Improving patient flow across organisations and pathways

Evidence scan

November 2013

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Key points

  • Analysing patient flow and putting in place steps to address bottlenecks can have a measureable impact on throughput and length of stay.
  • It is possible to transfer improvement techniques to a healthcare context, but it is essential to recognise contextual factors and adapt the methods.
  • It is important to undertake detailed ‘diagnostic’ work to understand patient flow, rather than moving straight into redesigning services. Real-time demand and capacity management may be important.
  • Flow issues may best be addressed by exploring processes across an entire hospital or a wider system comprising primary care, ambulance, hospital, social care and community services, rather than in specific departments.
  • It can take time for new processes and systems to embed. Adequate time, resources and management support are needed to facilitate change.
  • The most successful redesign initiatives include extensive staff engagement and training. If people are being asked to change the way they work, it is important that they understand why and what the benefits will be for themselves and patients.
  • There is no ‘one size fits all’ approach. Many different methods have been used with the potential to improve healthcare.

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?

Further reading

Learning report

Improving patient flow

This learning report describes the work undertaken by two NHS trusts as part of the Health Foundation’s Flow Cost Quality pro...

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