An analysis of the concept of patient flow management

Benjamin, Ellen; Jacelon, Cynthia S.

doi:10.1111/nuf.12681

Cited by 6 publications

(30 citation statements)

References 33 publications

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“…Hospitals facing overcrowding, poor staffing, and rising expenses turn to patient flow solutions to reduce costs and improve patient care 2 . Despite efforts to develop effective patient flow strategies, research focused on patient flow management is limited 3 , 4 . Benjamin and Jacelon first clarified the meaning of patient flow management in 2021, 3 but no study has explored how ED nurses understand this concept.…”

Section: Introductionmentioning

confidence: 99%

“…Despite efforts to develop effective patient flow strategies, research focused on patient flow management is limited 3 , 4 . Benjamin and Jacelon first clarified the meaning of patient flow management in 2021, 3 but no study has explored how ED nurses understand this concept.…”

Section: Introductionmentioning

confidence: 99%

“…Despite decades of research, patient flow solutions remain insufficient 7,8 . Patient flow research is criticized for its inadequate exploration of the complexity of patient flow processes, the role of staff in shaping flow processes, and the nature of patient flow management decisions 3,4,7,9–12 …”

Section: Introductionmentioning

confidence: 99%

“…Effective patient flow management requires complex, real‐time decision‐making, 2,9 but the work of nurses performing patient flow management is poorly understood 3,4 . A 2020 systematic review of literature found that nurses mitigate patient flow barriers and increase ED efficiency in specialized roles like nurse navigators, ambulance offload nurses, journey coordinators, and bed managers 4 .…”

Section: Introductionmentioning

confidence: 99%

“…A 2020 systematic review of literature found that nurses mitigate patient flow barriers and increase ED efficiency in specialized roles like nurse navigators, ambulance offload nurses, journey coordinators, and bed managers 4 . Harnessing the potential of nurses to improve patient flow management is a cost‐effective, yet under‐explored opportunity 3,4 …”

Section: Introductionmentioning

confidence: 99%

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“ Nurses are every bit of the flow:” Emergency department nurses' conceptualization of patient flow management

Benjamin

Wolf

2022

Nursing Forum

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Aim To validate and refine Benjamin and Jacelon's 2021 definition of patient flow management using the experience and knowledge of practicing emergency department nurses. Background Patient flow requires complex, real‐time decision‐making to match patients to limited resources and facilitate their movement through care processes. A literature‐based concept analysis of patient flow management was first performed in 2021, but the voice of nurses is largely absent from existing patient flow research. Design This study employed an expanded concept analysis methodology, as articulated by Kathleen Cowles. Data source Focus groups of nine emergency nurses were conducted. Results Emergency nurses' conceptualization of patient flow management differs from the definition as it has emerged through patient flow literature. Patient flow management is a nurse‐driven process that relies on nursing knowledge and the work of all emergency nurses, including bedside nurses. Emergency nurses perceive the ultimate goal of patient flow management to be the collective safety of patients, and they work to promote patient safety within their own scope of responsibility. Conclusion Understanding patient flow management as a nurse‐driven process emphasizes the importance of nurse training and capacity to effective patient flow. Future research should explore the role of emergency nurses as active directors, rather than passive components, of patient flow. More work is needed to investigate this complex nursing task.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

“ Nurses are every bit of the flow:” Emergency department nurses' conceptualization of patient flow management

Benjamin

Wolf

2022

Nursing Forum

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The scope of emergency nursing viewed through the lens of complex adaptive systems: a discussion paper

Göransson,

Drennan,

Mainz

et al. 2024

International Journal of Nursing Studies Advances

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Analysis of patient flow and barriers to timely discharge from general medical wards at a tertiary academic hospital in Cape Town, South Africa

Hunter,

Peters,

Khumalo

et al. 2024

BMC Health Serv Res

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Background Movement of patients through a health establishment is a complex activity reliant upon multi-actor co-ordination across departments. The challenge of enhancing service delivery to meet the needs of a growing and aging population, whilst minimizing expense, is a global concern. There is an urgent need to understand and quantify systemic gaps in the efficient delivery of healthcare services. Stagnation of patient flow has negative impacts on both staff and patients by increasing risks of adverse outcomes, staff frustration and job dissatisfaction. An inefficient discharge process can be a significant barrier to timely patient movement. Methods A retrospective cohort study was conducted at a tertiary, academic hospital in the Western Cape, South Africa to assess the journey of medical patients from admission to discharge across the five different medical teams (firms) within the general medicine department. Consecutive sampling was used to capture all eligible adult medical in-patients admitted from the emergency department (ED) to general medicine from the 11th – 20th April 2023 and discharged up until the 30th of April 2023. We reviewed the patient notes (folders) of these individuals using a data-extraction tool to ascertain reasons for admission and barriers to timely discharge. Results Among 86 patient folders reviewed, cumulatively accounting for 596 in-patient days, a difference in the median length of in-patient stay between medical firms (p = 0.042) was noted. The shortest length of stay corresponded to firms with the greatest proportion of daily senior staff oversight (defined as documented patient reviews by a registrar, medical officer and/or consultant independently or in addition to reviews done for the day by interns and/or students). While 52% of patients vacated their beds between 14:00 and 17:00, 66% of patients were admitted after 20:00. Reasons for prolonged admission were variable, and attributable to a range of different disciplines across the multidisciplinary team. Conclusion Whilst this study did not evaluate the appropriateness of chosen medical management but rather systemic drivers affecting patient movement and barriers to timely discharge, the delays in discharge were noted to be multi-factorial including facets across the efficient delivery of medical care, availability of resources and the internal operational frameworks for the institution. Understanding the need to optimize internal process efficiencies with regards to prompt acquisition of investigations, improvement of senior staff oversight and the creation of a standardized discharge process, could enhance efficient patient movement.

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An analysis of the concept of patient flow management

Cited by 6 publications

References 33 publications

“ Nurses are every bit of the flow:” Emergency department nurses' conceptualization of patient flow management

“ Nurses are every bit of the flow:” Emergency department nurses' conceptualization of patient flow management

The scope of emergency nursing viewed through the lens of complex adaptive systems: a discussion paper

Analysis of patient flow and barriers to timely discharge from general medical wards at a tertiary academic hospital in Cape Town, South Africa

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