Improve Bed Availability and Reduce Unnecessary Days: Patient Flow and Room Turnover
Takeaways:
- Length of stay (LOS) issues are the outcome of multiple, unrelated clinical and operational variables, which together impact a patient’s care progression and discharge readiness.
- Rapid Room Turnover eliminates idle bed time that frequently occurs after patients are discharged and before documentation has caught up. Patient Flow Agent addresses care progression delays that occur between admission and discharge.
- Rapid Room Turnover can help address ED boarding and LWBS rates (capacity management), while Patient Flow Agent reduces clinically unnecessary days (LOS).
When a COO or CFO reviews quarterly performance, he or she sees a dashboard that outlines several unwelcome surprises: an increase in clinically unnecessary days, driving up length of stay (LOS) from 4.2 days in 2022 to 5.5 days; and a noticeable rise in ED boarding and the left without being seen (LWBS) rates.
Most dashboards will group these metrics together, but this isn’t entirely accurate: while they are related and do affect each other, they also cover different departments, workflows, and teams. Getting patients into beds faster to reduce ED boarding and LWBS rates is a capacity management challenge, whereas cutting excess days from LOS is a care progression problem.
For the former, a doctor signs a discharge order at 9 AM, and the patient leaves the hospital at 12 PM. Then, the hospital’s EHR does not register the discharge until a nurse finishes discharge documentation at 3 PM, after caring for other sick patients. Even when the discharge is documented, the bed is still not available, until environmental services (EVS) finishes cleaning the room. In many hospitals, the time between actual patient discharge and room clean can be several hours.
For the latter, the more efficiently that patients can be seen and move through their patient journey, the lower the chance that they’ll spend additional, unneeded days in the hospital. One reason for care progression delays is slowed specialist consults, which account for a 19% increase in average length of stay from 2019 to 2022. This is also an operational breakdown, but in a different way: specialists may have long patient lists, prioritization may occur in a first-in-first-out order, or coordination between care teams may be uneven.
Rapid Room Turnover vs. Patient Flow Agent
In order to get admitted patients in beds faster and to ensure that patient discharges are stopped by preventable operational issues, hospitals need to take a multi-faceted approach; this is why Kontakt.io created Rapid Room Turnover and Patient Flow Agent.
Both tools, however, do have one thing in common: they are built on a foundation of real-time location system (RTLS) data, including patient tags, staff badges, and in-room sensors. This continuous stream of information provides comprehensive visibility into hospital operations, vital for both agents to identify and unblock any obstacles that arise.
How Rapid Room Turnover works
Between the two products, Rapid Room Turnover runs more targeted, specific interventions that deal only with the operational breakdowns that keep patients waiting in EDs and PACUs longer than they need to be there.
Currently, without an automated solution, most hospitals coordinate patient discharges via manual steps and actions, which are heavily reliant on documentation: nurses fill out forms, patient flow coordinators make calls, and EVS teams wait for work orders to clean rooms.
Instead of waiting on this fragile workflow, Rapid Room Turnover bypasses these dependencies, using RTLS data to detect when a patient has left; it then connects this data to a discharge order that’s already present in the EHR and ensures that EVS prioritizes room cleans appropriately. Accelerating the room cleaning process also leads to improving room availability, and thus, capacity management.
How Patient Flow Agent addresses the big picture
While turning over rooms faster is helpful, the other part of the equation remains: facilitating care progressions, so that patients can be released in a timely manner, and don’t occupy beds longer than is clinically necessary.
A 2025 study of the Veterans Health Administration examined the causes behind length of stay increases, and found that only 16% of this growth stemmed from the sort of avoidable, discharge-related delays that Rapid Room Turnover addresses. The authors hypothesized that the increases may instead “reflect longer periods of acute care delivery…Improving acute care processes may more effectively reduce hospital capacity strain.”
That’s where Patient Flow Agent fits into the equation. Rather than intervening in clinical care, Patient Flow Agent identifies and removes the obstacles to care. This could take the form of Patient Flow Agent helping patients get seen by providers sooner, prioritizing high-impact interventions like CT scans, and prompting early coordination to avoid weekend stalls, among others.
How Patient Flow Agent uses data
Patient Flow Agent accomplishes this by painting a holistic view of the hospital, ingesting real-time location signals alongside EHR data, including ADT feeds, orders, and consult activity, across a patient’s entire stay. In essence, it analyzes care progressions to find out where they stall, whether it’s a diagnostic order that was never carried out, a lab test that no one analyzed, or a consult that never happened.
At most hospitals today, these events slip through the gaps too easily. Because they are small, often involve different departments, and occur cumulatively, it’s too hard for humans, like patient flow coordinators, to identify and resolve the issues, at least not without going case by case. At scale, this is unsustainable: mapping out the care journey of every patient at a 200 bed hospital would take an army of coordinators, reams of data, and far too much time, expense, and effort.
Because it’s analytic and algorithmic, Patient Flow Agent can operate at the level of a hospital or even health system, fixing this issue where humans cannot. In contrast to Rapid Room Turnover, Patient Flow Agent depends more heavily on reconciling RTLS and EHR data, deals with a wider, more diverse range of roles (including physicians, specialists, and case managers), and must learn from changes (such as when a nurse or case manager overrides a flagged delay as clinically appropriate instead of operationally unnecessary).
Patient Flow Agent for specialist consults
To return to the previous example of delayed specialist consults, Patient Flow Agent uses RTLS data to identify which patients aren’t being seen by specialists, closing a vital gap that otherwise remains unknown.
For instance, if a consult is ordered, but then the patient goes two hours without being seen by a specialist, then Patient Flow Agent will use its EHR integrations to alert the consulting service. All the while, it will continue to track response times, creating a data record that CMOs, VPs of Medical Affairs, and department chiefs can use to optimize their operations, or even to help make the case for hiring more specialists.
Where the two systems meet
In fact, Rapid Room Turnover and Patient Flow Agent are complementary, not competing tools. The key is to treat discharge-day mechanics and whole-stay coordination as two separate disciplines that, when addressed together, create tangible improvements in capacity management and LOS, driving down key metrics like unnecessary days or bed availability.
A hospital that has Rapid Room Turnover but not Patient Flow Agent will recover bed capacity on the day of discharge, but continue to struggle with operational delays earlier in a stay. On the other hand, a hospital that deploys Patient Flow Agent without Rapid Room Turnover will recapture time and capacity with faster procedures, but won’t be able to improve discharge day delays.
Hospitals that make measurable progress on length of stay succeed by addressing both discharge delay problems and blockers earlier in the care journey. Even discharge day mechanics are not uniform: an AJMC study found that the majority of discharge orders were written before 11 AM, a concentration associated with meaningfully longer delays to patient departures, likely because so many discharges were competing for limited resources, such as nurses, transport, and paperwork.
When the CIO reviews dashboards and notices an increase in LOS, this phenomenon is due to several distinct issues that are unrelated but cumulative. Each requires different visibility, tools, and departments to resolve, which is exactly why Rapid Room Turnover and Patient Flow Agent exist as two separate but supplementary tools. In order for hospitals to ensure that existing patients don’t stay longer than medically necessary and that beds will be rapidly available for new patients, they will need both tools.
