Collaboration helps BWFH manage high inpatient volume

Each morning, clinical and operational leaders from across Brigham and Women’s Faulkner Hospital gather for a brief, 15-minute meeting—referred to as Daily Safety Huddle—to identify obstacles to managing patient care and flow in a safe, timely manner. Recently, a subgroup from that meeting has begun staying behind when needed to focus specifically on managing high inpatient volume.

“It’s not any one diagnosis that’s contributing to our high inpatient volume,” says Chief Nursing Officer and Vice President of Patient Care Services Cori Loescher, MM, BSN, RN, NEA-BC. “We have patients who’ve just had surgery in our operating rooms, and we have patients who come to us through the Emergency Department with an array of diagnoses. But their needs are the same—they need a bed on an inpatient unit where they can receive the care they require.”

Loescher, along with Chief Medical Officer and Vice President of Medical Affairs Scott Schissel, MD, PhD, conduct the Daily Safety Huddle each day. With key stakeholders already in the room, it seemed like a prime opportunity to collaborate further to address the growing daily need for inpatient beds.

On days when inpatient capacity is a challenge—either there are more anticipated admissions than discharges or the Emergency Department is on Capacity Disaster—the group huddles to discuss how best to use the resources available.

Asked to participate in the huddle are the Nursing Supervisor, Nurse Directors for all the inpatient units, the perioperative services leader, leaders from Emergency Department, Department of Medicine and Department of Surgery, Case Management, Admitting and directors from support services such as the Laboratory, Radiology, Infection Control and Non-Invasive Testing.

“The main goal is to identify barriers to discharge. With this group together in one room, we can evaluate our patients who are preparing for discharge and work together to make sure the proper steps can be taken in a timely manner to get them safely home. That might mean asking the Non-Invasive Testing Department to prioritize a patient’s echocardiogram or asking the Lab to rush a sample. It might mean moving a patient who is fully independent but just waiting on a test result to our discharge lounge. We’re looking for opportunities to free up those much-needed beds as soon as possible,” explains Dr. Schissel.

“Every bed counts,” says Loescher. “Even if one or two patients can leave their room, it allows that room to be cleaned and prepared for the next patient.”

The ultimate goal is to ensure every patient who comes to BWFH receives the care they need, when they need it.

Published 10/26/22