The Four Keys to Increasing Hospital Capacity Without Construction

The Four Keys to
Increasing Hospital
Capacity Without
Construction

© 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Transforming Healthcare Business Strategy
This report is based on a 2018 Healthcare Analytics Summit
presentation given by Yohan Vetteth, MBA, CAO, and Rudy Arthofer,
RN, BSN, MHA, Administrative Director of the Hospital Operations
Center, both at Stanford HealthCare, entitled, “Adding Capacity Without
Construction: A Collaboration of Analytics and Frontline Operations.”
Yohan Vetteth, MBA
Chief Analytics Officer
Stanford HealthCare
Rudy Arthofer, RN, BSN, MHA
Administrative Director of the Hospital
Operations Center, Stanford HealthCare

Many health systems are facing a hospital
capacity problem. The demand for patient beds
is greater than the number of beds available.
This can lead to several negative effects, such
as surgery cancellations, increased length of
stay, and declining patient and staff
satisfaction.
While building capacity is vital to meeting
demand, construction is costly and time
consuming, and it isn’t always an option.
Increasing Hospital Capacity

This leaves health systems with the
challenge of adding capacity without
construction, and many are looking to
healthcare analytics to help address
this challenge and get ahead of demand
while maintaining or improving patient
outcomes and satisfaction.
Increasing Hospital Capacity

The impacts of a bed capacity problem can
be significant.
Some academic medical centers are turning
away transfer patients because there aren’t
any available beds, which means patients
who need specialized care cannot get it or
have to travel farther to get it.
Surgeries are cancelled as well, sometimes
even at the last minute, putting patient
satisfaction and health at risk.
Impacts of Limited Hospital Capacity

Surgery cancellations also interrupt workflow,
which can decrease staff satisfaction.
Another risk of limited capacity is an increase
in emergency department boarding hours.
Interestingly, some hospitals see an
increased length of stay for all patients
in the ED when there aren’t enough
available beds.
As the population ages and grows, bed
capacity will continue to be an issue unless
health systems can find a viable solution.
Impacts of Limited Hospital Capacity

The most important part of developing a
process to manage bed capacity is creating a
plan based on a collaboration of leaders and
staff throughout the hospital.
Having daily interdepartmental huddles is key
to understanding the root of the problem and
how to best address it.
Solutions must focus on maintaining or
improving quality and outcomes. Patient
safety and patient experience need to be
top of mind when initiating any change.
Developing a Hospital Capacity
Management Process

Data analysis can help organizations
increase capacity without construction.
Using available data, organizations can
understand how past decisions and
actions contributed to the capacity
problem before they try to address it.
They can also identify key process
and outcome metrics across departments
to inform the interventions chosen to
address the dearth of beds.
This can help increase transparency
and measure impact.
Using Data Analytics to Guide
Resource Allocation

Health systems can leverage data by
creating an interactive dashboard that
allows staff to dig deep into the data.
This gives staff an opportunity to look at
capacity constraints and understand
the root of the problem in their
respective areas.
Resource Allocation

A dashboard also removes some pressure
from the analytics team because it provides
basic information staff can access without
submitting a request.
While a dashboard is an effective and
necessary tool, it’s just part of the process
because it only provides historical data,
looking backward rather than forward.
Resource Allocation

Next, organizations can develop forward-
looking tools that leverage the power of data
science and take advantage of predictive
analysis capabilities, such as:
A hospital operations center daily report
A 24/48-hour discharge dashboard
An annual capacity management assessment
Resource Allocation
>
>
>

Hospital Operations Center Daily Report
This report can provide accurate, timely data
about current and future bed availability and
provide leadership a view of the entire
organization.
It can also provide a tool to gather data and
predict whether capacity demands can be
met and, if so, how.
Resource Allocation

A 24/48-hour Discharge Dashboard
Show the patient discharge plan throughout
the hospital.
This type of report uses predictive analysis
to provide a picture of what bed availability
will look like throughout the day so staff can
develop countermeasures if necessary.
This isn’t a clinical decision-making tool, but
rather a predictive modeling tool for support
services that helps align resources so patients
ready for discharge aren’t taking up beds.
Resource Allocation

Annual Capacity Management Assessment
Helps analyze the effectiveness of interventions,
which helps with future resource allocation.
This can also help organizations understand
whether there is a year-long capacity problem
or whether there are seasonal spikes.
These tools and others like them help
move organizations from the theory of
problem solving through the actions that
increase capacity.
Resource Allocation

