Evaluating and Planning for Unit Consolidation

Healthcare today faces many challenges, and traditional techniques to manage issues through volume and cost controls are no longer enough. Many health systems may want to consider adjusting the parameters in which they are operating. Is unit consolidation right for your organization?

Key indicators to help identify if your organization could benefit from unit consolidation planning include sustained, low census; recruitment and retention challenges; patient population changes; and temporary collapsing of beds or units.

While undertaking a unit consolidation evaluation, be sure to vet volume trends for seasonality (is this a temporary or predictable situation?), community culture (will there be challenges securing buy-in from leadership, staff, providers, or patients?), and geography (will the new space meet our needs?).

Once an area is identified as a good candidate for consolidation, developing a collaborative, thorough workplan will be critical to execution. Start by defining the project scope and goals clearly and identifying multidisciplinary teams that would be involved to ensure all impacted parties are included in the discussion.

Considerations and Methods

• Vet volume trends for seasonality
• Consider if the situation is temporary or predictable
• Evaluate the community culture
• Identify challenges securing buy-in from leadership, staff, providers, or patients
• Survey workspace needs and geography
• Identify and adjust patient placement protocols

Next, build an implementation plan to address the following key areas:

• Logistics: identify technology or equipment needs, geographical concerns, layout
• Transition: immediate conversion or soft rollout
• Communication: internal/external, high-level, detailed, progressive
• Staffing: competency evaluations, education, plan, revised matrices or position control, delineation of roles and responsibilities
• Impact on other departments: scheduling, float pool, administration, quality, accounting/finance, revenue cycle, human resources

If planned and executed well, the consolidated unit should see more consistent staffing, reduced costs, streamlined operations, and coordinated care that will benefit both the organization and patients. Although collapsing (or expanding) operational footprints to better meet patient demands is an attractive addition to productivity activities, gauging organizational buy-in and developing/executing on a cohesive workplan are the integral pieces for operational success.