Hospital Metrics Matter: Tips for Maximizing Reimbursement

Tracking performance is a way of life for those in the healthcare industry. With so much regulation and with the constantly changing landscape of priorities for industry leaders, it’s important to understand which metrics matter most when it comes to providing excellent patient care. We’ve compiled some top areas with tips that help realign strategy to match efficiency with quality.

Patients Wait until They Leave – Reducing LWBS

Rapid Treatment Areas (RTA) – Patients present to the Emergency Department requiring the full spectrum of care, from true emergencies to routine primary care. With RTA areas, patients are easily evaluated as to the complexity of their particular situation. Utilizing a designated RTA nurse, the processing of orders for labs, necessary x-rays, blood and urine samples, as well as starting IVs if needed, streamlines workflow. While patients are in this area, a physician or APC can evaluate them, and registration can begin to process patient information, expediting these processes and reducing LOS.

Work Flow Analysis – Are you working through issues that delay processes in your ED? Have you had an opportunity to identify the obstacles that cause flow issues? Many health systems are moving toward LEAN exercises to identify how to improve patient flow, and with much success. For example, Value stream mapping (VSM), a lean manufacturing or lean enterprise technique used to document, analyze and improve the flow of information or materials required to produce a product or service for a customer.

Using VSM or LEAN techniques help identify problem areas that could potentially help in a variety of metric areas including LWBS and Patient Satisfaction.

Growing Satisfied Patients

We Care Challenge – The We Care Challenge is a 10-week patient experience immersion project. The basic We Care Challenge is broken down into the following weekly focus areas, but is not a one-size fits all. The program can be customized to best fit the needs of the facility:

  • Knock before entering and introduce yourself
  • Sit down whenever talking to patients
  • Use blameless apology for wait and estimate time course of visit
  • Address pain or comfort with every patient touch
  • Utilize white boards
  • Close the loop at end of visit
  • Encourage patient questions throughout the visit
  • Round –Someone touches patient every 30 minutes
  • “Thank you for choosing our hospital.”
  • Encourage response to survey

Set Expectations and Over Communicate – There is no such thing as over communication. By using various forms of communication, patients can stay in the loop on what’s going on with their care. As a care giver, giving the patient time expectations for lab work or imaging, as well as offering a quick check-in every few minutes (as reasonable), goes a long way when it comes to the patient’s experience. That positive experience transfers over to patient satisfaction and is a win-win for everyone.

Using Technology – Many of our partner hospitals utilize technology to help educate and entertain their patients in the ED. By using tablets in waiting areas and patient rooms, the individual’s wait time is occupied with educational videos on after-care and conditions, as well as games and other apps. Helping the patient ease their mind by simply helping pass the time while they wait is a big factor when it comes to patient satisfaction.

Focusing on the Core – How does your Facility Measure Up?

Core measures are standardized best practices designed to improve patient care and could include anything from hand hygiene, stroke management, cardiac care, time measured from door to discharge/ admit, EKG within five minutes of arrival and more. These measures are dependent upon what your hospital chooses to improve and measure.  There are mandatory core measures required by CMS and Joint Commission (stroke, sepsis, cardiac) and nurses play a huge role in initiating protocols that help reach core measures and, in return, improve patient care and outcomes.

  • Make sure your teams are aware of protocols (example: patient c/o chest pain an EKG will be obtained within five minutes of arrival for ruling out AMI)
  • Clear communication with provider/imaging concerns (example: patient presents with slurred speech and weakness – getting patient to CT is critical for treatment, so keeping the provider informed and having CT ordered, as well as making sure CT is notified, are best practice)
  • Knowing specific guidelines to follow (example: signs and symptoms of sepsis, to be able to initiate treatment within three hours of arrival decreases mortality)

It is important to keep nursing aware of protocols, as many are initiated by your nursing teams.

Metrics are more than numbers.  Improving front end efficiency so patients begin their evaluation and treatment quickly, improving patient communication and satisfaction and meeting quality measures all translate to one thing – Improved patient care, compliance and outcomes.


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