Traditionally, health systems have operated and behaved as unified entities in name only, with different hospitals and facilities within the same system working off of their own sets of key performance metrics, finances, and operating processes.
While these locations and facilities may technically exist under the same banner, too often the emphasis has lied on maximizing the value of the individual parts rather than sharing resources or optimizing the overall performance of the whole system. This lack of unity and integration was satisfactory for the most part, however the pandemic exposed the problems associated with operating as a diverse collection of parts rather than a single, unified whole.
Confronted with a surge in patient demand, health systems’ fragmentation has become a significant constraint to care delivery as many struggle to effectively share resources. Health systems now have an opportunity to re-evaluate their structure, workflow, and operations to ensure they are best equipped to serve their communities going forward.
The days of ‘build it and they will come’ are over
When health systems operate as disparate parts instead of one system of care, they essentially adopt the growth strategy of “build it and they will come.” Due to the new operating realities facing health systems, this reactive approach is unlikely to achieve the results it did in the past. Rather, health system leaders must make changes to the way they manage patient flow and care orchestration, evaluated through their ability to control the levers of demand, capacity, and throughput.
The typical health system operates several patient care settings, however as these settings become more varied and numerous, health system leaders must make often difficult decisions about the optimal setting for specific types of care to best serve their overall patient populations. Rather than leave these important decisions to patients, caregivers, and clinicians, they must take an active role in rethinking and coordinating patient flow across all facilities to optimize care quality and patient safety.
For example, to stimulate demand, health systems should ensure that they have open channels for referrals for acute-care patients. With today’s staffing shortages, many health systems have a reduced capacity to care for patients, making it critical that they optimize their resources by directing patients to only the locations and facilities that are appropriate for their conditions.
In the traditional health system, the most significant obstacle standing in the way of achieving full capacity has not been labor shortages, it has been throughput. When throughput is managed efficiently, patients move out of the acute setting as soon as their conditions allow to the next-best care setting, which may be going home with a caregiver or staying for some time at a skilled nursing facility or rehabilitation center.
Understanding and being able to take care of patients into, through, and outside the four walls of the hospital is critical to improving patient outcomes, thus amplifying the need for a centralized command center that ensures care is coordinated between providers and patient flow is optimized across the care journey.
Health system executives must ensure that patients are getting out of acute settings in a timely, efficient manner. When one patient stays in one bed one day too long, it prevents another more complex patient from obtaining access to that same scarce resource. In this way, throughput problems can represent the major barrier to getting patients in the door and improving demand.
Purpose-built solutions to solve demand, capacity, and throughput challenges
Despite health systems’ heavy investment in different information technology systems in recent decades – electronic health records (EHRs), and billing and scheduling systems, for example – they often lack the means to efficiently measure and control factors like demand, capacity, and throughput. In many cases, the relevant data needed to arrive at these figures resides in multiple information systems that must be integrated to properly exchange data.
Consequently, health systems need an umbrella care orchestration solution that standardizes processes, centralizes enterprise-wide data from disparate systems, and organizes that information to help leaders make better-informed decisions. Information systems that manage medical records, billing, and scheduling were not created to address this process, so purpose-built care orchestration solutions that can be extended into existing infrastructure represent a straighter path to success.
When health systems solve issues with throughput, they operate more efficiently, which creates additional capacity to serve more patients. Further, when they gain efficiency, they acquire the ability to automate many manual tasks, such as phone calls, emails, and text messages to patients, enabling clinicians to work at the top of their licenses and improving the work environment for clinicians and staff.
During the pandemic, health systems that operated in a siloed manner felt the costs of the inability to coordinate operations and share resources in the forms of compressed margins, frustrated staff, and suboptimal patient outcomes – particularly as care expanded outside of traditional settings. However, by more precisely improving care orchestration by reimagining patient flow across disparate care settings, health systems can improve demand, capacity, and throughput challenges.