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UCHealth’s new success in directing patient flow, part 2: on the move – knowing when to transfer patients

Pallabi Sanyal-Dey, MD, FHM

Director Client Services, iQueue for Inpatient Beds Associate Clinical Professor, UCSF School of Medicine

The first part of this series, which discussed hospitals’ underlying challenges in bed management and directing patient flow, and how UCHealth equipped staff to solve delayed inpatient admissions, is available here. 

As concluded in the previous post, directing patient flow throughout the hospital in a timely manner is a complex process. Ensuring the right beds are available for patients at the right time is critical and “opening” an intensive care unit (ICU) or other specialized unit beds is an integral piece of this puzzle. Once a patient placed in the ICU recovers or is stable enough, he or she should be transferred to a lower acuity unit, which due to capacity constraints and unpredictable patient surges is often easier said than done. Often a patient must wait for a bed in their needed unit to become available, in turn occupying a higher-acuity bed that another patient awaiting admission needs. The delay of unit transfers thus negatively impacts patient satisfaction and care, while contributing to bottlenecks that block patient flow throughout the hospital. 

The 12-hospital system UCHealth has had marked success in reducing the amount of time to complete ICU transfers. One effective tactic UCHealth deployed was the creation of the physician-level Administrative Clinician Triagist role, which is fully staffed and available to the organization 24/7 to help with patient placement decisions. Then, to address continued supply and demand mismatches between services and units, nurses were cross-trained to work on both primary and secondary, or sister units, so they could support different units depending on patient populations.

UCHealth also implemented LeanTaaS’ iQueue for Inpatient Beds to support all clinicians and staff in making informed decisions regarding transfers. The tool’s Transfer Toolkit provides up to date recommendations regarding which patients might be ready for transfer and which unit or bed either has or will soon have the capacity to accept them. Patient care teams can rely on the Toolkit for accurate information to support the best transfer decisions for their patients. 

The Transfer Tool relies on mappings of specific service lines to units. This ensures service line care teams will see only those recommendations that apply to the units they use, so that for instance a neurology care team will be directed to the neurology unit their patients need, rather than the surgical unit that might not be as well equipped to handle patients’ needs. 

By surfacing the right transfer recommendations in a timely manner, UCHealth saw a 65% reduction in time to complete transfers from the ICU.

Adopting iQueue for Inpatient Beds to reduce patient throughput “bottlenecks”’ and increase communication has benefitted UCHealth system-wide. Hospital-specific and network information can be accessed by responsible personnel from laptops, tablets, or mobile phones so informed decisions can be made regarding patient placement.

If you would like to learn more about what iQueue for Inpatient Beds has to offer hospitals, please click here.

*UCHealth is an integrated health care delivery system serving Colorado, southern Wyoming, and areas of Nebraska. The network, which utilizes Epic, consists of 12 hospitals with a total of 1,997 inpatient hospital beds and had over 141,000 inpatient admissions and observation visits in FY2021.

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