Lean Healthcare Consulting
LEI Group Australia is a recognised leader in the application of Lean techniques in the Healthcare sector. The Group works closely with a diverse set of primary and ancillary healthcare providers, across various stages of Lean and Continuous Improvement deployments, delivering a range of advisory and support services, including the new and innovative Patient Throughput Review (PTR) Audit .
Patient Throughput Review Audit
The PTR audit uses evidence-based criteria in the flow process to ensure the clinical appropriateness of the patient every day and evaluate their readiness to transition or discharge. The solution adopts a patient-centric approach to the hospital journey, moving away from the traditional expected date of discharge or average length of stay. By managing flow this way, it is possible to clearly identify barriers to delay with associated reasons.
A significant difference with this process versus traditional patient flow engagements is that the data collection is based on actual patient records, without the need for hospital IT/decision support systems. With the Patient Throughput Review of a representative sample of discharged patient records you can assess:
- ED visits – met versus not met admission criteria
- Number of patient days that did not meet inpatient clinical criteria for the stay
- Number of avoidable days caused by physician delays; social issues; post-acute provider delays etc.
Comprehensive data allows for the financial quantification of the impact of inappropriate admissions/delayed discharges that can lead to longer wait times for patients and increased costs.
Joe Aherne, CEO, of the Leading Edge Group commented that “A number of hospitals recently availed of the PTR audit and they recorded over 30% of avoidable days i.e. those patients could have received treatment as outpatients or under observation status”. Some findings from individual hospital audits completed in Canada and the UK include:
- 12% of patients were avoidable admissions
- 90% of avoidable admissions were attributed to hospital and physician reasons
- 52% of in-patient days on the medical units were potentially avoidable
- If every patient had been discharged or transferred when they no longer needed to occupy an acute care bed, the Average Length of Stay would have been decreased by 2.5 days
- Patients who need a lower level of care such as Rehab, have lengthier stays than those who are discharged home to be transferred to another acute care facility
- For 37% of the days reviewed, patients were ready for discharge or transfer to a lower level of care. These were clinically stable patients that remained in acute care beds unnecessarily
- 65% of records reviewed were found to have patients discharged after 12.00. 64% of the reasons were due to physician; 28% were due to community