2019 Discharge Planning & Capacity Management Summit
September 16-17, 2019
Westin Kierland Resort & Spa, Scottsdale, Arizona

2019 Discharge Planning & Capacity Management Summit

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About the Conference

Care coordination within hospitals and health systems has never been more important as it helps to align priorities of care teams and minimize waste within the system. Delayed discharges are not just an inconvenience; they lead to poorer experiences for patients and prevent hospitals from providing responsive care for patients requiring acute care, and those requiring admission for planned procedures. Poorly managed hospital-wide patient flow and capacity management has critical implications for both patients and providers.

Integrated healthcare strategies are essential in supporting successful discharge planning and providing efficient, high quality and timely patient-centric healthcare. This conference brings together leaders from hospitals, health systems, home care, health plans and managed care organizations to discuss best practices for improving care coordination, reducing readmissions, preventing avoidable healthcare utilization, and collaborating across the continuum. Network with leading practitioners on discharge planning and learn from the success of others on how to prevent hospital readmissions through comprehensive discharge planning; move patients quickly, efficiently and safely through the hospital system; improve capacity planning and service design; enhance patient care and satisfaction; and much more.

Who Should Attend?

From Hospitals/Health Systems/Health Plans
 

  • CEO’s
  • CFO’s
  • VP
  • Quality Improvement Director
  • Emergency Room Director
  • Patient Flow Director
  • Discharge Planning
  • Case Management Director
  • Nursing Director
  • Care Coordination
  • Utilization Review
  • ICU Director
  • Admissions Director
  • Hospitalists
  • Billing
  • Patient Financial Services
  • Medical Directors
  • Social Service Director
  • Patient Flow
  • Clinical Operations Director
  • Patient Transportation
  • TeleICU

Conference Agenda

Day One – Monday, September 16, 2019

7:15am – 8:00am
Conference Registration & Networking Breakfast

8:00am – 8:15am
Chairperson’s Opening Remarks

8:15am – 9:00am
Keynote: Care Coordination Across the Continuum: Hospital-Wide Strategies and Approaches to Improve Efficiency and Collaboration

Many recognize that diversions, long waits, and delays in the ED are a hospital-wide issue, not solely an ED issue. Waits are often the result of ED beds being occupied by patients waiting for admission to the hospital.

Yet, while many understand the problem, they don’t often have the strategies needed to address hospital-wide patient flow. In order for hospitals to keep pace with their flow strategies, they must focus on operational efficiency. Patient flow strategies must evolve beyond improving throughput and patient outcomes to incorporating initiatives that enhance patient experiences as individuals travel through the continuum of care. In this session you will learn tips and tools that will streamline work processes and are aimed at the multiple disciplines responsible for hospital discharge. Topics to be discussed will include:

- Creating multidisciplinary collaboration to shorten the discharge process
- Standardizing patient flow practices across an enterprise
- Identifying overlap and reduce variation

Michael Young, MHA, FACHE
President and CEO
Temple University Hospital

9:00am – 9:45am
Efficient Patient Flow: All Hands on Deck in a Community Hospital

Patient flow continues to be one of the most difficult hurdles to overcome in healthcare. Emergency room overcrowding involves service and quality operational challenges to consider, moreover, the safety factor in caring for a boarder patient in a busy Emergency room becomes a risky business. The boarding practice has led to ED staff confusion and dissatisfaction, cyclical and increased ED overcrowding, and the potential of adding onto patient length of stay. It is essential to maintain an efficient patient flow model throughout a healthcare organization. All departments of the healthcare organization have to be committed to efficiently assuring that timely care precedes a timely discharge. The reduction of long discharge wait times within the inpatient arena has created a smoother patient flow cycle throughout the Emergency Department, including the reduction of patients left without being seen.

