The number of hospital beds in the United States has been steadily shrinking since the 1970s, according to the American Hospital Association. The reasons are numerous, including the continued shift of medical care to outpatient settings.
The trend has made capacity planning a top priority for hospital executives because a shortage of beds can be a significant problem, as we witnessed during the coronavirus pandemic.
One of the biggest challenges to managing bed availability is dealing with patients who stay longer than clinically necessary because of administrative delays. This is especially true for sicker patients who need follow-up care after hospitalization, whether in the home or at another facility.
Finding the right post-acute care is often a laborious process that complicates discharge planning. We’ve identified three bottlenecks and solutions that will help you better manage these care transitions and increase your hospital capacity — without adding more beds.
Delay #1: The first area spans from the moment a someone is admitted to when the post-acute referral is created. This is often a chaotic time. The care team is not always aligned on what the post-acute needs are, and everyone is working on his or her own silos. Further complicating matters, many patients and their family members have never heard of post-acute care until they need it. They often feel helpless and overwhelmed during a vulnerable time, which can lead to tense conversations with care teams.
Solution: Give authority to case managers to take a more active role in discharge planning. If they are captains of the discharge process, then nurses and other clinical team members can spend more of their time on the provision of care and less on the administrative task of coordinating a post-acute bed for a patient. In addition, there are certain diagnoses that almost always require post-acute care, such as a knee replacement. From the time of admissions, start communicating with patients and family members about the need for post-acute care so they are not surprised.
Delay #2: The second area that can get unnecessarily stretched out is the time between start of a referral and its completion. Handling referrals is a workflow that in many places is mired in the 1980s. It seems hard to believe but communication with post-acute facilities is still handled with phones and fax machines. This isn’t efficient from a resource, staffing or time perspective, and the manual processes can add hours to a patient’s stay.
Solution: Organizations that have invested in digital tools that streamline referrals and provide a full view of the post-acute marketplace are seeing benefits, such as reduced lengths of stay and increased staff satisfaction, and empowering patients to make more informed decisions. Digital tools created structured workflows, set deadlines and flag any delays. An open referral marketplace also brings competition into a space that is too dependent on word-of-mouth recommendations. Competition increases the quality of care and brings transparency to an industry that is fragmented and siloed. Improved visibility also gives patients choice instead of just selecting the provider closest to home. The post-acute industry also wins because the best providers are rewarded with more patients.
Delay #3: The third area of delay in the patient progression comes after follow-up care has been secured to the time of discharge. The biggest reason time is wasted is because of the time it takes to get insurance authorization. Another factor potentially holding up patients from leaving the hospital is transportation availability.
Solution: Unite the entire ecosystem of case managers, insurers and post-acute providers. Documents are stored in one place with controlled access to the appropriate users. Everyone is in the same communication channel, reducing the chance of missed phone calls or emails and flagging important notifications like an insurance denial. The system can also coordinate transportation and equipment that an individual may need to begin healing at home or at a post-acute facility.
The shrinking number of beds means hospitals have to manage capacity like Southwest Airlines’ famous rapid gate-turnaround. The patients have to move with the right cadence without sacrificing care and satisfaction. The choreography takes planning, and Aidin is the foundation of your post-acute planning. Learn how Aidin helps you better manage your bed capacity while increasing transparency and patient choice.