Beeman DE. Hospital's traffic cop eases jam. The Press-Enterprise. E-pub March 13, 2006.

This article describes how nurse supervisor, Richard Parenteau, is part of a team at Redlands Community Hospital that monitors patient flow to finds needed beds.

Beeman DE. Diverting ambulances only shuffled the problem. The Press-Enterprise. E-pub March 13, 2006.

Ambulances are stacked up outside the emergency entrance at Hemet Valley Medical Center. While patients with life-threatening illness are treated immediately, those with lesser problems can wait for hours on ambulance gurneys.

Nolan T, Schall M, Berwick DM, Roessner J
Boston, Massachusetts, USA: Institute for Healthcare Improvement; 1996

**NOTE: This Breakthrough Series Guide was published in 1996 and has NOT been updated. Please be advised that much of the clinical content may be out of date.**              This book includes an overview of the Model for Improvement and its application in organizations participating in the Institute for Healthcare Improvement’s Breakthrough Series Collaborative on Reducing Delays and Waiting Times Throughout the Healthcare System. Many concrete examples, inspirational success stories and practical tips, all from health care organizations.

Bisognano M, Plsek P, Schummers D
Chicago, Illinois: Health Administration Press with the Institute for Healthcare Improvement; 2005

Authors Maureen Bisognano and Paul Plsek — both frontline figures in the improvement and innovation field — share concepts in enhancing care and service delivery that have been developed and successfully implemented in outpatient as well as inpatient settings of actual health care organizations. Topics include creativity and innovation, bundles, pattern mapping, Rapid Response Teams, medication reconciliation, flow, spreading improvements, and more. [This is the second book in a series.]

Berman S (editor)
Chicago, Illinois: Joint Commission Resources and the Institute for Healthcare Improvement; 2005

Health care leaders are now finding quality and safety to be vital not only to the health of patients but also to the health of the enterprise. In this book, the experts widely considered top in their respective fields describe the most challenging issues facing health care leaders today and provide guidance and suggestions on how to address them. Topics include microsystem peak performance; organizational infrastructure for patient safety; using information technology for safety and quality; patient flow; staffing for organizational excellence; and strategies to spread improvement.

Litvak E, Buerhaus PI, Davidoff F, Long MC, McManus ML, Berwick DM. Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety. Joint Commission Journal on Quality and Patient Safety. 2005;31(6):330-338.

Increases in adverse clinical outcomes have been documented when hospital nurse staffing is inadequate. Since most hospitals limit nurse staffing to levels for average rather than peak patient census, substantial census increases create serious potential stresses for both patients and nurses. By reducing unnecessary variability, hospitals can reduce many of these stresses and thereby improve patient safety and quality of care.

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Focus on Five: Strategies for Implementing the New Patient Flow Standard. Joint Commission Perspectives on Patient Safety. 2005;5:11.

This article outlines five strategies to help your hospital meet Joint Commission standard LD.3.15 for patient flow, which became effective for all accredited hospitals on January 1, 2005.

EC Strategies to Help Improve Patient Flow. Environment of Care News. Apr 2004;7(4):1-3.

This standard created by the Joint Commission in 2004 focuses on leadership's responsibility for maintaining patient flow and avoiding overcrowding. However, Environment of Care (EC) professionals play a key role in helping to meet this standard. This article addresses facility services and safety-related strategies EC staff can use to help improve patient flow.

Designing for Improved Patient Flow. Environment of Care News. May 2004;7(5):8-10.

This article addresses facility and process design strategies that can improve patient flow in health care organizations. Some strategies require significant capital, while others do not. Each is worth considering in all care areas where overcrowding may be a problem due to inefficient patient flow.

New Leadership Standard on Managing Patient Flow for Hospitals. Joint Commission Perspectives. 2004;24:13-14.

The Joint Commission’s Standards and Survey Procedures Committee approved a new "Leadership" standard relating to efficient patient flow throughout the organization. The standard, which became effective for all accredited hospitals on Janurary 1, 2005, calls on hospital leadership to develop and implement plans to identify and mitigate issues in a hospital that can interfere with efficient movement of patients across the continuum of care. This article contains the language of the new standard and JCAHO contact information regarding questions on this standard.