Kelly Heatherington, DNP, RN NEA-BC
Director, Capacity Management and Support Services
UPMC East and UPMC McKeesport

9:45am – 10:15am
Networking & Refreshments Break

10:15am – 11:00am
Effective Strategies to Improve Emergency Department Throughput

Emergency department visits, in the United States, have steadily increased over the past 15 years despite a decline in the number of emergency departments during the same time and the Affordable Care Act’s promise to reduce the use of emergency departments as a site for primary care. This has created a significant mismatch in supply and demand, negatively affecting the triple aim of reduced cost, improved quality and increased patient satisfaction. Unfortunately, factors affecting ED throughput are not solely under the control of ED leadership. It requires hospital-wide collaboration to effect lasting change. This discussion will focus on operational, innovative, strategies, from the time of patient entry into the emergency department to disposition that have proven to have a positive impact. Some of the highlighted processes that will be discussed are: “provider in triage,” “split flow” sorting, nurse-provider “team- based” care, leveraging the benefits of an ED observation unit as a more appropriate site for prolonged “work-ups”, and as a pathway for direct admissions and outpatient infusions in lieu of funneling those patients through the ED. Lastly, we will discuss partnering with hospitalists to expedite patient hand-off at admission

Anthony J. Guarracino, DO, MHA, FACEP
Chair, Department of Emergency Medicine
UPMC Pinnacle

11:00am – 11:45am
Enhancing the Discharge Process through Patient Transport

Patients may receive the best care possible at the bedside but once their discharge process is delayed everything else is forgotten. Patient satisfaction crumbles and patient flow slows down. Hospitals have implemented many multidisciplinary strategies with the hope of addressing this dilemma. Everyone is involved, from nurses to providers to case managers, pharmacists and even transporters. Many times, the work of the patient transporters is understated. They are “just transporters”. In reality however, the patient transporters are the bridge that connects patients from the ED to unit for admission, from unit to procedural areas and more importantly escorting patients out for discharge. This presentation will highlight how to streamline this process while emphasizing the role of patient transporters.

Pamela Douglas-Ntagha
The University of Texas MD Anderson Cancer Center

11:45am – 12:30pm
Discharge Processes and Checklists: Tales from the Trenches

Discharging a patient involves many steps, including examination and sign-off by appropriate providers and patient education. For each patient, the time of discharge and the tasks that need to be performed will be provided one day ahead of time. This allows for everyone involved in the discharge to self-organize on the day of discharge to get the work done within the window necessary to meet the scheduled discharge time. In this session you will learn how to improve efficiency during the discharge process and understand how to effectively plan for discharges in advance. Topics to be discussed will include:

- Determining what care, services and equipment the patient needs
- How to predict patient demand and align resources
- Early identification of patient requirements
- Barriers to timely discharge

Tibian Abramovitz, MD
Director, Case Management and Denials
Brookdale University Hospital and Medical Center

12:30pm – 1:30pm
Lunch

1:30pm – 2:15pm
How to Improve Outcomes, Decrease Readmissions, Increase Bed Capacity, Increase Efficiency, Improve Throughput and Ensure Financial Viability

What can be done at the outset before the patient is admitted or placed in a bed? Why is it critical to determine the correct status at the beginning? What can be done at the onset and during the patient’s stay prior to discharge in order to improve discharge planning and increase capacity? Why is it important for “front loading” management of the patient? Some key findings from the literature will be noted. Topics to be discussed include:

- Appropriate patient selection
- Getting stakeholder buy-in including physicians
- Tools for improving throughput
- Use of metrics
- The importance of appropriate observation

Sharon E. Mace, MD, FACEP, FAAP
Professor of Medicine
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Director, Research, Emergency Services Institute (ESI)
Former, Director, Observation Unit, ESI
Cleveland Clinic

2:15pm – 3:15pm
Panel: Discharge Scheduling to Improve Throughput and Patient Flow

