboration.

Methods:

For some of the hospitalist services at our hospital, we used “queuing theory” along with admissions/discharge data segmented into two 12‐hour periods (ie, day and night) to analyze changes in hospital throughput for establishing GLUs. Review of operational data showed that most IM admissions failed to get beds assigned on GLU at night. The variance between the demand for GIM beds and available bed supply on the designated GLUs was used to determine hospital throughput, to estimate the number of beds to be held for night admissions, and to calculate the risk of these “held” beds remaining vacant. Based on the analysis, 8 beds on the GLUs were held for night admissions.

Results:

Overall, the number of patients for the selected hospitalist's services on GLUs increased from 30%r40°/o to 70%‐80% during the study period. We also estimated that most new admissions at night would require no additional wait time for beds, and only 28% of night admissions would have waited an additional 1.25 hours for an assigned bed. The risk of a “held” bed staying vacant during the night admission cycle was 8%.

Conclusions:

A combination of queuing theory with hospital throughput data may help to design GLUs and quantify the associated risks.

Author Disclosure:

A. Usmani, None; A. Rajamanickam, None; C. Phillips, None; S. Suri, None.

To cite this abstract:

Usmani A, Rajamanickam A, Phillips C, Suri S. Localizing Patients for Hospitalist Services on Dedicated Nursing Units. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 68. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/localizing-patients-for-hospitalist-services-on-dedicated-nursing-units/. Accessed June 27, 2019.

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