Improving patient flow across organisations and pathways

Document type
Literature review
Silva, Debra de
Health Foundation
Date of publication
1 November 2013
Evidence scan; no. 19
Health Services
Social welfare
Material type

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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 empirical evidence reviewed by the scan suggests that healthcare teams wanting to analyse and alter patient flow should note the following key learning 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