Patient Progression at Intermountain: What it is and why it's a priority

What is patient progression?

Patient progression (also called "patient flow") involves streamlining the way patients move through our hospitals and improving processes to help us deliver the right care at the right time in the right place. It's an initiative that's being implemented at 11 Intermountain hospitals.

What are the benefits?

1. It improves quality of care by helping us deliver the right care at the right time.
2. It improves patient satisfaction by giving patients the care they need at the time they need it, then helping them return to their normal lives.
3. It improves satisfaction among physicians and other care providers by improving collaboration, efficiency, and communications.
4. It helps manage the cost of care by allowing Intermountain to use existing space more efficiently and avoid adding new beds or building new facilities.
5. It helps us serve Utah's growing and aging population. When they need inpatient care, we will have beds available.

How does patient progression work?

It focuses on four key areas:

1. Patient placement. The process uses an electronic bed-board and a comprehensive patient placement model to place patients in the appropriate bed upon admission.
2. Case management. A strong partnership with case management and social work helps care providers assure patients are at the right level of care, patient care needs are planned in advance, and follow up is completed efficiently.
3. Care coordination. The process reduces unnecessary delays in the plan of care and discharge by coordinating care planning with nursing, physicians, case managers, and other clinical areas on a daily basis.
4. Bed turnaround. It improves bed access by adjusting Environmental Services' staffing and processes to ensure that beds are cleaned and prepared for a new admission as soon as the patient discharges.

Where is patient progression happening?

Patient Progression will be implemented in 11 facilities:

• Intermountain Medical Center has completed implementation (2009).
• Utah Valley Regional Medical Center is in process and will complete implementation in November 2009.
• McKay-Dee Hospital Center is in process and will complete implementation in February 2010.
• Plans are to start Dixie Regional Medical Center and Valley View Medical Center in October 2009.
• The remaining facilities (LDS Hospital, Alta View Hospital, Riverton Hospital, Logan Regional Hospital, American Fork Hospital, Primary Children's Medical Center) will be implemented over the next 3 years.

What is the impact?

Patient Progression has achieved significant improvements:

Intermountain Medical Center

• 6.74 hours average length of stay reduction across all service lines, creating approximately 20 virtual beds.
• 50% faster bed turnaround (88 minutes baseline to 44 minutes).
• 92% improvement in reduction of "emergency" bed turnaround requests (averaged 130/week to 10/week).
• Improved 8 targeted patient satisfaction scores.
• Placing the patient in the right bed improved from 83% to better than 90%.
• Improved identification of anticipated discharges.
• Improved bed placement times for the Post Anesthesia Care Unit, Intensive Care Units, Emergency Department, and direct admits.
• Decreased denials (36 fewer cases denied).

Utah Valley Regional Medical Center.  Initial metrics identify improved bed turnaround times, anticipated discharge accuracy, and appropriate placement.

McKay-Dee Hospital Center.  Early metrics indicate significant improvements in anticipated discharge and bed turnaround times.