3. Alternative single measures are less likely to engage the wide range of hospital staff involved in patient care and flow and are unable to detect specific performance areas that contribute to the flow.

4. Composite scoring also allows for moving performance goals without changing the overall structure of measurement, as was demonstrated in the move from FY10 to FY11.

5. Further investigations can further refine composite scoring and explore the impact on clinical and financial outcomes.

6. Describe a patient flow composite score tool developed at a large, urban children’s hospital.

7. Five teams in the patient flow initiative proposed measures for their domains. Goals were based on historical performance.

8. Domains summed to 100 points; 80 was set as a goal (green zone); yellow zone (70-79): red zone <70.

9. Used for one fiscal year and then modified in slight ways for the next fiscal year; goals were changed to encourage continuous improvement.

10. The composite score (Fig 1) was well-received by the patient flow improvement teams and administration.

11. Areas needing improvement were called out by performance in the yellow or red zone; these areas became the focus of improvement work.

12. Performance tracked with occupancy and turnover, as a well as special events, such as H1N1 pandemic (fall ‘09) and new inpatient computer provider order entry (CPOE) system (Jan ‘11) (Fig 2).Patient Flow Composite Score for a Children’s Hospital Evan Fieldston, MD, MBA, MSHP1,2; Bhuvaneswari Jayaraman, MPH1; Martha Parra, RN1; Lisa Zaoutis, MD1,2; Kathleen Gorman, MSN, RN1 1The Children’s Hospital of Philadelphia and 2University of Pennsylvania School of Medicine, Philadelphia, PA The authors have no conflicts of interest to disclose * *CV = coefficient of variation (standard deviation / mean)