Acute care settings are plagued with waits, delays, and diversions. 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.

Thus far, attempts to improve patient flow have involved little, if any, capacity planning or linkage to the overall demand for services. System-level changes are required to solve the issues of flow. Looking upstream and downstream from "problem" hospital units is essential to make changes that will result in hospital-wide improvements in flow.

The Problem

• In the US, a study by the University of Texas School of Public Health found that severely injured patients are 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.**

*Source: The Connection, State Report (December 2002). American College of Emergency Physicians (ACEP) website.
**Source: "Large Hospitals Say They Are Full: ACEP and AHA Continue to Search for Solutions to Overcrowding." EM Today Digital, April 25, 2002.

Better Models of Care Exist
Understanding variability is key to making improvements in flow through the acute care setting. Natural variability should be optimally managed and artificial variability should be reduced and, where possible, eliminated. "Lengthening the chain," or making connections with other community resources such as long-term care facilities and outpatient clinics, to ensure that the right patient is in the right place at the right time will further increase efficiencies in the system.

Better models for flow can be found by looking outside of the health care industry. The trucking and airline industries have used resource allocation to better serve their customers, reduce costs, and improve safety.

Sample Results