Understanding Patient Flow: FAQ for Facilities

Patient flow refers to patients’ progress through a healthcare system, often a hospital, from admission to discharge. It encompasses all routes of entry, from emergency department (ED) walk-ins to elective surgery intakes and continues as patients are transferred around the hospital for treatments and tests. The process ends when they leave the facility — sometimes long after they’ve been medically cleared.

As hospitals adjust to value-based care (VBC) payment models, optimizing operations is a high priority. Under VBC models, providers are rewarded for efficiency and positive patient outcomes. Streamlining the movement of patients through the facility can directly increase a facility’s profit margins and improve health outcomes for patients.

We’ll answer some of the most frequently asked questions, and share strategies for operational improvements as we look into this crucial topic in more depth. We’ll also discuss ideas for handling flow failures and delays, and give you insights into the use of AI-driven predictive tools and other emerging technologies.

The Flow of Patients in Healthcare Facilities: Overview

The optimized movement of patients through a healthcare system requires the efficient orchestration of patient admissions, treatments, and discharges. Problem areas are not isolated, but rather seen as a part of an interconnected system that needs to be managed as a whole for best results. This effort typically requires high levels of leadership involvement and the application of operations management principles.

The Reason For Increased Focus on Flow Patterns

The need for better care progression through complex healthcare systems gained industry-wide recognition due to the issue of overcrowding in EDs. This persisted for decades, with patients often “boarded” (sometimes in hallways for 24 hours or more) while waiting for beds. Because longer board times are linked to higher risks of adverse events, longer hospital stays, and increased mortality rates, the issue had to be addressed. It became evident that while overcrowding manifested in the ED, it was actually a symptom of poor flow throughout entire facilities.

In 2004, The Joint Commission (TJC) released new standards requiring hospitals to manage, measure, and set goals for the flow of patients. This standard, along with other initiatives responding to ED overcrowding, led to more focus on managing flow in hospitals.

Patient Flow Management: FAQ

The movement of patients through a healthcare system or facility is highly individualized to the system. You may want to consider the unique features of your facility as you integrate best practices into your own operations.

What is flow management in healthcare facilities?

Flow management is the coordination of care for all patients within a facility, seen in a big-picture view that encompasses the facility or healthcare system as a whole. Large hospitals in particular represent complex systems with many variables, and managing them requires strategies that identify and account for the variables. Looking at high volumes of ED admissions data, for instance, is one way to identify patterns that will guide management strategies.

How are healthcare facility flow patterns measured?

To assess flow through a facility, leaders must collect and analyze data. Metrics commonly measured include:

• Admission rates and routes
• Bed occupancy rates
• Bed turnover rates
• Room turnover time
• Time of discharge orders
• Discharge to clean time
• Length of stay (LOS)
• Patient satisfaction scores
• Readmission rates

What is an example of poor flow in a hospital?

A common pain point for facilities is dysfunctional scheduling of elective surgeries. The example below illustrates how this variable effects flow through the facility.

Example: A hospital’s surgical department scheduled elective surgeries early in the week and underestimated the resources needed to handle all cases. By Monday afternoon, several patients took longer than expected to meet the requirements to transfer out of the PACU. With the PACU full, the downstream flow of patients out of the ORs was blocked, delaying the start of the next surgeries. The hospital incurred the costs of inefficiently utilized OR rooms and surgical staff. Several procedures had to be postponed, leading to lost revenue and frustrated patients and staff.

What is an example of good flow in a hospital?

Flow through a facility is increasingly managed with the help of advanced technology, such as AI-powered software. Let’s look at an example that illustrates how software can help facilities gain a real-time, big-picture view of what’s happening throughout their systems.

Example: A large hospital uses a central command hub and AI-driven software to perform real-time tracking of bed utilization and other flow metrics. The algorithms detected suboptimal use of a bed in the ICU, prompting ICU staff to evaluate whether a patient was stable enough for transfer to a med-surg floor. The transfer was deemed appropriate, and the patient was moved to a med-surg bed. A critically-ill patient was then swiftly moved from the ED to the ICU to receive life-saving care.

What are the typical steps for improving flow at a facility?

To improve system-wide operations, facility leaders typically perform the following steps:

• Perform a flow assessment to figure out the resources and processes that need attention.
• Respond to the problems identified in the assessment.
• Evaluate interventions and use iterative processes to optimize operations.
• Perform reassessments periodically to account for changing patient demands.

What roles exist to help manage flow processes?

There are a variety of positions that can strengthen operational efficiency at hospitals, including:

• Patient flow coordinator
• ED/ER flow coordinator
• Surgical coordinator
• Operations analyst
• Healthcare project manager
• Patient intake coordinator

Improving patient flow in outpatient clinics may require additional staffing at pain points where long wait-times tend to occur, such as the front desk.

What technology can be used to streamline patient care?

Integrating new technology can have a significant positive impact on patient processing. There are two key types of technology that hospitals use for streamlining care: real-time location systems (RTLS) and AI-driven patient flow prediction. In hospitals, RTLS is used to generate live data about resources, such as available beds, staff, and medical equipment. This can help facilities optimize resource allocation. AI-powered predictive software can be used to analyze large datasets to benefit multiple areas of operations, including staffing and patient scheduling.

Stay Current on Advances in Healthcare

As a leader in today’s healthcare environment, you’re asked to be an expert in many fields — from patient flow management systems to emerging tech — and that takes time and effort. We’re here to support you with healthcare resources and facility guides that deliver up-to-date info on the trends and strategies impacting healthcare today.