Efficient patient flow management is more important than ever
Huge backlogs for patient care and decreasing public satisfaction with the NHS have seen new clinical challenges around patient flow that require NHS Trusts to become leaner, more agile, more efficient, and more digitalised.
This comprehensive guide on how to improve patient flow management tackles all of the key issues. Beginning with the fundamentals, it moves on to explore patient flow mapping, best practices from the Flow Cost Quality improvement programme, and the complexities of patient flow management in the emergency care pathway. We’ll also consider the technological solutions that can facilitate a more accurate and efficient approach, including how to use RFID for better patient flow management.
What is patient flow?
Patient flow refers to the way patients move through a healthcare system, from their initial appointment or interaction to their eventual discharge. It involves coordinating and optimising resources and service to ensure timely, safe, and efficient care.
The management of patient flow is a critical aspect of healthcare delivery that requires a strategic approach in order to meet the demands of patients and healthcare providers. The overarching goal of patient flow management is to enhance patient outcomes and reported satisfaction by minimising wait times, reducing bottlenecks across all services, and improving the quality of care delivered to patients. Effective patient flow management can also help to increase the capacity of our healthcare systems; reducing costs which benefits both patients and healthcare providers.
Currently patient flow management is focused on upgrading outdated, error-prone, working practices. The introduction of patient flow technology such as electronic health records (EHRs), automated appointment scheduling, and patient tracking systems are vital tools that healthcare providers should be looking to integrate into their facilities to enhance the delivery and standards of care.
However, it’s not just about optimising processes and technology at system level. Healthcare providers must also consider the patient’s lived experience including delivering clear communication, prompt and timely care, and a smooth discharge process. In addition to this, there’s also the healthcare workers needs to take into consideration. Monitoring workload, staff wellbeing, mental health and burnout risk are also key to promoting a healthy work environment.
Why is improving patient flow imperative?
Improving patient flow is crucial for the healthcare system. Proactively and reactively optimising hospital capacity around a robust patient flow policy helps to provide care for as many patients as possible while also relieving key pressure points. NHS vacancy statistics published in September 2022 have revealed that the vacancy rate has increased from 7.9% (103,809 vacancies) in 2021 to 9.7% (133,446 vacancies) in September 2022. With the NHS pressured to deliver higher standards of patient care with fewer members of staff across all roles, improving
Patient flow policies focus on supporting hospitals and other healthcare facilities to deliver better care to patients while reducing the amount of pressure and stress on staff and resources. Addressing these issues not only has a positive impact on patient satisfaction and outcomes while improving staff satisfaction scores and reducing healthcare costs, as a 2012 report by the Agency for Healthcare Research and Quality (AHRQ) found. patient flow has never been more critical.
Given that patient flow concerns itself with delivering high-quality healthcare services, protecting the wellbeing of healthcare staff and optimising operational efficiency and meeting new targets while the healthcare system is under the most significant amount of pressure in history, improving patient flow really has no downsides.
Hospital patient flow best practices
Patient flow management ensures that people move through the hospital efficiently resulting in a positive impact on both the patient and healthcare providers. By moving from outdated management methods to a live digital environment, healthcare professionals can admit, transfer and discharge patients in real time, with everyone involved in that patients care having access to the same critical, and most up to date, information. In order to do this, there are a number of patient flow best practises to take into consideration:
By taking the time to define clear goals and set SMART targets, leadership teams can ensure that they are pointing in the right direction before they start running. Communication is also essential to ensure that all staff members understand the plan, and are invested in what it means for them, and their patients. A survey by the Nursing Times carried out in 2020 found that 33% of the 3,500 nurses that responded rated their mental health and wellbeing as ‘bad’ or ‘very bad’, so ensuring that impact that any new initiatives will have on resources and staff is vitally important.
Trusts should also establish a multidisciplinary team to identify challenges and develop solutions. Utilising a team that has experience across the board will ensure that every department is fairly represented, and all angles are considered when creating the plan and targets. Finally, when the targets are set, regular performance reviews should be scheduled in. Pulse-checking whats; working well and what isn’t means that you can respond to feedback quickly, remain agile, and respond to events in real time to keep on track.
