Challenge
Methodist Medical Center was looking for opportunities to enhance the quality of care for its admitted patients while reducing the hospital’s operating costs by properly managing length of stay (LOS) and hospital resources.
Solution
TeamHealth and the hospital established a performance improvement team to conduct a root cause analysis. The group determined that the discharge planning process,which had been inconsistently applied, needed to be more rigorous, and that the implementation of multi-disciplinary rounds would best address the hospital’s goals.Every morning physicians and healthcare professionals from multiple departments—typically case management, nursing, pharmacy, social work, rehabilitation, hospice, and sometimes nutrition—meet to discuss a select group of patients and coordinate their approach to each patient’s care. The meetings generally last about 25 minutes and begin with a brief clinical synopsis of the patient by the hospitalist, followed by input from other team members regarding the best course of action, with special attention given to discharge planning.
Results
While some clinicians were hesitant at first to add another meeting to their daily routines, the benefits of the program soon became evident. Within 30 days of implementation, the average LOS dropped almost one full day, and within just a few months, the multi-disciplinary rounds yielded other impressive results:
- Lab utilization was significantly reduced as the team became better at staging tests more efficiently.
- Pharmacy costs decreased as changes were made to medication orders based on discussions during the meetings.
- The number of patients the team cared for increased without an increase in staff because the workflow process became more efficient.
- As reported by participants, the multi-disciplinary rounds resulted in a stronger sense of teamwork and camaraderie among physicians, nurses, and other healthcare professionals.
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