No one enjoys being in the hospital. They want to go home as soon as possible. In fact, the hospital actually wants patients to go home too – or to whatever the next step in care is for their situation – as soon as possible. Leaving helps patient recoveries, and it also helps the hospital’s financial health to move patients through the system as efficiently as possible, from admission to discharge. Collaboration among caregivers, administration and support staff is the only way for patients to move through that system efficiently.
Unfortunately, that smooth process seldom happens. Healthcare faces a critical bottleneck: “bed blocking.” This occurs when patients who are medically stable and ready for discharge remain hospitalized due to factors beyond their health situations. These discharge delays can be caused by issues such as incomplete discharge paperwork, a breakdown in communication with the receiving facility, a last-minute medication or test order, or other internal coordination challenges that prevent a bed from being turned. When communication relies on a patchwork of pages, phone calls, emails and other modalities, there exists a lack of transparency and accountability, making it easy for staff to stall with little urgency. This is often the case with nurses who are burnt out and overworked, as taking new patients adds to their burden. Transportation is also a consistent culprit in causing delays because it’s simply unavailable – even seemingly simple things like getting a wheelchair to the patient’s room. Unfortunately, the repercussions of bed blocking are far-reaching.
The cost of congestion
Bed blocking happens because of a host of delays, glitches and confusions that prevent effective collaboration among staff and departments. We have coined the term Collaboration Waste to describe these activities because even though they might seem disconnected – a glitch here, a delay there – they are part of the same operational fabric. Time, money, staff abilities and more are wasted as patient throughput stalls.
Bed blocking can impact every part of the healthcare experience, from degrading patient care and pushing the needle on nurse and physician burnout to severe financial ramifications for the hospital. A recent Massachusetts Health and Hospital Association report paints a grim picture. Staffing shortages and the lingering aftershocks of the pandemic are creating intense logjams in transitioning patients to post-acute care facilities.
Delayed hospital discharge can have an array of negative impacts on patient care. Prolonged hospitalization can expose patients to a higher risk of hospital-acquired infections, sleep deprivation, and other physical impacts, which can further extend their stay. A lack of available hospital beds also disrupts patient flow, overcrowding emergency rooms and straining staff, furthering the impact of clinician burnout and the possibility for medical errors. These delays cause discomfort for patients and families and significantly strain hospital resources and finances.
Low staffing levels in hospitals exacerbate Collaboration Waste and create a vicious financial cycle. With fewer staff, hospitals can’t treat as many patients, leading to lost revenue. Additionally, discharge delays due to staffing limitations eat into profit margins even for patients they see. This rising cost of care and lower patient volume further strain already stressed hospital finances. Data from New York State reveals a staggering cost: discharge delays resulted in a collective loss of $169 million for 52 hospitals in just three months. Peak seasons compound the situation with surges in hospitalizations witnessed, particularly amid the ongoing challenges posed by Covid-19, influenza, and respiratory syncytial virus (RSV) cases.
Hospitals must adopt strategies to address Collaboration Waste and optimize care coordination processes amid this tumult. Thankfully, technology equipped with modern communication methods is ready to help break the bottleneck and mitigate the risks of bed blocking.
The cure: Streamlining communication
One solution to enhancing care coordination is through effective clinical communication and collaboration (CC&C) platforms. These modern communication tools foster information exchange – via multi-modalities such as text, voice and video – between all stakeholders involved in a patient’s care journey, seamlessly integrating with existing electronic health records and clinical systems and allowing for faster collaboration and interventions. Healthcare staff, external care facilities, and families can access real-time updates on patient status, discharge plans, and any logistical or care-related roadblocks. These secure platforms offer features like role-based messaging and smart routing, ensuring messages reach the right person or team. Staff don’t need to know each team member’s name—identifying their role, like “hospitalist,” is enough to route your message to the on-call individual. Integration with scheduling systems further ensures the right person receives alerts. Beyond improved care, CC&C platforms boost a hospital’s financial health and unlock the full potential of existing investments in EHRs and scheduling systems by unifying these siloed tools into a cohesive environment for clinicians.
Technology plays a significant role in helping improve healthcare communication, both externally by facilitating coordinated patient transfers between facilities and internally by streamlining communication between staff in the ER, main hospital floor, and other departments. Many people are involved in the internal transfer of a patient from the ER to the main hospital floors – bed control, head nurses, transport, the receiving physician, etc. That means there are opportunities for miscommunication and resulting delays. This is where technology becomes a critical ally.
In this case, the right clinical communication system can help locate the proper professional or patient quickly rather than relying on phone calls. Additionally, the person sending the initial communication can see what messages have been viewed and received, making it easier to communicate with all constituents and providing more transparent communication, ultimately driving better accountability and reducing patient transfer delays.
The path forward: A proactive approach to healthcare
The current healthcare landscape demands proactive solutions. As patient volumes rise and resources remain strained, effective communication strategies are no longer optional; they’re essential. Collaboration Waste takes its toll on patient, staff and hospital financials.
Modern CC&C platforms empower hospitals to break through bed-blocking gridlock, fostering a more streamlined and cost-conscious healthcare system. By harnessing technology’s potential, these systems dismantle communication silos, eliminate delays, and pave the way for efficiency. Ending Communication Waste can unlock the full potential of our healthcare ecosystem, ensuring timely interventions and a smoother path to patient recovery.
Photo: FS Productions, Getty Images
Will O’Connor, M.D. is TigerConnect’s chief medical information officer. He’s an industry-known physician executive with more than 20 years of healthcare experience focused on operations, strategic planning, consulting, client delivery, and thought leadership across the healthcare industry.As an orthopedic surgeon, Dr. O’Connor has significant provider experience as well as deep commercial experience, having worked for multiple companies, including McKesson, Allscripts/Eclipsys, and PriceWaterhouseCoopers. He specializes in assisting large health systems, academic medical centers, community hospitals, and payers leverage healthcare information technology and operational improvements to advance their clinical and financial outcomes.Additional experience includes EHR and HIE implementations, clinical communication and collaboration, clinician adoption, analytics, clinical decision support, provider operational analysis, and clinical process redesign.
