Committee decreases length of stay at Rapid City Hospital

Committee decreases length of stay at Rapid City Hospital

Patient Flow Oversight Committee wins Quality Showcase award



Every person who comes to the hospital is someone’s mother, brother, husband, aunt, etc. Nita Dunham, MS, BSN, CMAC, CDP, keeps this front-of-mind in her work as Senior Director of Case Management for Monument Health. From a patient’s perspective, the work of nursing case managers often happens behind the scenes, yet their work can have great impact on each patient and family.

Nita’s team and the Patient Flow Oversight Committee won this quarter’s Quality Showcase award for their work to decrease patients’ length of stay at Rapid City Hospital. “We’re getting people back to their home environments,” she said. “Being in the hospital is not optimal for anyone, so we want to help patients make that transition as soon as it is medically safe to do so.” The project also reduced transfers within the hospital and has reduced diversions to other hospitals.

The committee first identified certain interruptions in a patient’s flow of care that can increase length of stay. They then implemented patient-centered interventions that aided in providing more proactive, timely and efficient care while maintaining high-quality standards. The team also created the role of the physician advisor, who serves as a medical consultant to care teams. “The goal was to deliver the right care at the right time and in the right place for every patient,” Nita said.

The initiative’s success involved strengthening relationships with long term care environments to ensure successful transitions, improving discharge education and utilizing Epic EMR for nursing home referrals. The committee relied on Monument Health’s Enterprise Intelligence Team for data that helped focus the group’s efforts. “Their insight regarding where to obtain data and how to ensure it was meaningful was key to our success,” she said.

As patients’ length of stay has decreased, hospital readmissions have also gone down. According to the Great Plains Quality Innovation Network, Monument Health has the best readmission relative improvement rate in its region.“Our low readmission rates are directly linked back to the quality of services we provide,” Nita said.

Work to lower readmission rates involved the creation of the Discharge Steering Team, a multi-disciplinary team of physicians, bedside caregivers, case managers and Epic colleagues. “Medications and diagnoses are complicated,” Nita said. “If we can untangle any confusion for our patients and ensure they understand everything before they go home, they’ll be more successful.”

After 22 years with Monument Health, Nita said it doesn’t feel like work. “It feels like a privilege. We get to do this. We get to be here for our patients. I just love it.” Thank you to Nita and all of the caregivers and physicians who work hard to provide individualized, high-quality care to our patients.

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