Achieving Hospital-wide Patient Flow



How to Cite This Paper:

Rutherford PA, Provost LP, Kotagal UR, Luther K, Anderson A. Achieving Hospital-wide Patient Flow. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2017. (Available at



Failing to achieve hospital-wide patient flow — the right care, in the right place, at the right time — puts patients at risk for suboptimal care and potential harm. It also increases the burden on clinicians and hospital staff and can accelerate burnout. Yet, while many understand the problem, they often lack the comprehensive strategies to address it.

Achieving hospital-wide patient flow, and ultimately improving outcomes and the experience of care for patients, requires an appreciation of the hospital as an interconnected, interdependent system of care. It also requires strong leadership; in fact, the role of executive leaders is critical for success.

The culmination of approximately two decades of IHI’s research, innovation, and learning about hospital-wide patient flow, this white paper guides leaders and quality improvement teams through an in-depth examination of a systems view of patient flow, theories for improvement, and high-leverage strategies and interventions to achieve hospital-wide patient flow.

The white paper includes:

  • A systems view of hospital-wide patient flow, including flow within the hospital (among departments and units), as well as flow into and out of the hospital from and to other care settings
  • Application of IHI's Will-Ideas-Execution framework to system-level improvement of patient flow
  • Detailed high-leverage change ideas, organized by three key approaches for improving flow: shape or reduce demand, match capacity and demand, and redesign the system
  • Recommended flow measures for the overall hospital system, as well as for specific departments and units
  • Guidance on developing a portfolio of improvement projects to support hospital-wide goals for patient flow, and for creating an action plan to get started

Achieving Hospital-wide Patient Flow

In this short video, Pat Rutherford, IHI Vice President and IHI White Paper co-author, gives a brief overview of Achieving Hospital-wide Patient Flow.

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