Institute for Healthcare Improvement: Flow

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Case for Improvement

Expert Host

Patient safety, hospital revenue, staff satisfaction, and patient satisfaction are all negatively impacted when patients, information, and materials do not move through hospitals in a timely and efficient way.

In the US, a recent study by the University of Texas School of Public Health found that severely injured patients were twice as likely to die when Houston’s level 1 trauma centers are on ambulance divert.
An American Hospital Association (AHA) survey showed the average patient waiting time for transfer from an Emergency Department to an acute or critical care bed is 3.2 hours.

	Kirk Jensen, MD, MBA, FACEP
	IHI.org asked Flow faculty expert Kirk Jensen to address some of the challenges to improving hospital flow. "Many hospitals are trying to run at or near 100 percent capacity. We also see a significant amount of variation in flow within the different hospital microsystems and variation in utilization of services. The challenge is to focus on achieving an 85 to 90 percent utilization rate so we can optimize patient service and patient safety." (See Commentary.)
	Host Picks Patient Flow in Hospitals: Understanding and Controlling it Better The Psychology of Waiting Lines Error in Medicine

	In the Spotlight
		Managing Variation in Demand The UK National Health Service provides a prime example of a system that has experienced the consequences when the issue is not dealt with satisfactorily, having suffered from excessive queues for a prolonged period. Learn More Restructuring the ER This NewsHour with Jim Lehrer interview with Eugene Litvak, PhD, and others at Boston Medical Center (Boston, Massachusetts, USA) shares their experiences in trying to figure out how to decrease ER overcrowding and diversions. Learn More

How to Improve
Measures
Advisors

Cracking the Code to Hospital-Wide Patient Flow - PLUS!
Flow is a property of the entire system and can only be optimized at the system level. Through IHI’s work with hundreds of institutions, a framework has evolved that allows for an organized approach to improving the system of patient flow.

September 20-21 in Washington, DC.

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Leadership for Smooth Patient Flow

This book focuses on the practical information and leadership techniques needed to foster change and remove the barriers to smooth patient flow. Real-life examples explain common patient flow theories and improvement methods. A solid business case for pursuing improvement efforts is provided.

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