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 Optimizing Patient Flow: Advanced Strategies for Managing Variability to Enhance Access, Quality,
Intermediate-Advanced

Optimizing Patient Flow:  Advanced Strategies for Managing Variability to Enhance Access, Quality, and Safety

Optimize patient flow for quality and savings!

Release Date: May 2018. 216 pages.

5 Star Rating from Doody’s Book Review!

  • An individual license is intended for single users only. This ebook cannot be shared, disseminated, downloaded, or posted for widespread or public use. 
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Product Description

Product Description

Edited by Eugene Litvak, Ph.D., a world-renowned leader in hospital operations management and redesign
 
Foreword by Dr. Harvey Fineberg, president of the Gordon and Betty Moore Foundation and former president of the Institute of Medicine 
 
Optimizing patient flow impacts patient safety and the quality of care, and it has financial implications for health care institutions. Yet the story hasn't changed much in the decades that patient flow has been a focus of health care administrators. Hospitals are straining to meet demand. Surgeries continue to be delayed. Ambulances are diverted. Emergency departments are overcrowded while waiting for inpatient beds. Staffing shortages and economic challenges only serve to exacerbate the inefficiencies of patient flow. Perhaps this approach to managing patient flow is not the best one.
 
Crowded emergency departments and empty operating rooms are indicative of the variability in patient flow throughout the hospital, including emergency rooms and ICUs, as well as the flow to other settings of care, such as home care. Our second title edited by patient flow expert Dr. Eugene Litvak, Optimizing Patient Flow: Advanced Strategies for Managing Variability to Enhance Access, Quality, and Safety, offers readers innovative techniques for optimizing patient flow and improving operations management while providing clear examples of successful implementation. It can help you optimize patient flow in your own organization.
 
This book goes beyond the introductory information provided in JCR’s popular Managing Patient Flow in Hospitals: Strategies and Solutions, Second Edition. Dr. Litvak has teamed with CEOs, doctors, and researchers who have compiled their own experiences with patient flow to produce a book that guides the reader to practical and achievable advances in patient flow by sharing stories of how it was attained in actual health care organizations and providing specific approaches to reducing and managing variability.
 
Key Topics
  • Reducing and managing natural and artificial variability
  • Smoothing and optimizing the admissions process and surgical flow
  • Capacity planning and queue management strategies 
  • Assessing the quantitative impact of patient flow issues on patients and staff  
  • Standardizing patient admission, transfer, and discharge 
Key Features
  • Hospital CEOs share their actual experiences implementing patient flow measures
  • Researchers present the “nuts and bolts” of the mechanics of patient flow
  • Real-life case studies illustrate how improved patient flow impacts emergency departments, telemetry bed utilization, and post-acute care
Standards: No direct standards correlations, but related to Leadership and Performance Improvement
 
Setting: Hospitals, critical access hospital, home care
 
Key Audience
  • Hospital executives including chief operating officers and chief financial officers
  • Board members
  • Physicians and medical officers
  • Nurses and nurse executives
  • Quality, process improvement, and productivity managers
  • Emergency department, surgery, critical care, and nursing operations professionals
About the Editor
Eugene Litvak, PhD, is President and CEO of the Institute for Healthcare Optimization. He is also an Adjunct Professor in Operations Management in the Department of Health Policy & Management at the Harvard School of Public Health (HSPH), where he teaches the course “Operations Management in Service Delivery Organizations”. Prior to his current position he was a co-founder (with Michael C. Long, MD) and director of the Program for the Management of Variability in Health Care Delivery at the Boston University (BU) Health Policy Institute and a Professor at the BU School of Management. Before joining Boston University Dr. Litvak was a faculty member at the Harvard Center for Risk Analysis. 
 