Health systems that have successfully increased capacity
without building new spaces follow four guidelines:
1. Successful organizations start with the problem
and the ideal solution.
2. The analytics team works with teams throughout
the organization—including leadership.
3. Leaders spend time with the operations team to
understand workflow.
4. Successful organizations focus on impact,
not the tool.
Roadmap to Increase Hospital Capacity

1. Successful organizations start with the problem and the ideal solution.
Before an organization can develop a
plan to address a capacity problem, it
must map out what the problem is and
agree upon an ideal solution.
Fully understanding the problem and
the changes that need to take place
should be the foundation of any
problem-solving mission.

2. Analytics team works with teams throughout the organization
A successful, efficient data analytics team
cannot operate in a vacuum.
They should be interacting with departments
throughout the organization to fully understand
the problem and how to best address it.
Leadership should make it a priority to ensure
the data analytics team is included in the entire
process, from the initial planning stage through
successful intervention.

3. Leaders spend time with the operations team to understand workflow
The entire process must integrate
the operations team and other vital
departments.
One of the best ways to get across-
the-board buy-in for any change
initiative is to get everyone together
in a room to talk about solutions.

4. Successful organizations focus on impact, not the tool
The data analytics tools are only as good as
the impact they have, and organizations
should strive for balance between using tools
already available in the EMR and solutions
beyond the EMR.
The ability to effectively leverage data to
assess interventions is vital.

The Value of Solving the Bed Capacity Problem
When capacity is a problem, hospital executives
and other leaders can spend two to three hours
per day addressing capacity management issues.
When that problem is addressed through an
effective capacity management process,
leaders get their time back.
This is a real benefit that can’t be
accurately measured.

The Value of Solving the Bed Capacity Problem
Staff efficiency will also increase, as
they aren’t burdened with trying to
manage a lack of bed space.
Instead, staff can spend their time
focusing on patient care.
And when patients have beds, they
are more likely to feel valued and
cared for—a positive effect on
patient satisfaction and outcomes.

For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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Mr. Vetteth is the Chief Analytics Officer at Stanford Health Care. His responsibilities
include driving clinical, operational and business improvement efforts through data
analytics and reporting, establishing and maintaining the enterprise data governance
processes.
Mr. Vetteth joined Stanford in 2011 from Accenture, where he was a Partner and led the Healthcare
IT Strategy practice in the US. His clients included both healthcare providers and payers who he
worked with to develop and implement IT and Analytics enabled business strategies.
Yohan holds a Masters of Business Administration from the University of San Francisco where he
was both a McLaren Fellow and a member of the Beta Gamma Sigma Honor Society. He also
earned a Bachelor of Science (Physics) from Loyola College in Madras, India.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Yohan Vetteth, MBA – Chief Analytics Officer, Stanford HealthCare

Mr. Arthofer is the Administrative Director for the Hospital Operations Center at Stanford
HealthCare. His responsibility is to the development and ongoing management of the
governance/structure, data/processing, and organizational change management for these
three priorities:
• Enhanced situational awareness across Stanford Hospital – monitoring clinical and
non-clinical support departments and their impact on patient flow
• Develop tools to track patients through their expected care path, early recognition of
variation including both affiliated and integrated sites
• Maximize data management to enhance the organizational decision-making process
to maximize capacity, including predictive modeling
Rudy holds a Masters in Healthcare Administration from the University of North Carolina
and a Bachelors Degree in Nursing from the University of Maine.
Rudy Arthofer, RN, BSN, MHA –
Administrative Director of the Hospital Operations Center, Stanford HealthCare

Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement company
that helps healthcare organizations of all sizes improve clinical, financial, and operational outcomes
needed to improve population health and accountable care. Our proven enterprise data warehouse
(EDW) and analytics platform helps improve quality, add efficiency and lower costs in support of more
than 65 million patients for organizations ranging from the largest US health system to forward-thinking
physician practices.
Health Catalyst was recently named as the leader in the enterprise healthcare BI market in
improvement by KLAS, and has received numerous best-place-to work awards including Modern
Healthcare in 2013, 2014, and 2015, as well as other recognitions such as “Best Place to work for
Millenials, and a “Best Perks for Women.”

The Four Keys to Increasing Hospital Capacity Without Construction

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