Early Discharge Planning:
Start discharge planning on the day of admission to enable safe, efficient patient discharge with transparency and real-time visibility.

24-Hour Discharge Prediction Bundle:
Accurately predict next-day discharges to create earlier access for waiting patients.

Multi-Disciplinary Rounds:
Integrate 24-hour predictions into rounds.

Identifying Contingent Discharges:
Identify 11am and 2pm discharges with contingent needs the day before.

Afternoon Huddles:
Nursing/Case Management conduct a 5-minute huddle to verify contingent needs for early discharge.

PatientTracking Portal:
Utilize the portal for the 24-hour charge nurse handoff.

Reporting:
Formalize reporting of yesterday’s discharge results during safety or bed meetings.

Provider Engagement:
Identify early discharges to ensure providers write orders early, enhancing bed availability.

Patient & Family Communication:
Communicate the patient’s projected discharge date daily to avoid delays.

Electronic Whiteboard Implementation:
Replace manual boards with real-time PatientTracking Portal displays.

Visibility Across Teams:
Enable clinical and non-clinical staff (EVS, Transport, Pharmacy, etc.) to view pending and confirmed discharges.

Customizable Real-Time Views:
Configure views to include Observation Timers, LOS, pending/confirmed discharges, milestones, transfers, assignments, bed status, and current patient location.

Bed Assignment Priorities:
Each unit should update bed priorities (identify at least three throughout the day).

Guidelines for Bed Changes:
Establish protocols to prevent unnecessary changes unless medically required.

Efficient Handoff:
Utilize a No Delay Nurse Handoff/Report to boost efficiency.

Virtual Bed Conversion:
Convert all bed requests to inpatient/observation status, allowing immediate transfer upon arrival.

EMR-ADT Integration:
Empower nursing to discharge patients via integrated systems.

Pre-Planning for Surgical Admissions:
Create a planned surgical/procedure admit list by targeting units the day before. Consider transferring off-service patients and scheduling earlier discharges.

Activation & Protocols:
Activate bed requests upon patient arrival in the Recovery Area. Develop clear protocols (e.g., “Ready to Move” criteria such as anesthesiologist clearance) and designate one owner to maintain list accuracy.

Centralized Dispatch:
Centralize the Transport Department for efficient service using an efficiency-focused dispatch set.

Dynamic Request Management:
Promptly cancel unnecessary requests and complete requests with a focus on proximity matching.

Minimizing Delays:
Keep delays under 5 minutes to avoid patient hold-ups.

Return Equipment & Alerts:
Utilize return equipment features for trip credit and real-time transport alerts for supervisors.

Staffing & Communication:
Align staffing (staggered breaks, overlapping shifts) to maintain rapid response. Use notifications to update sending/receiving areas on job status.

Auto Transport:
Implement auto transport to expedite patient flow.

Transport Request Status:
Mark requests “in progress” once a transporter is engaged to prompt timely bed cleaning.

Patient Readiness:
Ensure patients are fully prepared before initiating transport requests.

Obstacle:
Clinically ready transfer patient not moved despite a clean bed assignment.

Considerations:
Identify if delays stem from handoff report issues or nurse availability. Institute a No Delay Nurse Report or automate the process. Automate transport requests post-bed assignment. Verify patient readiness before initiating transport.

Obstacle:
Lack of consistent communication when a patient is set for discharge.

Considerations:
Provide daily updates on the projected discharge date. Use whiteboards in patient rooms to document discharge dates.

Procedure Scheduling:
Develop and evaluate guidelines covering routine to emergent add-on cases, including cleanup/setup durations.

Pre-Registration:
Preregister procedural cases with concise demographic and financial data to prevent day-of delays.

Real-Time Visual Cues:
Use icons to communicate changes (add-ons, time/location/procedure adjustments) to ensure staff productivity.

Strategic Case Timing:
Schedule inpatient and outpatient procedures (that won’t require new bed assignments) as first cases or early in the day.

Isolation Cases:
Perform isolation cases last or in designated locations to reduce cleaning delays.

Start-Time Alignment:
Define and educate all team members on a formal start-time.

Reporting:
Use reporting tools to compare scheduled versus actual durations and address deviations.

Real-Time Scheduling Adjustments:
Leverage the ScheduleVue™ Screen to identify gaps/overlaps and adjust accordingly.

Electronic Boards:
Use prominently displayed boards in high-traffic areas for real-time updates on cases, patients, providers, and resource allocations.

Communication of Milestones:
Ensure intraoperative and room turnover milestones are communicated in real time.

Staff Visibility:
Display accurate staff assignments to facilitate reassignments or case shifts.

Room Turnover Accountability:
Discuss role expectations and track room cleaning times to ensure accountability.

Preoperative Readiness:
Expedite incomplete medical records (history & physical, consents, labs, X-rays) to facilitate on-time starts.

Clear Preoperative Instructions:
Provide detailed arrival times and NPO guidelines to avoid delays and cancellations.

Real-Time Patient Readiness:
Utilize system alerts for caregiver readiness, ensuring real-time visibility of delays.

Dynamic Rescheduling:
Monitor delays in real time to enable immediate rescheduling of staff, resources, or room allocation.

Patient Movement Tracking:
Capture real-time updates of patient arrival and movement via electronic screens or device alerts.

Automated Escalation Alerts:
Trigger alerts for extended wait periods for timely staff intervention.

Preoperative Charge Member:
Designate a charge member to oversee the preoperative suite flow and expedite readiness.

FamilyVue Screen:
Provide waiting areas with a FamilyVue screen to offer real-time updates on patient movement, reducing phone inquiries.

Family Icon Usage:
Utilize a Family Icon to signal when a patient is ready for visitors.

Service Recovery:
Activate service recovery measures through active monitoring of length of stay across all areas.

Accurate Placement:
Use patient/bed attributes and isolation requirements to ensure correct placement.

Ready-to-Move Indicator:
Mark patients as “Ready to Move” once recovered to facilitate timely bed assignment.

Timely Transport Requests:
Request transport as soon as the assigned bed is clean and the patient is ready.

Provider Communication:
Contact providers 15 minutes prior to the scheduled start if not present.

Real-Time Updates:
Notify providers and anesthesia personnel of any schedule changes immediately.

Delay Reporting:
Report all case delays to the surgical services and anesthesia committees.

Obstacle:
Discrepancies in procedure duration estimates and case line-ups.

Considerations:
Follow up with surgeons on requested case duration versus historical data to prevent delays and overtime.

Obstacle:
Delays due to staff or instrument availability.

Considerations:
Ensure availability of high-volume instruments and trays. Schedule special equipment the prior afternoon. Install electronic boards (e.g., with the Clinical Workflow Suite) in the Sterile Processing Department to monitor equipment and instrument readiness.

Obstacle:
Insufficient staff resources during room turnovers.

Considerations:
Assign dedicated room turn teams to specific ORs during prime hours.