Improving Patient Flow

Once we successfully carry out an analysis of the patient journey it becomes possible to identify bottlenecks and overlap, and start making process improvements to assist patient flow.

Many questions need to be addressed, including:

• Do processes require batching? Or should we promote the first in first out rule? For example, specimens being sent to the laboratory for analysis.
• How does communication flow? For example, how do pathologists find out which patients are waiting to see them?
• Who is responsible for the patient’s care at any given point in time? Are there points in the patient flow where it is unclear, or when no one is in charge?

It is key to maintain smallest batch size possible so that patients move through the system in groups as small as possible, and that there is clear notification when patients have moved from one part of the process to another. It is also critical for one individual to be in charge of coordinating the entire process, and that they are able to identify backlogs and respond accordingly in real time.

The 80/20 rule applies in hospitals too – 80% of patients will present with common or easily handled conditions, and 20% will be rare cases that slow the entire system down. The latter may be unpredictable and will require customised response. The system should be able to keep both types of cases moving while still maintaining a high quality of care.

The net result of patient flow optimisation usually results in not only a reduction in wait times and an expedited patient journey, but also increased capacity, lower costs as well as happier staff and patients.

Alan Spinks Clinical Advisor, Emendo

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