Improving patient flow across organisations and pathways: evidence scan – The Health Foundation – November 2013

Posted on November 28, 2013. Filed under: Health Mgmt Policy Planning | Tags: , |

Improving patient flow across organisations and pathways: evidence scan – The Health Foundation – November 2013

“Poor patient flow increases the likelihood of harm to patients and raises healthcare costs by failing to make the best use of skilled staff time. This evidence scan compiles examples, from published empirical research, of strategies used to help improve patient flow across organisations or pathways of care.

The scan addressed the question:

What empirical literature exists about methods to analyse or alter patient flow across organisations or pathways of care?

The empirical evidence reviewed by the scan suggests that healthcare teams wanting to analyse and alter patient flow should note the following key learning points:”

… continues on the site

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Hurry Up and Wait: Differential Impacts of Congestion, Bottleneck Pressure, and Predictability on Patient Length of Stay – Harvard Business School Working Paper – released 1 March 2012

Posted on March 5, 2013. Filed under: Emergency Medicine | Tags: |

Hurry Up and Wait: Differential Impacts of Congestion, Bottleneck Pressure, and Predictability on Patient Length of Stay – Harvard Business School Working Paper – released 1 March 2012

Authors: Jaeker Berry, Jillian, and Anita L. Tucker

“High work load, from high inventory levels, impacts unit processing times, but prior operations management studies have found conflicting results regarding direction. Thus, it is difficult to predict inventory’s effects on productivity a priori, inhibiting effective capacity management in high load systems. We categorize load into in-process inventory (congestion) and incoming inventory, decomposing the latter into its levels of bottleneck (BN) pressure and predictability, and quantify the magnitudes and directions of change on processing times. Using data from 283 hospitals, we find (1) high congestion increases a patient’s hospital stay up to 28%, indicating inefficiencies from overloaded resources; (2) a patient stays up to 11.7% longer if there is a high load of incoming low BN pressure patients, consistent with the slowdown associated with “social loafing”; (3) a patient’s stay is up to 10.2% shorter when there is a high incoming load of predictable patients, consistent with workload smoothing.”

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Evidence driven strategies for meeting hospital performance targets – CSIRO – 25 February 2013

Posted on March 5, 2013. Filed under: Emergency Medicine, Health Mgmt Policy Planning | Tags: , , , |

Evidence driven strategies for meeting hospital performance targets – CSIRO – 25 February 2013

“The most visible challenge facing our healthcare system is overcrowding in hospitals, which has been labelled an ‘international crisis’ [1]. Overcrowding and long emergency waiting periods have a significant impact on the quality of patient care and patient experience.

National Emergency Access Targets (NEAT) introduced by the Federal Government in 2011, will require hospitals to ensure that 90% of all patients arriving at emergency departments are seen and admitted or discharged within four hours by 2015[2].

Our health services research team is helping hospitals meet these emergency access targets, whilst solving the challenge of overcrowding and system bottlenecks.

This report gives an overview of the patient flow modelling research currently being undertaken at CSIRO. It outlines how CSIRO’s analytics, optimisation and operational decision support tools can help give hospitals a better understanding of what they could do to meet these targets.”

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Volume, Flow, and Safety Issues in the ED – HealthLeaders Media Intelligence [US] – May 2012

Posted on June 1, 2012. Filed under: Emergency Medicine, Patient Safety | Tags: |

Volume, Flow, and Safety Issues in the ED – HealthLeaders Media Intelligence [US] – May 2012

By Joe Cantlupe

“Contributing forces, from the primary care shortage to the rise in the uninsured, are adding to overcrowded emergency departments and deep concerns about patient safety. Hospital leaders, uncertain about their systems’ preparedness, as well as how healthcare reform will further affect the flow of patients, are strategizing to reduce congestion, cut wait times, and improve care coordination.

As health systems try to improve their EDs, healthcare leaders are watching the financial framework with caution. About 80% say they expect their ED revenue margins will worsen as a result of healthcare reform and 78% say their reimbursement also will get worse. View the data from the most recent HealthLeaders Media Intelligence Report, Volume, Flow, and Safety Issues in the ED, in this slideshow.”

