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. 2023 Jan 7;23(1):17.
doi: 10.1186/s12913-022-09015-w.

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

Philip Åhlin  1 , Peter Almström  2 , Carl Wänström  2
Affiliations

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

Philip Åhlin et al. BMC Health Serv Res. .

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.

Keywords: Capacity utilization; Efficiency; Healthcare; Hospital ranking; Organizational efficiency; Process improvements; Productivity; Strategy.

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Conflict of interest statement

The authors declare that they have no competing interests concerning the material discussed in this manuscript. This accounts for interests of either financial (such as grants, consultancies, equities, or other employment) or non-financial nature (such as professional, personal relationships, or subjective beliefs).

Figures

Fig. 1
Fig. 1
The hospital-wide process model, Åhlin et al., [40]
Fig. 2
Fig. 2
The patient flow improvement framework
Fig. 3
Fig. 3
The hospital patient flow improvement plan
See this image and copyright information in PMC

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