Failure to integrate discharges with admissions commonly results when discharges are not managed appropriately. Creating a more consistent and predictable discharge schedule can help improve patient flow and capacity management. Traditionally, hospitals have attempted to "batch" discharges by establishing a set time for all patients to be discharged; however, this approach has been largely unsuccessful. Scheduling the discharge creates a continuous patient flow process, spreading discharge times throughout the day. This approach streamlines the process, better addresses the needs of patients and families, and helps coordinate the placement of patients who are admitted and transferred with discharges that occur throughout the day. Topics to be discussed will include:

- Processes for scheduling discharges
- Tasks that must occur prior to discharge
- Synchronizing admissions and transfers to the discharge schedule

Panelists:
Carl Balcom, RN, BSN, MHA, CHE, NEA-BC
Clinical Director, Emergency Services
HCA Houston Healthcare | Kingwood

Monika Czarny, MSN, RN
Nurse Manager, Department of Medicine Rapid Evaluation Treatment Unit
Mount Sinai Hospital

Sharon Neenan, MBA, BSN
Chief Nursing Officer and Vice President Patient Care
OhioHealth-Grant Medical Center

3:15pm – 3:45pm
Networking & Refreshments Break

3:45pm – 4:30pm
Trials and Tribulations of Emergency Department Patient Flow: The Daily Dilemma for Emergency Medicine

The increasing utilization of emergency departments for healthcare continues to impact patient care. Additionally, this increased utilization has tremendous impact on efficiency and patient flow throughout the health care system. The problems are many as are the solutions. There is no one solution that fits all but there are solutions that will work at your institution. This presentation will discuss the present-day challenges and solutions to patient flow in an academic medical center. Topics to be discussed will include:

- Identifying inefficiencies
- Multi-team approach
- Implementing solutions
- Become “proactive” instead of “reactive”
- Attending on arrival
- Nurse driven protocols

Janine Duran Llamzon
System Director Emergency Service Line
St. Joseph Health

4:30pm – 5:15pm
Capacity Management in the Emergency Department

This presentation walks through the patient flow process of one emergency department struggling with capacity issues. We will discuss the multidisciplinary team approach to creating capacity when struggling with long length of stays of admissions to the inpatient arenas, emergency psychiatric patients, and patients with complicated social determinant of care. How we were able to maximize resources and decrease the length of stay for discharged patients, while maintaining capacity for our most acutely ill patients.

Jess Almeida, MSN, RN, CEN
Nursing Director, Kaiser Sunnyside Medical Center Emergency Department
Kaiser Permanente

5:15pm
End of Day One

Day Two – Tuesday, September 17, 2019

7:15am – 8:00am
Networking Breakfast

8:00am – 8:15am
Chairperson’s Remarks

8:15am – 9:00am
Establishing Centralized and Coordinated Communication to Improve Throughput Priorities and Discharge Processes

In order to be successful, hospitals must leverage effective communication between clinical teams to drive efficient patient throughput, maximize resource utilization, and reduce costs. Daily communication with the healthcare team must occur in a multidisciplinary fashion so that care managers, physicians and other healthcare providers are all aligned. Topics to be discussed will include:

- Identifying key players and developing effective methods to communicate throughput priorities to different hospital stakeholders
- Promoting multidisciplinary communication
- Making clinical information transparent across all disciplines

Michelle A. Lyn, MD, FAAP
Associate Professor of Pediatrics
Baylor College of Medicine
Medical Director for Care Management, Patient Flow and APP
Texas Children's Hospital

9:00am – 9:45am
Creating Competition to Improve Early Discharge Times

Engaging frontline champions to improve early discharges. We worked with our nurse managers and charge RN’s to drive improving 11 AM discharges, 2 PM discharges and 5 PM discharges using weekly scorecards and unit competitions to drive improvement. We were able to increase our 11AM discharges from 3-5% to 12-15%, which lead to improvements in discharge time for both 2PM and 5PM. This process helped us free up critical beds more timely with a decrease in ED boarding times. By improving the early discharges, we were able to change our staffing on units who typically receive post-surgical patients. The staggering of our discharge goals allowed for less batching of discharges and less discharges after 5PM, which causes other operational workflow issues for EVS, ED and staffing. By engaging frontline staff they were able to understand the goals and develop workflows that worked on their units and understand the challenges they face every day with patients, families and physicians in achieving the goals.

