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How to start a Bridge Order initiative How do Bridge Orders affect ED Operations Monitoring for Continued Success (C) COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS OBJECTIVES
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BOARDING SOLUTIONS
INCREASE PROFIT
S BY ENDING ER GRIDLO
CK
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANSEm
ergency
Medicin
e
Summit 5
/4/2011
BRIDGE ORDERS:
DECREASE TIME TO
DEPART FO
R ADMITTED
PATIENTS
TAMERA BARNES, MD, FA
CEP
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
• How to start a Bridge Order initiative
• How do Bridge Orders affect ED Operations
• Monitoring for Continued Success
(C) COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
OBJECTIVES
BUILD CONSENSUS
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
• MEET WITH YOUR ADMISTRATOR TO GET THEIR SUPPORT
• MEET WITH HEAD OF HOSPITALIST GROUP
• MEET WITH ED PHYSICIANS
• IRON OUT SPECIFICS OF THE PROGRAM
• DEVELOP A HAND-OFF TOOL TO ENSURE INFORMATION EXCHANGE IS MAXIMAL FOR PATIENT SAFETY
• MEETING BETWEEN ED PHYSICIANS AND HOSPITALISTS
• MONITOR DATA; INTERMITTENT MEETINGS
HAND-OFF TOOL
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
• PATIENT’S NAME/PCP
• DIAGNOSIS/CHIEF COMPLAINT
• VITAL SIGNS
• SIGNIFICANT POSTIVE AND NEGATIVE TESTS
• TESTS STILL PENDING
• ED COURSE
• TYPE OF BED (I.E. TELEMETRY, ICU, ETC.)
• INPATIENT VS. OBSERVATION
WHEN NOT TO WRITE BRIDGE ORDERS
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
• IF PATIENT UNSTABLE
• IF CONTROVERSY WHETHER PATIENT MEETS INPATIENT CRITERIA
DASHBOARD DATA
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
BEFORE AFTERED VISITS 2184 2238ARRIVAL TO TRIAGE
3.02 5.78
ARRIVAL TO GREET
21.08 27.19
LWBS % 0.6% 0.85%ADMITS 24.8% 23.7%DISPO TO DEPART(ADMITTED PTS)
172.8 69.3
WHAT DOES THAT MEAN FOR YOUR HOSPITAL?
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
• 103.5 MIN SAVED• 23.7% ADMIT RATE = 530 ADMITS THAT MONTH• 530 X 103.5 MIN SAVED/ADMIT = 54,855 MINUTES
SAVED OR 915 HRS• AVG LOS FOR ALL ED PATIENTS 150-180 MINUTES• CREATES CAPACITY FOR 304-365 MORE PATIENTS
WITH SAME STAFF, NO ADDED BEDS• $100/PT. = AVG COLLECTION FOR ED MD =
$30,000/MONTH• $350/PT = AVG COLLECTION FOR HOSPITAL =
$122,500/MONTH OR $1.4 MILLION PER YEAR • $4000 HOSPITAL REVENUE/ADMITTED PT X 78 MORE
ADMITTED PATIENTS/MONTH = $312,000/ MONTH OR $3.7 MILLION PER YEAR ON ADMISSIONS FROM ED
• TOTAL INCREASED REVENUE = $5.1 MILLION
QUESTIONS?
© COPYRIGHT 2011 VIRGINIA COLLEGE OF EMERGENCY PHYSICIANS
