Institute for Healthcare Improvement: Setting Aims

The following aim statements reflect the overall aim of improving flow across the system and within specific areas or processes. Note that all of these aims are outcomes oriented, with specific numeric goals and timeframes. To impact flow across the system, an organization typically has several focused workgroups working on more than one aim at a time, but they should all report to one core oversight flow team.

Aim Example 1:
Redesign the system in order to improve timeliness and reduce delays to safe and efficient flow of patients through the OR and across the system by achieving the following goals within one year:

Increase to 75 percent ED patients admitted to the hospital within one hour of the decision to admit.
Increase to 80 percent patients transferred out of PACU within one hour of transfer order.
Increase to 90 percent patients transferred from SICU to an inpatient bed within four hours from transfer order.
Increase on-time surgery first starts by 25 percent (goal 90 percent).
Increase Pre-Admission Center assessments to 90 percent.
Reduce the percentage of cancellations on the day of surgery (including after 5 p.m. day before surgery) by 25 percent.
Increase the percentage of unscheduled cases in OR #18 (designated OR) to 85 percent.
Increase Pre-admission Center phone interviews to 20 per day.

Aim Example 2:
Improve patient flow through the acute care setting by scheduling patient discharges to increase capacity and reduce delays between levels of care within one year by achieving the following goals within one year:

Increase to 80 percent discharges that are scheduled.
Increase to 60 percent scheduled discharges meeting the discharge appointment time.
Increase to 75 percent patients placed from ED to inpatient bed within one hour of decision to admit.
Increase to 60 percent patients placed from ICU to inpatient bed within four hours.
Increase to 80 percent patients placed from inpatient to long-term care within 24 hours.

Aim Example 3:
Improve patient flow in order to expedite patient care through the ED and across the system within one year by achieving the following goals within one year:

Decrease ED diversion hours per month by 50 percent. Baseline=66 hours per month.
Decrease ED time from arrival to discharge to two hours or less. Baseline=3 hours 30 minutes.
Decrease radiology turnaround time from time test ordered until results received for plain radiographs by 75 percent.
Increase to 80 percent ED patients placed in an inpatient bed within one hour of decision to admit.

Aim Example 4:
Redesign the system in order to improve timelines and reduce delays to safe and efficient flow of patients throughout the acute care setting using the following goals within one year:

Increase to 80 percent ED patients to inpatient bed achieving a one-hour disposition.
Decrease to zero the number of times per month the ED is on diversion.
Increase to 90 percent patients transferred from the ICU to acute care bed to within four hours.
Increase the use of multidisciplinary rounds in the ICU to 100 percent of patients.
Maintain at 90 percent the time from transferring a patient from acute care to long-term care within 24 hours.