For more than 20 years Dr, Litvak has led the development and practical application of innovative approaches for managing patient flow variability for cost reduction and quality improvement in health care delivery systems. He has authored more than 60 publications in the area of operations management in health care delivery, as well as editor of JCR's Managing Patient Flow in Hospitals: Strategies and Solutions, 2nd Edition. He was a member of the Institute of Medicine (currently the National Academy of Medicine) Committees “The Future of Emergency Care in the United States Health System”, “The Learning Health Care System in America” and “Optimizing Scheduling in Health Care.” Dr. Litvak also served as a member of the “National Advisory Committee to the American Hospital Association for Improving Quality, Patient Safety and Performance”.  Currently, he serves on the Executive Leadership Council, Strategic Innovation Engine, Centers for Medicare & Medicaid Services.
Table of Contents

Table of Contents

Acknowledgements
Foreword by Dr. Harvey Fineberg, MD
Introduction by Dr. Eugene Litvak, PhD
Prologue: Lewis Blackman—Lessons Learned from a Ninth Grader by Ellis “Mac” Knight, MD, MBA, FACP, FACHE, FHM

Part I: CEO Perspectives: Committing to Optimized Patient Flow

Chapter 1: How We Improved Care and Added Millions to the Bottom Line: An Outsider’s Perspective by James M. Anderson, JD. 
Chapter 2: Using Operations Management to Reduce Variability in Surgical Demand by Jack Kitts, MD
Chapter 3: A Proactive Initiative to Improve OR Scheduling by William C Rupp, MD as interviewed by Hakmeng Kang, MBA
Chapter 4: Using Science and Design to Improve Patient Flow by John B. Chessare, MD, MPH, FACHE 

Part II: The Mechanics of Flow

Chapter 5: Reduction and Management of Variability in Health Care Delivery by Julia L. Krol, RN, BSN, MBA, and Michael C. Long, MD
Chapter 6: Using Variability Methodology to Improve Patient Flow: Three Projects Offering Tangible Results by Julia L. Krol, RN, BSN, MBA, and Michael C. Long, MD 
Chapter 7: Variability Methodology: Tools & Techniques by Cheri Ward, MPH, DPT, and Kristy Zhou, BSc, BComm, MM in Operations Research

Part III: How We Did It: The Case Studies

Chapter 8: Right Focus, Right Solution: How Reducing Variability in Admission and Discharge Improves Hospital Capacity and Flow by Peter Viccellio, MD, FACEP; Katherine Ardalan Hochman, MD, FHM; Peter P. Semczuk, DDS, MPH; and Carolyn Santora, MS, RN, NEA-BC, CSHA, CPHQ
Chapter 9: New Jersey’s Collaborative on Patient Throughput by Mary A. Ditri, DHA, MA, CHCC; Aline M. Holmes, DNP, MSN, RN; Patricia A. McNamee, RN, MS; Robert G. Lahita, MD, PhD; and Elizabeth Ryan, JD.
Chapter 10: Rightsizing Inpatient Medical Units: Developing Telemetry ADT Criteria by Robert G. Lahita, MD, PhD, FACP, MACR, FRCP, and Jennifer Crist-Muñoz, APN-C
Chapter 11: Standardizing Admission, Transfer, and Discharge Processes to Reduce Artificial and Clinical Variability by Daniel J Beckett, MD, FRCP, MBChB(Hons), MSc., BSc (Hons); David A. McDonald ProfD, BSc (Hons), MCSP; Patrick Rafferty, BN; and Martin Hopkins, MA(Cantab), MBA

Part IV: Whole System Flow: Beyond the Hospital Setting

Chapter 12: Bottlenecks in Flow to Post-Acute Care by Alan Forster, MD, FRCPC, MSc; Renate Ilse, RN, DHA; Daniel Kobewka, MD, MSc; and Kednapa Thavorn, PhD
Chapter 13: Pulling Out All the Stops: Delivering Whole System Flow by David Fillingham, MA (Cantab), MBA, CBE; Bryan Jones, PhD; and Penny Pereira, MA (Cantab)
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Contributors

Contributors

About the Editor

 
Eugene Litvak, PhD, a world-renowned leader in hospital operations management and redesign, is the president and chief executive officer of the Institute for Healthcare Optimization in Newton, Massachusetts. He is also an adjunct professor in Operations Management in the Department of Health Policy and Management at the Harvard School of Public Health. He was a co-founder and director of the Program for the Management of Variability in Health Care Delivery at Boston University. He was also a professor at Boston University School of Management. Litvak has authored over 60 titles involving operations in health care. Currently, he serves on the Executive Leadership Council, Strategic Innovation Engine, at the US Centers for Medicare & Medicaid Services.

