Patient workflow in a hospital is the series of tasks and processes that need to be completed in sequence or in parallel to ensure quality care is provided throughout the patient’s journey through a hospital, from intake to diagnosis and treatment and discharge.
That journey could easily see the patient interact with many different departments and dozens of healthcare employees, with many back-office staff also conducting tasks related to the patient. When hospitals work efficiently, patient workflow in a hospital can be streamlined. The patient will move efficiently through the system while being provided with quality care and patient stays will be decreased, helping to improve bed utilization.
Inefficient patient workflows in hospitals can lead to considerable delays to a patient’s journey. There can be long wait times at several points in that journey, starting with admission and continuing until discharge. There will naturally be delays that are beyond the control of a hospital, but oftentimes there are patient workflow inefficiencies that can easily be addressed.
These inefficiencies in patient workflow in a hospital hamper patient flow through a hospital, reduce patient throughput, lower patient satisfaction, can negatively affect patient outcomes and reduce hospital profits.
While there are many benefits to be gained from improving patient workflow in a hospital, identifying areas where patient workflow can be improved can be a challenge.
Good patient workflow is critical to the patient experience. When there is good patient flow, patient satisfaction improves. It also helps to reduce the pressure on staff and is important for clinical safety. Optimizing patient workflow in a hospital is concerned with improving efficiency, reducing waste, achieving better resource utilization, and accelerating patient flow. Optimization is about quickly, efficiently, and effectively meeting the demand for care and carefully matching resources for every admission.
Patient workflow problems in hospitals are common. They are most commonly associated with bottlenecks that occur when there are too few resources available for the volume of patients. These bottlenecks often occur due to poor scheduling or due to an increase in patients visiting the emergency department. It is difficult to predict the latter, but there is usually room for improvement in scheduling.
Scheduling many appointments early in the week, especially for elective surgery, has its advantages, as it ensures that patients will be given time to recover during the week when there are more resources available, but this stacking places pressure on post-operative units which can cause patient flow problems. It is often better, in terms of patient flow, to spread out elective surgeries throughout the week.
Scheduling is a task often given to a low paid member of staff, but scheduling can have a huge impact on patient flow. It is essential for the staff responsible for scheduling to understand the impact scheduling has on productivity and efficiency. Ensuring a highly skilled member of staff is given the task of scheduling is important. It can easily increase the number of patients by one or two a day and greatly improve patient workflow.
Identifying areas where patient flow is being hampered is made easier with patient flow software. The software can be used to identify where bottlenecks are occurring, with can be fed back to scheduling. By determining where choke points are occurring, steps can be taken to address the issues causing patient workflow problems. These choke points could be addressed by increasing resources, delegating tasks to reduce workload on specific departments, and identifying areas where efficiency needs to be improved.
There are often communication inefficiencies in hospitals which slow patient workflow. Many hospitals are still heavily reliant on outdated communication tools such as pagers and landlines. Most clinicians now carry mobile devices, yet they are often not used for clinical communication. Electronic health record systems have been introduced which have resulted in major improvements to patient flow, but the full benefits of these systems are not being realized. Information is fed into these systems, but clinicians still need to visit a workstation and log in to view essential information.
Clinical communication and collaboration (CC&C) platforms offer a solution and have been shown to greatly improve patient workflow in a hospital. These platforms are text message based and are accessed through mobile phones, but also support voice and video calls. The platforms link with EHRs and allow alerts to be sent directly to the mobile devices clinicians are carrying and help to close the gaps in EHR functionality. The platforms replace pagers with a two-way communication channel, allowing responses to be sent much faster. They allow clinicians to prioritize their responses in a way that is simply not possible with pagers.
Hospitals that have adopted these CC&C platforms report significant improvements in patient workflow. The improvement to communication efficiency has allowed clinicians to spend more time at patient’s bedsides, bottlenecks have been reduced due to the improvement in care coordination, patient transfer and discharge times have been reduced, and there is better bed utilization.
The improvement to patient workflow in a hospital achieved through the use of these platforms has also helped to improve patient satisfaction scores and more effective and efficient communication has helped to improve patient safety by reducing the potential for medical errors.