The onset of COVID-19 required hospitals to consider how they planned to care for large numbers of patients who needed acute care. A 341 licensed bed hospital needed to prepare a surge plan to accommodate their average daily census of non-COVID patients and an additional projected 400 COVID patients. 

By gathering key stakeholders and using strategic facilitation techniques and data, the organization was able to successfully develop surge plans that would allow them to safely care for the projected number of patients. A combination of strategies included:

• Re-structing inpatient units to accommodate appropriate patient care
• Pausing elective procedures
• Converting clinics to inpatient units
• Re-deploying staff from closed clinics to acute care
• Team nursing

The four-phase plan was created and reviewed on a regular basis to adapt to rapidly changing projections. The hospital activated 3 phases throughout the course of the pandemic, and the solid plan that accounted for staffing and capacity made it easy to move from phase to phase. 

Fortunately, the large-scale surge plan was never fully deployed. However, as operations returned to normal, the organization continued to refer back to that particular surge plan to accommodate new surges of patients. The Pacific Northwest experienced an unprecedented heat wave in June 2021 and the hospital was able to safely accommodate a huge influx of critical and acute patients by referencing the existing COVID-19 Surge Plan.

A moderate sized hospital birth center had a longer than industry standard length of stay. Goals for this work included:

• Create a standard RN discharge process
• Increase RN satisfaction with discharge process by 50%
• Maintain patient satisfaction with discharge process of 80% 
• Reduce LOS for vaginal and C-section deliveries by 10%

The team gathered for a five-day event where they developed and tested a variety of solutions, primarily focused on involving the patient in discharge readiness. Some of the solutions included:

• Discharge readiness tasks poster
• Education checklist
• Estimated discharge timeline to share with patient (based on delivery time)

After deploying these strategies for three months, they saw LOS go down by 2 hours and average discharge time shifted from 2 PM to 12 PM. Staff satisfaction for couplet discharge process improved by 64%, and patient satisfaction increased from 80% “Satisfied” to 94% “Satisfied” with the discharge process. In addition to higher patient satisfaction, patients also reported a 40% increase in discharge readiness post implementation.