October 24, 2003

Strategic planning spotlight: Optimal Use of Campus Capacity Task Force

Since the MGH embarked on an intensive strategic planning effort several months ago to determine the future direction of its clinical programs, members of seven task forces have been meeting, planning and preparing to make preliminary recommendations to the Strategic Planning Steering Committee. Hotline is highlighting the work of some of these task forces.

The charge of the Optimal Use of Campus Capacity Task Force is best described in the task force's name — to ensure the best and most efficient use of the hospital's capacity to care for patients. Chaired by Andrew Warshaw, MD, MGH surgeon-in-chief, and Rick Bringhurst, MD, senior vice president for Medical Services for the MGH and the Massachusetts General Physicians Organization, the task force will be developing recommendations for further reducing patient length of stay (LOS) and other improvements in clinical operations focused on the efficient use of campus resources.

"Our main goal is to evaluate how we can take better care of more patients within the physical and personnel constraints of the institution," says Warshaw. "We now often exceed the optimal level of activity for efficient patient care. This phenomenon impedes the access of patients to our services. For example, long waiting times for diagnostic tests are one cause of delayed discharges from the hospital, which in turn sets up a chain reaction that slows the entire flow of patients throughout their hospital experience, right back to new admissions through the emergency department. If a patient cannot be discharged in a timely manner, others may be backed up in the operating rooms and post-operative recovery units. When there are excessive waits for bed placement, the Emergency Department fills to capacity and potential new patients must be diverted to other hospitals. We must find more efficient ways to move patients safely through the chain of care."

In addition to analyzing patient flow, task force members will seek to maximize the utilization of beds in intensive care units, minimize patient transfers between general care units and reduce the need for boarding patients away from their principal service units.

Four subgroups of the task force have been formed, focusing on LOS reduction, bed demand and patient inflow, management of existing capacity, and creation of new capacity. By increasing the effective bed capacity, the task force hopes to enable a continued growth in admissions. They perceive that the hospital needs to develop a flexibility to adapt to future changes in service mix and new technologies while maintaining an "open door" for Emergency Department admissions, patient transfers from other hospitals and elective operations.

"We hope to integrate the work of other hospital committees that have focused on these issues as well," says Warshaw. "We don't want to reinvent the wheel, but rather to capitalize on the extensive work done by groups such as the Clinical Performance Management committees in order to make this a coordinated effort."

Any employee is welcome to submit ideas to the Strategic Planning Steering Committee by visiting http://is.partners.org/mghstrategicplan or by sending written ideas through interoffice mail to Bulfinch 240.