Health care is changing. Fast. But one constant remains — the challenge of managing the flow of patients in and out of your hospital or health system.
Even before COVID-19, patient transfers were problematic for most hospitals and health systems. Then, the pandemic added more strain. Finding the best way to handle patient flow has become increasingly difficult, with higher patient volumes and staff shortages.
In a study published by the Journal of Patient Safety, doctors and patients on both the transferring and accepting end indicated dissatisfaction and frustration with aspects of the transfer process. Many health systems don’t have a centralized, standardized process in place, which impacts both patients and providers significantly.
Health leaders are more commonly turning to transfer centers to manage all parts of a patient’s transfer in and out of a hospital system in one centralized location. Ultimately, improving patient flow helps improve the quality of care, which often leads to improved patient and provider satisfaction. And it saves resources and time — when every minute counts.
Whether transfers start in the Emergency Department (ED) or elsewhere, there are strategies that can help overcome common transfer problems.
“The most important reason for wanting a robust Transfer Center is for our patients. We owe it to them to coordinate their care and ensure that they’re provided great care from the beginning of their stay to the end.”
-Chris Hilton, CFO
Bon Secours Mercy Health
Patient flow improvement strategies
Challenge: Patient transfer processes and procedures are disorganized, inconsistent, repetitive
or unclear.
At many hospitals and health systems, there’s a high level of boarding in the ED. With a fragmented patient transfer process, coordinating a transfer is complex. It can take multiple calls to find the right fit, which further challenges the ED.
Inefficient processes, including admission and discharge, negatively affect other areas — wait times, patient experience, staff satisfaction and the bottom line.
9 out of 10 hospitals report holding patients in the ED to wait for inpatient beds.
Strategy: Find ways to centralize and standardize patient transfers.
Busy providers seek hospitals and hospital systems that respond to transfer requests quickly. To help expedite a physician’s acceptance of incoming patients, hospitals should find opportunities to standardize transfer processes among physicians, clinicians, administrative staff and other clinical staff. It’s important to create efficiencies and ensure all staff follow best practices. There are several ways to improve this process:
• Capturing pertinent clinical information to enable providers to make timely decisions regarding acceptance, level of care, and urgency of the transfer.
• Centralizing patient transfers with the ability to call one number.
• Creating efficient protocols that streamline admission processes and ensure appropriate patient placement.
• Promoting direct connection with accepting physicians that improves timely acceptance.
• Coordinating and collaborating with providers of different health systems to increase overall capacity to better serve patients and communities, in cases where a patient needs to be transferred outside of a health system.
Reducing ED boarding time by one hour could result in over $9,000 of added revenue.
“A transfer center can be a great partner. They take a huge volume of calls off the front lines. They make sure they are taking care of transfers by helping reach outside of the regular channels in the footprint to arrange transport for patients.”
-Wael Haider, MD, CCO
Bon Secours Mercy Health
Get the data you need
Challenge: The difficulties with identifying and quantifying transfer problems prevent improvement.
Many health systems don’t have a process in place for monitoring. Without data, they can’t:
• Decrease outmigration of appropriate patients.
• Ensure rapid acceptance and transport of appropriate patients
• Find service line gaps and opportunities for growth.
• Realize ongoing results, including financial savings.
• Understand surge capacity and capability.
• View metrics that help predict and manage patient volume.
Strategy: Use data to optimize patient acquisition.
Closely examining the transfer process from start to finish will help hospitals and health systems optimize patient acquisition. For example, finding the time it takes from intake to physician acceptance, and then from physician acceptance to bed placement, are critical data points. These steps are necessary to support an organization’s goal to optimize patient acquisition, and more importantly, patient outcomes. A continuous evaluation of metrics can help systems realize ongoing results, which can include better patient access and care, and financial savings.
“One of the great values I’ve seen from working with a transfer center is the insights on actionable data as a financial leader. Anecdotes are great, but data is invaluable. We get reporting daily and monthly, and a lot of it is actionable. We take that data and put it into a governance type structure with our local markets to make sure that wherever there are opportunities, that information and insight is getting to market leaders to act on.”
-Chris Hilton, CFO
Bon Secours Mercy Health
Support your staff
Challenge: There aren’t enough staff (or time) to fix transfer problems.
The demand for hospital staff is higher than ever, especially for nurses. An estimated 1.2 million new RNs will be needed by 2030 to address the current shortage. This means efficiency and job satisfaction are critical for hospitals and health systems. And current staff often don’t have time to manage transfer issues.
On average, it takes nurses 42 minutes to manage patient transfers, equating to 11.3 full-time nurses each month. Journal of Clinical Nursing
Strategy: Dedicate resources to the patient transfer process.
Hospitals and health systems need support when managing the complexities of the patient transfer process. Most don’t have the in-house resources, operational capacity or expertise to implement improved transfer processes. Partnering with an organization like Conduit Health Partners can help achieve optimal, patient-centered care through our customized 24/7 patient transfer center model. Take a look at how our model helped conserve staff resources and increase transfers across three different health systems from 2020-2021.
“The results that Conduit has delivered to Bon Secours Mercy Health are spectacular. We had over 33,000 transfers in 2021. Our organization reached so many people over the past year, which wouldn’t have been possible without Conduit.”
-Brian Smith, President & COO
Bon Secours Mercy Health
How Conduit can help you optimize patient acquisition and improve timeliness to care
Conduit is an outsource partner that offers customized health care solutions for health systems, health plans, employers and others to improve care and access for patients and employees. Partnering with Conduit can help you solve your transfer issues, make your life easier and keep your hospital focused on growth.
• We serve as an extension of your team and as a single access point to manage patient flow across networks of care.
• We offer the resources and expertise needed for time-saving patient admissions and improved patient outcomes.
• We use a registered nurse first model.
• We understand clinicians because we are clinicians.
• We help improve patient flow, which can lead to patient safety, health, and satisfaction.
• We streamline and expedite patient transfers 24 hours a day, 7 days a week.
Although dedicating resources to the transfer process may require an initial investment, hospitals can realize immediate benefits to their patient flow — and patient and provider satisfaction — by partnering with Conduit Health Partners.
About the Author
Cheryl Dalton-Norman, President at Conduit Health Partners, has over 40 years’ experience in health care and was instrumental in the development of Conduit’s innovative business solutions. Her history of leading high-functioning teams and achieving results in the hospital and health care industry continues to bring success to clients across the country
