Innovative stroke patient management system cuts hospital bed usage by more than 25 percent

Posted: Published on October 7th, 2014

This post was added by Dr Simmons

An innovative patient management system at the acute stroke unit of Kelowna (BC) General Hospital has reduced the number of stroke patient bed days by more than 25 per cent, according to a study of the system presented at the annual Canadian Stroke Congress in Vancouver.

In total, it is estimated the new system is saving the 380-bed hospital more than 1,000 bed days per year. This represents annual savings of up to $800,000, all achieved without the need for any new investment in devices, treatments or personnel.

"It's a win-win situation," says Dr. John B. Falconer, director of the transient ischemic attack (TIA) and stroke clinic at the hospital, and author of the study. "Patients are better and more efficiently treated, the hospital saves resources and the morale of the whole unit is much better."

The program is called Proprietary Physician, or Pro-MD. It involves assuring that one of the hospital's five neurologists is always designated as primarily responsible for best bed usage and patient flow on the acute stroke unit.

"The ward becomes "that doctor's" ward; they have a propriety interest in it functioning well," says Dr. Falconer. Each doctor's assignment as Pro-MD could last several weeks or a month.

A crucial component of the program is that beyond the normal care to the patients by their own neurologist and other caregivers, the Pro-MD makes twice-weekly rounds of all patients with the full care team. This includes the ward head nurse, physiotherapist, occupational therapist, social worker, transition nurse, pharmacist, rehabilitation ward head nurse and -- very importantly according to Dr. Falconer -- the patient's family.

"This brings everyone who needs to have input into decisions about a patient's care together to agree on the action needed," says Dr. Falconer. "This is very advantageous compared to formerly having to compare written notes from one another and wait for input from others."

The meetings take only 30-45 minutes to discuss the usual half-dozen patients, but result in everyone agreeing on the course of care, including the family. This is crucial, particularly when discussing the timing and terms of a patient's discharge from hospital.

A further benefit, added Dr. Falconer, has been a huge boost in staff morale on the ward. "We're now the primo ward of the hospital, with staff enjoying the team-based collaboration," he says.

The program is actually very simple but has proven very effective. "It could perhaps be used in other areas of the hospital, but it's particularly relevant to stroke care because of the many players involved and the crucial role the patient and family play in rehabilitation."

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Innovative stroke patient management system cuts hospital bed usage by more than 25 percent

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