About 800,000 Chronic Obstructive Pulmonary Disease (COPD) patients are admitted annually to U.S. hospitals, where they receive medications three to four times daily, however many are given late, contributing to longer hospital stays and high readmission rates. These patients represent about 20 percent of all inpatients at U.S. hospitals. Unfortunately, the inhaled medications that are typically prescribed for COPD patients are often administered late due to a variety of factors ranging from the time it takes to give the medication to the high number of patients who require it. With the assistance of Whitman’s supply chain management faculty, Crouse Hospital developed and implemented a strategy that helps ensure inhaled medications are administered on time.
“Many times the respiratory care specialists have to administer nebulizer treatments to 30 to 40 patients at roughly the same time,” explained Fred Easton, professor of supply chain management and director of the Robert H. Brethen Operations Management Center at the Whitman School. “The treatments take about 20 minutes to complete so you can imagine the time and staff it takes to care for these patients.”
To meet that challenge Dr. Easton and his colleague, Gary La Point, professor of supply chain management practice, together with Russell Acevedo, MD, medical director of the intensive care unit and respiratory care at Crouse Hospital, decided to pilot a new staffing technique called “swarm staffing.”
“Swarm staffing,” a new model for health care operations, pools scheduled and unplanned demands for respiratory care across multiple care units, reducing workload variability. Respiratory therapists work in teams moving from unit to unit to take care of the patients.
In just 10 months of using the new staffing model, Crouse was able to reduce its incidence of late medications by 90 percent. What’s more, the number of times a patient refused his or her treatment went down because the timing was more appropriate and patients were not in the middle of meals or sleep. This model shows promise for reducing length of stay, as well, since patients will receive their treatment at the right times, helping them get better faster. It also had some unexpected interpersonal results.
“We found that this model is not only operationally efficient but it also allows the therapists to develop primary care relationships with the patients,” said Dr. Easton.
Crouse also believes this model will lead to greater employee satisfaction among respiratory therapists and lower turnover in what is already a tight labor market.
“The therapists love this new system,” said Dr. Easton.
The study recently was chosen as a semi-finalist for the 2016 Franz Edelman Award, a prestigious operations management award presented annually by the Institute for Operations Research and the Management Sciences (INFORMS).