Carina Menjivar, MA, BSN, RN, CNML
Nurse Manager, Resource Center
Pomona Valley Hospital Medical Center

Lolla Mitchell, MSN, RN, NEA-BC
Director of Nursing Operations and Clinical Practice
Pomona Valley Hospital Medical Center

M. Carina Menjivar, MA, BSN, RN, CNML
Nurse Manager, Resource Center
Nursing Administrative House Supervisor
Pomona Valley Hospital Medical Center

Lolla Mitchell
Director of Nursing Operations and Clinical Practice
Pomona Valley Hospital Medical Center

9:45am – 10:15am
Networking & Refreshments Break

10:15am – 11:00am
Improving Safety at Discharge and Transfer of Care

Transfer of care planning should begin prior to admission for planned patients, and as soon as possible after admission for emergency patients. Delayed transfers of care are a significant concern to frontline staff. This session will address how to improve the transfer of care, including:

- How to best move the patient from the hospital to their home or another healthcare facility
- Improving patient transition pathways
- Transport coordination and prioritization, including centralizing patient transport and bed placement
- Achieve improved care coordination from inpatient to ambulatory level of care

Gavin Malcolm, MSW LCSW
Director, Population Health
Broward Health

11:00am – 11:45am
The Relationship Between Capacity Management and Utilization Review/Management

The utilization review/management process is a key lever in successful capacity management. Evaluating appropriateness of admissions, facilitating discharges, and determining the correct level of care helps to reduce impacts to the revenue cycle and directly impacts patient flow. With the ever-changing payer landscape and capacity challenges, a successful healthcare organization must ensure the right patient is in the right bed at the right time. This session will explore the role of the UR/UM team in addressing capacity management and discharge planning issues as well as their role in quality improvement.

Varadarajan Subbiah, MD
Chief Medical Officer
Arrowhead Regional Medical Center

11:45am – 12:30pm
Impacting Patient Outcomes and Length of Stay through Improved Sepsis Management

According to the CDC, more than 1.5 million people get sepsis each in year in the US and one in three patients who die in a hospital have sepsis. St. John Medical Center, the tertiary facility within the health system, was found to discharge over 300 patients a month with a diagnosis of sepsis. St. John was concerned with their low pass rates for sepsis core measures. Knowing the severity of impact associated with sepsis, St. John pulled together a multi-disciplinary team to focus on sepsis. Opportunities that were identified included communication, education, IT, and cultural buy in. Using Lean Six Sigma methodology this team identified the problems, measured the current state, analyzed the metrics and workflows, developed action plans, and continues to monitor and control the implemented processes. With the action plans in place, St. John’s Health system was able to positively impact patient outcomes, reduce length of stay, increase the publicly reported core measure, and decrease cost per visit.

Katherine Barkat
Performance Improvement Advisor
St. John Health System

12:30pm
Conference Concludes

Workshop – Tuesday, September 17, 2019

12:45pm – 2:45pm
Using People, Processes and Data to Accelerate Patient Throughput

Effective management of patient throughput requires orchestration of people, decision-making, sound processes, and ongoing reliable data. This workshop will present a range of models and solutions that integrate these key elements into a successful throughput program. Process maps, integrated team rounding tools, and data dashboards, and other data reports will be used as tools of communication, methods to measure achievement, and to diagnosis areas for further development. Workshop participants take an active role in simulating common patient throughput situations and using tools to overcome barriers and develop their own solutions.

