Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

The Engineering of the Acute Care Continuum

2/25/2013 9:55:40 PM | 0 comments

In this time of rapid change and financial challenges in healthcare, there is a need for change management.  Process engineering, also called management engineering, can be a valuable resource in negotiating these challenges across the Acute Care Continuum.  

Process engineering, an offshoot of industrial engineering, looks at the big picture of an organization and utilizes a number of tools to create improvements that will help the organization operate more efficiently. For example, the Lean process was first devised by the manufacturing industry, used to identify methods to streamline workflow processes. The process engineer uses tools, like Lean, to look at all the people involved and translate their different activities into metrics that can be reviewed, measured, and assigned goals.

The hospital setting lends itself very well to process engineering. Engineers, or consultants with an understanding of operational improvement initiatives, observe as healthcare staff perform their jobs in an effort to devise ways for them to work more efficiently.  The process engineer provides an outside eye, engaging with staff in learning to see things differently, how to break down old processes and old habits, and come up with new solutions.  Healthcare management, which has been lagging behind other industries in terms of efficiency, is quickly catching up.  The Acute Care Continuum, in fact, is a working model of change management.   By integrating hospital departments, it is increasing efficiencies and equipping the staff to meet future challenges.

One of the biggest process challenges to hospital administration is variability.  There is truth in the adage, “variability is the enemy of efficiency”.  While insurers want standardization, there is an inherent challenge to standardization in the ED.  One way process engineers have worked to standardize the normally chaotic ED is by focusing on patient throughput to the inpatient department. By working with both emergency and inpatient physicians, engineers are able to help develop joint protocols and standard order sets. By establishing guidelines for the most common diagnoses, both the ED docs and the hospitalists can anticipate next steps for patients presenting with those symptoms; thereby improving patient flow and satisfaction.

Transitions of care is another place where change management can make a big difference.  As patients go upstream and downstream, there is a need for improved collaboration and coordination among the different hospital departments. The process engineer finds ways to coordinate the different services so that patient handoff goes more smoothly. This commitment to operational improvements is why more and more hospitals are engaging process engineers. We shine light on issues and, rather than implement changes ourselves, engage the staff for solutions that best fit them.   The end result goal is a set of changes that enhance efficiency.

While specific methodologies  in process engineering, such as Total Quality Management (TQM),  come and go, the science of process engineering itself  is here to stay. The increased coordination taking place through the Acute Care Continuum is a big picture illustration of process engineering in action, and yet the daily data metrics and the appropriate adjustments taking place are what is creating the fabric and fluidity of the Acute Care Continuum.

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