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Improving Patient Flow and Reducing Emergency Department Crowding. A Guide for Hospitals – AHRQ – October 2011

Posted on January 11, 2012. Filed under: Emergency Medicine | Tags: , |

Improving Patient Flow and Reducing Emergency Department Crowding. A Guide for Hospitals – AHRQ – October 2011

AHRQ = US Agency for Healthcare Research and Quality
 
“This guide presents step-by-step instructions that can be used by hospitals in planning and implementing patient flow improvement strategies to ease emergency department crowding.

Contents
Acknowledgments
Executive Summary
Section 1. The Need to Address Emergency Department Crowding
Section 2. Forming a Patient Flow Team
Section 3. Measuring Emergency Department Performance
Section 4. Identifying Strategies
Section 5. Preparing to Launch
Section 6. Facilitating Change and Anticipating Challenges
Section 7. Sharing Results
References
Appendix A: Guide to Online Resources Successfully Used by Hospitals to Improve Patient Flow
Appendix B: Implementation Plan Template
Appendix C: Example Implementation Plan
Appendix D: Additional Readings”

McHugh, M., Van Dyke, K., McClelland M., Moss D. Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals. (Prepared by the Health Research & Educational Trust, an affiliate of the American Hospital Association, under contract 290-200-600022, Task Order No. 6). AHRQ Publication No. 11(12)-0094, October 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/ptflow/

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Data briefing: Emergency bed use. What the numbers tell us – King’s Fund – December 2011

Posted on January 4, 2012. Filed under: Emergency Medicine | Tags: , , |

Data briefing: Emergency bed use. What the numbers tell us – King’s Fund – December 2011

“Summary

The NHS will need to find £20 billion in productivity improvements by 2015 to avoid reducing quality and making significant cuts to services. The acute sector is already receiving less for treating patients and so is under particular pressure to make those improvements. Could reducing the use of hospital beds for emergency admissions help?

Hospital beds are used for emergency admissions and elective admissions, but bed use for elective admissions has fallen significantly in recent years – although they account for 55 per cent of admissions, they occupy less that 30 per cent of overall bed days. So reducing bed use for emergency admissions offers the most potential for savings. Our new data briefing explores the figures in more detail and identifies the groups of emergency patients with the greatest scope for reductions in bed use.”

… continues

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Taming of the Queue VI – Improving Patient Flow – Canadian Policy Research Networks Research Report – June 2009

Posted on June 30, 2009. Filed under: Health Systems Improvement | Tags: , , |

Taming of the Queue VI – Improving Patient Flow – Canadian Policy Research Networks Research Report – June 2009
by Eddy Nason  Glen Roberts   53 p.

“This report is a summary of a conference program that reflects select perspectives on issues related to wait times. Neither the report nor the presentation summaries are necessarily intended to represent the perspectives of the planning committee organizations or the range of perspectives and initiatives in the field.

Executive Summary

Identify the problem before you identify the solution.

That was the sage advice from one presenter at the Taming of the Queue VI – Improving Patient Flow, the sixth instalment of the wait times conferences held annually in Ottawa. The above statement encapsulates the conference as a whole, which aimed to address the issues around wait times in primary care, referrals to secondary care, how to manage patient flow and what methods exist to mitigate demand for health services through prevention and appropriateness of care (thereby reducing the pressure on the health system).

The Taming of the Queue series of conferences began in 2004 as a means to address the burning issue of long wait times for treatment in the Canadian health care system. As an annual event, it has since covered the measuring, monitoring and management of wait times; new frontiers in wait time management; and excellence in wait time management. In the 2009 incarnation of the Taming of the Queue, there was a focus on innovation and best practices across the continuum of care to reduce and manage wait times. Taming of the Queue VI aimed to:

• explore the underlying factors that drive waiting times for health services;
• share research and experiences with wait time measurement/management among a broad cross-section of stakeholders; and
• identify policy implications of improved wait time measurement from the perspective of payers, providers and patients.” … continues on the website

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Wait Watchers III: Order and Speed…Improving Access to Care through Innovations in Patient Flow 26 March 2009

Posted on April 29, 2009. Filed under: Patient Journey | Tags: , , |

Association of Canadian Academic Healthcare Organizations  26 March 2009

ACAHO Shines a Light on Innovative Solutions that Improve the “Order” and “Speed” in which Patients Access Care
The Association of Canadian Academic Healthcare Organizations (ACAHO), releases its third report on innovative wait times management strategies entitled “Wait Watchers III: Order and Speed…Improving Access to Care through Innovations in Patient Flow”.

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