Learning Objectives:

1. Identify pertinent data to create a meaningful performance dashboard
2. Create processes to facilitate early discharges
3. Develop plan for focused interdisciplinary rounds
4. Detail a plan to improve your organization’s performance

Bonnie Barndt-Maglio, PhD, RN
Managing Director
Prism Healthcare Partners LTD

Featured Speakers

Michael Young

Michael Young

President and CEO

Temple University Hospital

Kelly Heatherington, DNP, RN NEA-BC

Kelly Heatherington, DNP, RN NEA-BC

Director, Capacity Management and Support Services

UPMC East and UPMC McKeesport

Anthony J. Guarracino, DO, MHA, FACEP

Anthony J. Guarracino, DO, MHA, FACEP

Chair, Department of Emergency Medicine

UPMC Pinnacle

Beth Liebhardt

Beth Liebhardt

Director – Emergency Services

Froedtert Hospital

Tibian Abramovitz, MD

Tibian Abramovitz, MD

Director, Case Management and Denials

Brookdale University Hospital and Medical Center

Sharon E. Mace, MD, FACEP, FAAP

Sharon E. Mace, MD, FACEP, FAAP

Professor of Medicine

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Director, Research, Emergency Services Institute (ESI)
Former, Director, Observation Unit, ESI
Cleveland Clinic

Janine Duran

Janine Duran

System Director Emergency Service Line

St. Joseph Health

Jess Almeida, MSN, RN, CEN

Jess Almeida, MSN, RN, CEN

Nursing Director, KSMC Emergency Department

Kaiser Permanente

M. Carina Menjivar, MA, BSN, RN, CNML

M. Carina Menjivar, MA, BSN, RN, CNML

Nurse Manager, Resource Center, Nursing Administrative House Supervisor

Pomona Valley Hospital Medical Center

Lolla Mitchell

Lolla Mitchell

Director of Nursing Operations and Clinical Practice

Pomona Valley Hospital Medical Center

Gavin Malcolm, MSW LCSW

Gavin Malcolm, MSW LCSW

Director, Population Health

Broward Health

Varadarajan Subbiah, MD

Varadarajan Subbiah, MD

Chief Medical Officer

Arrowhead Regional Medical Center

Bonnie Barndt-Maglio, PhD, RN

Bonnie Barndt-Maglio, PhD, RN

Managing Director

Prism Healthcare Partners LTD

Pamela Douglas-Ntagha

Pamela Douglas-Ntagha

Director, Patient Resources

The University of Texas MD Anderson Cancer Center

Carl Balcom, RN, BSN, MHA, CHE, NEA-BC

Carl Balcom, RN, BSN, MHA, CHE, NEA-BC

Clinical Director, Emergency Services

HCA Houston Healthcare | Kingwood

Monika Czarny, MSN, RN

Monika Czarny, MSN, RN

Nurse Manager, Department of Medicine Rapid Evaluation, Treatment Unit

Mount Sinai Hospital

Sharon Neenan, MBA, BSN

Sharon Neenan, MBA, BSN

Chief Nursing Officer and Vice President Patient Care

OhioHealth-Grant Medical Center

Michelle A. Lyn, MD, FAAP

Michelle A. Lyn, MD, FAAP

Associate Professor of Pediatrics

Baylor College of Medicine
Medical Director for Care Management, Patient Flow and APP
Texas Children's Hospital

Venue

Westin 1

The Westin Kierland Resort & Spa
6902 East Greenway Parkway
Scottsdale, AZ 85254
480-624-1000

Sponsors and Exhibitors

TBA

FAQ

Are there group discounts available?

  • Yes – Register a group of 3 or more at the same time and receive an additional 10% off the registration fee
  • What is the cancellation policy?
  • Cancellations received 4 weeks prior to the event will receive a refund minus the administration fee of $225. Cancellation received less than 4 weeks prior to the event will receive a credit to a future event valid for one year.

Can the registration be transferred to a colleague?

  • Yes – please email us in writing at info@brinetwork.com with the colleague’s name and title

Where can I find information on the venue/accommodations?

  • Along with your registration receipt you will receive information on how to make your hotel reservations. You can also visit individual event page for specific hotel information. The conference fee does not include the cost of accommodations.

What is the suggested dress code?

  • Business casual. Meeting rooms can sometimes be cold so we recommend a sweater or light jacket

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