Solutions for improved hospital-wide patient flows – a qualitative interview study of leading healthcare providers

Abstract

Background Hospital productivity is of great importance for patients and public health to achieve better availability and health outcomes. Previous research demonstrates that improvements can be reached by directing more attention to the flow of patients. There is a significant body of literature on how to improve patient flows, but these research projects rarely encompass complete hospitals. Therefore, through interviews with senior managers at the world’s leading hospitals, this study aims to identify effective solutions to enable swift patient flows across hospitals and develop a framework to guide improvements in hospital-wide patient flows. Methods This study drew on qualitative data from interviews with 33 senior managers at 18 of the world’s 25 leading hospitals, spread across nine countries. The interviews were conducted between June 2021 and November 2021 and transcribed verbatim. A thematic analysis followed, based on inductive reasoning to identify meaningful subjects and themes. Results We have identified 50 solutions to efficient hospital-wide patient flows. They describe the importance for hospitals to align the organization; build a coordination and transfer structure; ensure physical capacity capabilities; develop standards, checklists, and routines; invest in digital and analytical tools; improve the management of operations; optimize capacity utilization and occupancy rates; and seek external solutions and policy changes. This study also presents a patient flow improvement framework to be used by healthcare managers, commissioners, and decision-makers when designing strategies to improve the delivery of healthcare services to meet the needs of patients. Conclusions Hospitals must invest in new capabilities and technologies, implement new working methods, and build a patient flow-focused culture. It is also important to strategically look at the patient’s whole trajectory of care as one unified flow that must be aligned and integrated between and across all actors, internally and externally. Hospitals need to both proactively and reactively optimize their capacity use around the patient flow to provide care for as many patients as possible and to spread the burden evenly across the organization.

Assessing the Performance of Non-specialised Private Hospitals in Malaysia Using the Pabón‐lasso Model

“…[36] Improving patient access can be achieved by standardising communication between departments in referral pathways and strategically adjusting capacity distribution based on demand patterns. [37] Additionally, combining bed pools within the facility and externally produces better performance.…”

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“…This study highlights to troubleshoot severe inadequacy of service by involved the senior manager. This effort is beneficial because the senior manager has more experience and more influence to the hospital service process [22]. The significance of effective internal processes and a skilled workforce in driving organizational performance in the healthcare sector [14,15].…”

Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system

“…Studies have shown that addressing patient flow issues can have several benefits, including reduced length of stay (LOS) and faster discharge process [ 1 , 2 , 20 , 21 ]. Improving patient flow is essential for enhancing medical quality, safety, and patient satisfaction while also reducing input and facilitating throughput and output from hospitals and EDs [ 3 , 8 , 22 ].…”

“…Changes in demographics, the prevalence of multimorbidity, the ongoing challenges posed by the COVID-19 pandemic, and persistent shortages in healthcare staffing have significantly increased the demand for healthcare services. [1][2][3]. Most hospitals face a mismatch between supply and demand, resulting in delays, staffing gaps, and inefficient hospital ward utilisation.…”

“…[3]. Globally, emergency departments are overcrowded and unable to meet an ever-increasing demand for healthcare [1]. The increasing demand for emergency care services is a significant challenge for healthcare systems worldwide [4][5][6][7][8][9].…”