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The
Challenge
The
rising demand for hospital services has created a scenario where
many institutions are confronted with high occupancy, rising patient
volumes, lower reimbursements, and substantial staffing constraints.
Many hospitals have made (or are about to make) sizeable capital
investments to expand their facilities.
If
higher volume is accompanied by lower margins, how does a hospital
produce sufficient revenues to support expanded debt service? And
beyond that, where will the staff come from?
 The
Solution:
IRI
has a solution that addresses these issues: Noon Checkoutsm.
By expediting patient throughput, hospitals are able to add virtual
capacity
to hospital beds and staff to increase revenues. A recent Health
Care Advisory Board* publication for hospital executives ("Recasting
the Inpatient Enterprise") presents an approach for increasing
bed availability, highlighting the IRI Noon Checkout. Developed
by
IRI and field-tested at the 500-bed Baptist Hospital of Miami,
IRI's Noon Checkout has significantly increased mid-day bed availability
and reduced backups in the Emergency Department.
Reaping
Economic Gains
Creating Virtual Capacity
Understanding the Issues
Why Noon Checkout Works
Noon Checkout Results
Is Noon Checkout For You?
Reaping Economic Gains
The Health
Care Advisory Board* estimates that a 500-bed hospital at 85%
occupancy can create as many as 26 additional available beds by
achieving earlier discharge. In economic terms, this means an additional
$2 to $4 million annual contribution to income. An additional benefit
of earlier discharge is the increased productivity of the hospital
staff. The Advisory Board estimates indicate, for a 500-bed hospital,
an increased productivity equivalent to 12 to 19 full-time nurses
- with no additional staffing cost.
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 Creating
Virtual Capacity
For hospitals at or near capacity, reducing capacity constraints
can help maximize the return on current beds and staff. Even hospitals
that have already shortened the length of patient stay are able
to realize substantial gains from an aggressive focus on expediting
patient throughput.
The
Advisory Board reports that hospitals stand to create up to 25%
more "virtual beds" from faster throughput. At capacity,
extra beds mean extra revenue with little or no capital investment.
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Understanding
the Issues
Each hospital faces unique obstacles that must be overcome. The
IRI Noon Checkout is not a silver bullet program. There is no new
science or technology that makes the new gains possible. Odds are,
your members already know everything that needs knowing about getting
patients out the door faster.
But,
what IRI can (and has done) is help collaboration between physicians,
nurses, ancillary services, and administration through the Fastrack
Teamssm process. This process starts at the goal, and backtracks
to eliminate the delays and bottlenecks. The outcome is innovative
solutions from energized members.
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Why
Noon Checkout Works
The IRI Noon Checkout is not about implementing massive new programs
or installing new software. It is about setting a realistic goal
(i.e. noon checkout), and then getting people energized to doing
a few routine things extremely well. It's about generating teamwork
between departments to achieve this common goal. It's about collaboration
between stakeholders. It's about getting every patient out the door
when they can no longer benefit from the high level of care they
receive in the acute care facility.
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Noon
Checkout Results
IRI developed and implemented Noon Checkout at the 527-bed Baptist
Hospital of Miami. The program provided the greatest benefits in
the form of better service to patients; beds became available earlier
in the day, shortening wait times (especially those from the ED),
and, in turn, minimize lost business.
According
to Lee Huntley, CEO of Baptist Hospital of Miami: "Baptist
applied the Fastrack Teams process in a series of ways to look at
what needed to be done for patients waiting to go home at noon.
We ran the process in lab, pharmacy, in imaging and the patient
care unit, and with the physicians to find the solutions and how
we'd implement them."
The
Noon Checkout results measured in the last four months indicate
that patients placed in bed after 10:00 PM have decreased almost
50%, while the direct admissions (not through the ED) per month
increased over 35%. Noon Checkout not only helps take better care
of patients, but it also provides increased revenues through virtual
capacity.
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Is
Noon Checkout For You?
Noon Checkout is not for every hospital. But, if your hospital is
at 85% or greater capacity, have more than 50% of your patients
on case rate, and a willing medical staff, then Noon Checkout can
help add virtual capacity to hospital beds and staff while increasing
revenues.
 Download
the Noon Checkout Calculator
To
see if Noon Checkout is for you, click
here to download our online
calculator (248 kb Excel document). The calculator has been designed
to determine whether or not Noon Checkout is right for your organization
- and, if so, the potential economic benefits available. Experiment
with the values by plugging in different numbers to formulate
"what-if" scenarios for your hospital.
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*
All references to "Advisory Board Report"
refer to "Maximizing Hospital Capacity, Expediting Patient
Throughput in an Era of Shortage" and "Throughput Gap Analysis,
Member Toolkit for Diagnosing Performance Improvement Opportunities,"
Health Care Advisory Board, The Advisory Board Company, Summer
2002. The Health Care Advisory Board (Washington DC) is a membership
based, for-profit research firm serving over 2,500
of America's leading hospitals and health systems.
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