Roundtrip Blog

Patient Transportation: A Common Barrier to Discharge

Lindsay Tsai

Two female medical professionals talk to elderly patient in hospital bed.

Optimizing Patient Flow through Targeted Workflow Improvements: Recapping our CMSA Poster Presentation

Patient transportation often emerges as a hurdle to timely patient discharge. At St. Luke’s University Health System (SLUHN), this challenge loomed large, impeding the seamless flow of patients through the improved continuum of care. The Communication Center struggled to keep pace amidst a rapidly growing demand from the system, already clocking in with 30% of inpatients needing transportation assistance.

Image Title: Processes Develop out of Necessity Not Intention. Image description: Flow chart detailing the inefficient process of ride bookings pre-optimization. First, a ride request is made my dispatcher. From there, calls need to be made to determine availability. After that, the patient's request looses the ability to be tracked. — *Processes Develop out of Necessity Not Intention. 30% of in-patients required transportation assistance. Our Community Center was planning to hire 6 FTEs to keep up with the demand.*

Operating conditions resembled a perpetual state of urgency, with resources stretched thin and staff feeling the strain. Compounding the issue was the absence of a centralized system of record, leaving teams scrambling to manage transportation requests and schedules efficiently.

Image Title: Transportation Workflows Compound Over Time. Image Description: Three columns of text highlight the ways in which transportation workflows can become ineffective. They are: "Burdensome Workflows", "Disjointed Coordination", and "No Record Keeping System". — *Burdensome workflow, disjointed coordination, and lack of a record-keeping system can result in ineffective patient transportation processes.*

Using Patient Transportation Data to Reduce Length of Stay

Enter data – the unsung hero in the quest for operational efficiency. SLUHN recognized that to truly revolutionize transportation and reduce the length of stay, a paradigm shift was needed. They reframed patient transportation not as a standalone function but as an integral part of the discharge process, intrinsically linked to patient outcomes.

Integrating existing software systems with a transportation management software, allowed for a completely redesigned workflow and seamless transfer of data between parties in the transportation workflow, capturing essential information necessary to continue to iterate their process.

Transportation metrics unveiled a slew of inefficiencies, shedding light on delays and bottlenecks previously unmeasurable.

The lead time represents the duration between initiating a request for transportation and the desired pick-up time.
Response time signifies the interval from initiating the request to receiving confirmation from a transportation provider.
The winning ETA reflects the agreed-upon time for patient pick-up, while the ETA deviation quantifies any deviation from the originally planned pick-up time.

Image Title: Timestamps are essential for measuring how transportation impacts length of stayImage Description: Left to right flow chart details the full process of orderinga ride to the patient recieving it. The points on the chart are as follows (left to right) - Ride created time (0 minutes), Ride actioned (15 mins elapsed), Requested Start Time (60 minutes elapsed), Winning ETA (150 minutes elapsed), and At Patient Timestamp (270 minutes elapsed). — *Without a way to accurately measure how long the transportation process takes, it is difficult to identify the areas that need optimization.*

By dissecting these data points, SLUHN unearthed hidden delays and inefficiencies, paving the way for targeted interventions. They identified systemic issues contributing to prolonged lead times, such as inadequate notice periods and fragmented communication channels. Response times were optimized through streamlined processes and enhanced accessibility to ride requests. Moreover, objective measures of on-time performance were implemented, ensuring accountability and rewarding excellence among transportation providers.

Using Transportation to Improve Patient Flow

The SLUHN team understood that transformation requires strategic alignment and visionary leadership. Recognizing transportation as a critical enabler of patient flow, SLUHN rallied a cross-functional team to spearhead change. Departmental alignment was paramount, with EMS/SLETS and Care Management operating in lockstep. Leadership buy-in was secured, with stakeholders across the organization lending their support to the cause.

A data-driven strategy paved the way for action, showcasing the tangible impact of optimized transportation on patient outcomes and organizational efficiency. SLUHN shared its vision for success, outlining clear objectives and measurable outcomes.

Image Title: Improving Transportation Reduces Length of StayImage Description: Six statistics highlight the benefit of improving transportation. The bottom text reads - "To shorten length of stay, transportation cannot be viewed as a separate entity, but rather the crucial final step in the discharge process." — *Improving the patient transportation workflow will result in overall logistical optimization.*

In the end, SLUHN’s efforts bore fruit. Length of stay plummeted, overnight stays dwindled, and delays became a relic of the past. By reframing patient transportation through a data-driven lens and building a comprehensive strategy, SLUHN improved a once formidable barrier to discharge and harnessed the power of data to drive meaningful improvements in patient care.

Click here to download Roundtrip’s full CMSA poster presentation.