‘Bed turn’ is at the heart of IHI throughput tool

While Providence Health System has used such methods as measuring length of stay (LOS) and focusing on “discharge by 11” to improve patient throughput, a recent Institute for Healthcare Improvement (IHI) “call around” offered some new food for thought on the subject, notes Kathy Campbell, black belt project manager for health services integration.

The call, billed as “What senior leaders need to know about flow,” essentially covered an electronic tool that can be used to diagnose an organization’s throughput problems, she says. The tool, known as the Hospital Flow Diagnostic, focuses on “bed turn” as a method for measuring hospital throughput and hospital activity, Campbell says. Bed turn, she adds, can be looked at both with and without adjustment for acuity based on the case mix index.

“[IHI says] the preferred method is to measure bed turn, and when you collect the data, run it through an algorithm,” Campbell says. “That tells you whether you have significant delays due to high demand, significant delays due to inefficient use of capacity, or significant delays due to high LOS adjusted for case mix.”

After determining whether the problem is LOS-related, there are too many patients who want the beds, or capacity is not being used appropriately, she adds, a facility can focus improvement efforts around its specific issues.

(Editor’s note: More information on the IHI throughput diagnostic tool is available at its web site: www.ihi.org.)