About the Foreword Writer

Harvey V. Fineberg, MD, PhD, is the president of the Gordon and Betty Moore Foundation. Formerly, he was the president of the Institute of Medicine as well as the dean of the Harvard School of Public Health. He has been a consultant at the World Health Organization and has served as president for the Society of Medical Decision Making. Fineberg earned his doctor of medicine and his doctor of philosophy from Harvard University. He has contributed to numerous academic journals in many areas, most notably in health policy.

About the Authors

 
The following authors contributed to Optimizing Patient Flow:
  • Ellis “Mac” Knight, MD, MBA, FACP,  FACHE, FHM, senior vice president and chief medical officer, The Coker Group
  • James M. Anderson, JD, Hon. DSc, former chief executive officer, Cincinnati Children’s Hospital Medical Center
  • Jack Kitts, MD, chief executive officer and president The Ottawa Hospital
  • William C. Rupp, MD, former chief executive officer, Mayo Clinic Florida (as interviewed by Hakmeng Kang, MBA Vice President of Strategic Partnership & Special Projects Institute for Healthcare Optimization)
  • John B. Chessare, MD, MPH, FACHE, president and chief executive officer GBMC HealthCare System
  • Julia L. Krol, RN, BSN, MBA, lead Methodologist Institute for Healthcare Optimization
  • Michael C. Long, MD, senior fellow & clinical consultant Institute for Healthcare Optimization
  • Cheri Ward, MPH, department lead Methodologist Institute for Healthcare Optimization
  • Kristy Zhou, BSc, BComm, MM, senior consultant, Institute for Healthcare Optimization
  • Peter Viccellio, MD, FACEP, vice chair and professor Department of Emergency Medicine, Stony Brook School of Medicine, and associate chief medical officer Stony Brook Medicine
  • Katherine Ardalan Hochman, MD, FHM, associate professor and associate chair for quality of care, Department of Medicine, NYU Langone Health, and assistant chief of medicine service, Tisch Hospital
  • Peter P. Semczuk, DDS, MPH, senior vice president and executive director, Montefiore Medical Center, Moses and Wakefield Campuses
  • Carolyn Santora, MS, RN, NEA-BC, CSHA, CPHQ, interim chief nursing officer and chief of regulatory affairs, Stony Brook Medicine
  • Mary A. Ditri, DHA, MA, CHCC, director, professional practice, New Jersey Hospital Association
  • Aline M. Holmes, DNP, MSN, RN, senior vice president and clinical affairs director, Institute for Quality and Patient Safety, New Jersey Hospital Association
  • Patricia A. McNamee, RN, MS, assistant vice president, Perioperative Services, RWJ Barnabas Health, Monmouth Medical Center
  • Robert G. Lahita, MD, PhD, chairman, Department of Medicine, St. Joseph University Hospital
  • Elizabeth Ryan, JD, president and chief executive officer, New Jersey Hospital Association
  • Jennifer Crist-Muñoz, APN-C, cardiology nurse practitioner, Hackensack University Medical Center
  • Daniel J. Beckett, FRCP, MBChB (Hons), MSc, BSc. (Hons) consultant in acute medicine, NHS Forth Valley, national clinical lead, Whole Systems Patient Flow Programme, Scottish Government
  • David A. McDonald, ProfD, BSc (Hons), MCSP, service improvement manager, Whole Systems Patient Flow Programme, Scottish Government
  • Patrick Rafferty, BN, head of nursing medical directorate, NHS Forth Valley
  • Martin Hopkins, MA (Cantab.), MBA, programme director, Whole Systems Patient Flow Programme, Scottish Government
  • Alan Forster MD, FRCPC, MSc, vice president, Quality, Performance, and Population Health The Ottawa Hospital; vice chair, Quality and Clinical Services, Department of Medicine, University of Ottawa; professor, Faculty of Medicine University of Ottawa
  • Renate Ilse, RN, DHA, vice president, clinical programs, The Ottawa Hospital
  • Daniel Kobewka, MD, MSc, assistant professor, Department of Medicine, University of Ottawa
  • Kednapa Thavorn, PhD, scientist, Ottawa Hospital Research Institute
  • David Fillingham, MA (Cantab.), MBA, CBE, chief executive, Advancing Quality Alliance (AQuA), Sale, England
  • Bryan Jones, PhD, improvement fellow, Improvement Team, The Health Foundation, London
  • Penny Pereira, MA (Cantab.) deputy director of Improvement, The Health Foundation, London