Guest ERCat Posted October 18, 2018 Share Posted October 18, 2018 I consider to be myself a good PA and have always thought I was one of the high performers. I am in terms of productivity, but just found out today that my discharge length of stay sucks. Any tips on how to decrease that number? The problem is I feel like I am already working my fastest and hardest. I see people at work laughing with each other and chatting about their weekends but I literally don’t do any of that. I barely even have time to run to the cafeteria to go to the bathroom. I feel like I am busy every single minute of the day. So decreasing my times seems kinda insurmountable... I know that one of my problems in admin’s eyes is trying to make patients completely comfortable before they go. Especially with back pain or migraine patients, if they say they still have pain even if it’s better I am likely to keep giving them meds until they feel A LOT better. The med, reassessment, med, reassessment, etc just isn’t helping my numbers. Link to comment Share on other sites More sharing options...
SERENITY NOW Posted October 19, 2018 Share Posted October 19, 2018 -you will likely find that the way you can impact this number the most is by putting the focus on low acuity patients. get these patients in and out in no time. when it gets busy, i don't give most 4s and 5s any meds in the dept - i just e prescribe and they can take it once they get to pharmacy like they would in an urgent care environment. putting in a med order, waiting for pharmacy to verify, nurse to find time to get it, etc, all adds up big time. -e prescribing is key - one of my coworkers said admin did a comparison and those who use e rx have shorter dLOS, and those who convert to erx improve as well -- no more nurses running around trying to find you to sign the paper rx. -avoiding unnecessary testing is also huge for decreasing dLOS... I clinically clear the majority of my simple MVC patients and have them in and out whereas many people are CT scanning constantly. -for patients who only need a positive/negative test (X-rays, hcg, etc), I use epic's "discharge pending" option right from the get go and tell patients the contingency plan up front... "I suspect this is an ankle sprain and so long as X-ray is negative, my team will come back with aircast and DC paperwork, but if there is a fracture I'll come back to talk to you" - that way the majority of the time I don't have to go back in there and nurses can discharge as soon as they see the X-ray is negative. -similar to the avoiding unnecessary testing, i have found that directly asking every patient something along the lines of, "what are you really here for?" many patients will come out and admit "I just want a med refill", "work note", "referral", etc. You can avoid an entire unnecessary workup and save tons of time by figuring out their goal. -with regards to you mentioning frequent reassessments on things like migraines, I hit it hard right up front. migraines get 3L IVF, toradol, compazine, benadryl, tylenol all up front... they always feel better quickly and I always have them out by around 1.5 hours max. (back painers - I don't give them any meds in the dept) I've been doing a new role with the admin team and focusing a lot more on improving these things myself as well, so I'd love to hear what others have to say too. -SN Link to comment Share on other sites More sharing options...
Guest ERCat Posted October 20, 2018 Share Posted October 20, 2018 Thank you so much for your very helpful tips. Link to comment Share on other sites More sharing options...
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