January 16, 2013 | | Comments 0
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Living on a thin line…

One of the realities of modern healthcare has been the shift (not everywhere, but in a lot of places) from inpatient volume to outpatient volume, with the result being a number of facilities that close and re-open patient care units based on demand. Now, certainly an organization has to be able to allocate resources appropriately, so consolidation, etc. is a very viable strategy.

But there are some states that can get a bit testy when it comes to the discussion of licensed beds, etc. and pushing the focus back on hospitals to be able to quickly (there’s no hard and fast number; what’s your state say?) restore those rooms/bed positions to service in the event of an increase in census.

Recently, I chatted with an organization that was facing a real challenge because some of the vacated patient units had been converted to other uses (offices, etc.); they are maintaining all the systems that are needed to return these spaces to patient care (just covering over the utilities in the headwall, etc. with a removable panel), so they’re good on that count. But where things have kind of squirted out the sides of the bag is the management of all the patient room furniture that has been displaced – can’t leave all that stuff in the corridors, etc.

So, this organization is looking at establishing a relationship with a medical furnishings vendor who can provide them with patient room furnishings within 48 hours (that’s the state mandate in this particular instance). This is after investigating the potential for off-site warehousing of the furniture now in service, etc., but it was decided that to do so with be extremely labor/resource intensive and since it’s been a while since they’ve actually had to flex back up, they’ve decided to try and work this through an external source.

So I thought that was pretty cool, but then the question became – how would CMS / TJC look at the farming out of the furniture component of their flex plan?

My first thought was they generally wouldn’t have much to say about stuff concerning licensed beds, etc. (beyond the application process), but then I was thinking that this could be an important component of your Emergency Operations Plan, particularly as a function of having to manage an influx of patients in an emergency. In which case, you’d need to be able to evaluate this process as a function (potentially) of your 96-hour plan, etc. I guess ultimately everything relates to everything else and any substantive changes you might make from an operational standpoint can come under scrutiny during survey. Is anybody out there in the listening audience faced with anything similar—maybe seasonal ebb and flow?

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at stevemacsafetyspace@gmail.com.

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