Intervention Title: A No-Tech Solution for Reducing Hospital Bed Turnaround Time – University Hospital; San Antonio, Texas
Goal: Improve patient flow by reducing inpatient bed clean-up and turnaround time.
Innovation: Staff developed a simple communication system between housekeeping and nurses by using jars with color-coded slips of paper that allowed staff to easily track beds that were available or that needed cleaning.
Result: This system improved efficiency and reduced bed turnover time at University Hospital in San Antonio (UHS) by 76 percent, down from a high of more than two hours and 40 minutes to a current average time of 40 minutes.
4520 Medical Drive
San Antonio, TX 78229
P: (210) 358-4000
From the C-Suite:
This simple innovation had a dramatic impact on our bed turnaround times at little to no cost. It has improved wait times, patient satisfaction and our operating efficiency. For hospitals and health systems struggling with heavy patient loads, limited budgets and no electronic bed tracking system, the red-light, green-light notification innovation should be seriously considered.
David Hnatow, M.D., F.A.A.E.M., F.A.C.E.P.
Medical Director, Emergency Center
Profile: University Hospital is a 400-bed facility in San Antonio, Texas, and is part of the public University Health System (UHS).
Clinical areas affected:
- All hospital units with patient beds
- Charge nurses and nursing staff
Timeline: One-week planning, consensus-building and implementation period
Contact: David Hnatow, M.D., F.A.A.E.M., F.A.C.E.P.Medical Director, Emergency Center David.Hnatow@uhs-sa.com P: (210) 358-2617
Innovation implementation: For large hospitals operating at high capacity, it is essential that patient beds are maximized. Efficiently managing them keeps patient flow smooth and reduces overcrowding in other areas, especially the emergency department. But at many hospitals, communication delays and difficulties following patient discharge mean that dirty beds remain empty for extended periods of time.
Working to address this problem, a team at University Hospital in San Antonio implemented an extremely simple and effective visual communications system between the floor nurses and the housekeeping staff. Two jars were placed at the nurses' station—one to represent clean beds and one to represent dirty beds. Once a patient checked out, the nurse put a bright red slip of paper with the patient's room number into one of the jars. When housekeeping staff finished cleaning and preparing the room for an incoming patient, they removed the red slip from the first jar and put a green slip with the same room number in the second jar. The green slip in the jar served as a highly visible notice to the unit clerk that an open bed was available and ready to be filled.
The implementation and operation of this solution cut down on bed turnaround time for UHS more significantly than any other strategy tried by staff prior to the implementation of an electronic bed tracking system. Furthermore, its ease and dramatic impact received attention throughout the hospital and significantly helped build support for exploring other quality improvement efforts.
Advice and lessons learned:
- Look toward simplicity.
- Consult everyone.
- Celebrate success
Cost/benefit estimate: With negligible costs involved in setting up the jars and colored slips of paper, the hospital keeps operating at a high capacity, reducing the time that beds are empty and maximizing its resources.