Creating Capacity: Patient Flow to Meet Demand at UAB Medicine

UAB Medicine is a 1,157-bed academic medical center that is the only American College of Surgeons [ACS]-designated Level 1 Trauma and Burn Center in Alabama. It manages 50,000 annual admissions, 57 OR Suites with 130 surgeries a day and 300 ED visits a day. In addition, UAB serves as a safety net hospital for the community, as 35% of the patients who come through the door are uninsured.

High patient volume was leading to significant challenges for the facility and the staff. For example, the hospital was on diversion 60% of the time, the average wait time for an inpatient bed was up to 210 minutes, only 15% of all discharge orders occurred before 12PM, and more than 30% of the transfer requests were denied.

“We needed to do something to address our capacity challenges—we were closing our doors 60% of the time to patients in the state of Alabama. Our chief nursing officer [CNO] led the charge to develop a strategic patient flow plan and build a centralized patient placement center that would support the need to keep our doors open to the state of Alabama,” says Brittany Lindsey, Director of Patient Flow at UAB Medicine.

“With that charge, we assembled a team and developed a framework for a center dedicated to improving patient flow. We determined that staffing needed to include a patient flow supervisor responsible for oversight of the daily operations, a patient placement coordinator and specialist, a nursing resource coordinator to act as an administrator, a stat nurse to handle all clinical needs and a Lean analyst to provide data analysis and project management to round out the team.”

AS THE PLAN UNFOLDED, THREE CORE BEST PRACTICES WERE IDENTIFIED THAT WOULD DRIVE EVERYTHING.