Improving Bed Turnover

EVS team plays a major role in managing hospital throughput

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores account for 25 percent of a hospital’s total performance score. Adding to this are escalating patient expectations, constantly evolving technology, increases in uninsured patients — all amidst rising costs and ever-tightening budgets. These challenges leave hospitals under enormous pressure to make sure patients are satisfied with their care while being discharged as soon as health allows. This balance requires effective, systematic throughput — the time from when patients enter the hospital until they are discharged. 

A major component of efficient throughput is bed capacity, aka, the number of beds available for patient occupancy at any given time. 

Bed capacity in a hospital is affected by several things:

  • Total number of beds owned
  • Beds that cannot be used due to maintenance/safety issues
  • Low bed turnover — a shortage of beds due to high demand or lengthier patients stays
  • Beds left unoccupied due to communicable diseases, gender preferences, or other reasons
  • Slow bed turnover — beds that are not available in a timely manner due to inefficient throughput.

While some of these points must be addressed by hospital management, the right environmental services (EVS) service provider can have a powerful, positive impact on improving bed-turn and, therefore, throughput.

Unnecessarily sluggish bed turnover can stem from a variety of inefficiencies, including:

  • Ineffective processes and procedures
  • Departments not adhering to throughput processes
  • Poor communication between departments
  • Insufficient staff training and subpar cleaning quality
  • Unclear expectations and goal setting 
  • Ineffective leadership and lack of accountability
  • Absence of ongoing monitoring and data collection.

When the right EVS team intersects with throughput, good things can happen. EVS can help improve bed turnover in the following ways:

Policies and procedures. EVS can set policies, such as requiring Nursing to alert EVS when a room is ready to be cleaned and, conversely, mandating EVS to let Nursing know when rooms are ready. Creating these and similar firm guidelines can greatly streamline processes and increase bed-turnover rates. 

Interdepartmental cooperation. To perform its tasks effectively and efficiently, EVS must be able to communicate with other departments. Nursing, for example, has the most contact with patients from admission through discharge. By establishing a good relationship and keeping the lines of communication open, EVS can initiate routines, such as checking in with Nursing at the start of the day shift to find out which patients are set to be discharged that day. This can evolve into partnering with other departments to meet shared goals as well. For example, EVS can suggest the emergency department use smart devices or some other type of paging system to immediately alert EVS when a room is ready for cleaning, receptacles need emptying, or linens are ready for pickup.

Quality. EVS is trained to clean and disinfect as expediently as possible without sacrificing quality and following all infection prevention and other hospital policies. This consistent quality goes a long way to preventing healthcare acquired infections (HAIs), which are a major factor in a hospital’s total performance score and can significantly lengthen patient’s stays — by as many as 8.2 to 12.6 days, according to a study cited by the U.S. National Institutes of Health

Staffing to demand. EVS can use historical data to look for patterns, such as surges in hospital occupancy during certain times, days, or months, and increase the number of available workers to meet this higher demand. 

Responsive supervision. As with most any service, effective leadership and accountability are crucial to success. The best EVS teams have both. This includes clearly defined and understood goals; it also requires a good working relationship between a dedicated EVS director/superior and hospital “sponsor,” someone with the authority to help EVS enlist the ongoing support of other departments as well as hold individuals accountable.

Monitoring and validating. The most effective EVS service providers are constantly monitoring their policies, procedures, and processes to validate service response times, quality, and end results. This data includes bed turnover rates and is invaluable to identifying where goals are being met as well as where challenges may still exist. It also can provide the solid proof needed to show EVS’ major contribution to enhanced throughput.

Stacey Wong is vice president of Servicon, a building service contractor based in Culver City, California. 

January 28, 2021

Topic Area: Environmental Services

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