Hospital moves patients by key strokes - patient escort services

Healthcare Financial Management, Sept, 1989 by Kevin Lumsdon

Hospital moves patients by key strokes

When officials at Henry Ford Hospital in Detroit, Mich., noticed that late trips, understaffing at peak hours, and other problems consistently snarled the movement of patients and equipment throughout the 937-bed facility, they turned to an electronic solution.

Today the tertiary care hospital meets the scheduling demands of its patient escort services department in a few key strokes, using a computer to work out the kinks.

"We knew we had a problem for some time," said Brenita Crawford Searcy, the hospital's vice president for hospital services. "We asked an operations analyst to look at the system and saw that it worked very much like a taxi service. We literally went out to visit a taxi company and watched their computer dispatch system at work."

The similarities between the two operations were clear, Searcy said. Both involved unscheduled requests, dispatching for pick-ups and deliveries, and scheduling staff and equipment.

Staff members assigned to the project then evaluated Ford's escort department to note problems and decide how the new system should work. Under the manual system, data needed to evaluate efficiency and chart problems often was incomplete. On top of this, tracking a single work day, consisting of 300 trips, took 40 hours to complete, Searcy said.

For these reasons, the team decided that the new system should coordinate and track all requests to move patients and equipment. They also wanted a way to monitor the productivity of workers.

"All hospitals have transport systems," Searcy said," and I suspect that many have problems with them. But they tend to be a low priority, even though they are an expense--a large expense."

Because the hospital lacked the staff to design the system, it contracted two years ago with a local software development company to tailor one to its specifications.

The resulting software, which took approximately nine months to develop, has eased problems and saved money, Searcy said.

The software generates daily reports, breaking down the number of requests, completed trips, equipment used, individual productivity and efficiency per employee, supply and demand analysis, and time and attendance information by day or date range. The report also lists reasons for delays, such as when the patient is eating or not ready to be escorted.

"Before, we had no way to monitor the system and adjust for volume," Searcy said. "The computer allows us to look at problems and to document them."

With the new software, the hospital is able to detect subtle problems before they grow out of hand and find a way to solve them. The escort department manager then can forsee shifts in performance and respond to them by shuffling staff members, adjusting the schedule, and using other means.

"Our daily report also serves as an attendance record," Searcy noted. "Employees code into the system when they report to work, and they are expected to respond as long as they are checked in.

"They also punch out for breaks and lunch hours, so we can tell if too many are unavailable at one time. We used to have poor coverage during the lunch hour, which also is a peak time for discharges," she added.

Searcy said the system performs workload balancing to remove chances for favoritism in dispatching. It also calculates timing of trips, based on patient pick up, destination, escort start location, time of escort availability, and equipment search times. The dispatcher can override the system for emergencies and special needs, she said.

Steve Hathaway, Ford's vice president for support services in charge of hospital finance, said the software already is paying off by helping lower the patient escort department's payroll 14.6 percent from 1988 to 1989.

The department's budget now stands at $330,771, with payroll accounting for $291,582.

The department had the equivalent of 16.2 full-time employees in 1988, but has reduced its staff to 15 in 1989. Other savings, Hathaway noted, came through reducing the number of overtime hours.

"I think we just didn't have a handle on the department before," Searcy said. "But the results of this system show that we do now."

PHOTO : An employee at Henry Ford Hospital in Detroit, Mich., wheels a patient to her destination.

Kevin Lumsdon is features editor of HEALTHCARE FINANCIAL MANAGEMENT.