While the integration of technology can sometimes feel overwhelming, introducing time-saving patient flow technology can significantly assist the progression and development of patient flow policies and practices. As an example, introducing touchscreen digital white boards that allow patient flow to be carefully monitored and enable all medical professionals to view a patient’s status, known issues, consultant information, and estimated discharge date. This information can also be accessed on mobile devices by ward-based staff, allowing them to monitor patients closely and add notes immediately.
When combined with an RFID patient tracking mechanism such as RFID patient wristbands which continuously track the patients location, treatment and equipment assigned to them, patient flow really starts to sing. By storing essential data like this in a central location, administrators can easily track the patient's progress and make informed decisions to optimise the hospital's resources.
With an estimated 237 million medication errors happening every year, 66 million of which are clinically significant and have been linked to poor outcomes, flexibility really is the key to success. Hospitals should be evaluated against specific dimensions, such as bed capacity and admissions/discharges to continuously identify areas of improvement.
The NHS Flow Cost Quality improvement programme
The NHS Flow Cost Quality (FCQ) improvement programme was designed to improve patient care, reduce costs and enhance the quality of services provided by NHS Trusts. Started in 2010, the programme focused on identifying areas of inefficiency, streamlining processes and reducing waiting times. It also emphasised the importance of engaging with both staff and patients, promoting a culture of continuous improvement, and data-informed decision making.
By collecting data on patient flow and costs, the Trusts are better equipped to analyse and identify patterns of demand within the healthcare system. Knowledge is power, after all, and with this data they can develop capacity plans and adapt to variations in demand. This impacts everything from staffing and equipment to patient needs. It doesn’t stop at the healthcare facility itself, either.
The programme also encourages Trusts to work with other organisations such as local authorities and community services to develop integrated care pathways that improve the patient experience and reduce costs at the same time. By taking a holistic approach to healthcare delivery, Trusts can ensure that patients receive the right care, in the right place, at the right time. The ultimate goal was to create a sustainable model of healthcare delivery that could be successfully replicated across different NHS Trusts.
Patient journey mapping
Patient journey mapping is the act of visualising a patient’s care journey through a flow diagram of their care experiences and touchpoints. Looking at the care journey from the patients perspective allows healthcare providers to reassess their delivery and approach to care.
What is the objective of patient flow mapping?
The primary objective of patient flow mapping is to identify and analyse the processes involved in the delivery of healthcare services, from the patient’s first point of contact through to their final discharge.
The process of mapping patient journeys involves the use of visualisation tools including flowcharts and process diagrams. By walking through the steps involved in delivering healthcare services in order, and by plotting all of the potential outcomes, this helps healthcare professionals identify inefficiencies, bottlenecks and opportunities for improvements throughout the patient experience. The result is a clear roadmap of where processes can be streamlined to reduce everything from wait time to patient satisfaction scores.
As an example, patient flow mapping can help identify areas where delays in the delivery of care occur, such as waiting for test results or consultations with specialists. By first shining light on these delays, providers can improve the overall quality of care and communication across their service and reduce the length of hospital stays.
Which touchpoints should be included in patient flow charts?
As patient journey mapping concerns itself with the patient experience, healthcare professionals looking to carry this function out should be aware of these touchpoints:
This includes the patients’ first contact with the healthcare system which might include scheduling an appointment, calling their GP, or visiting a walk-in clinic.
The triage touchpoint involves the assessment of the patient’s condition, and the decision about the urgency of their healthcare needs. This might involve a telephone appointment or an in-person assessment with a medical professional.
This covers collecting the patient information including personal details, medical history and, if required, insurance information.
At this point, the patient will be meeting with a medical professional such as a doctor or nurse to discuss their symptoms, medical history and treatment options.
Blood tests, X-rays, or scans.
The treatment touchpoint involves the delivery of medical treatment such as medication, surgery or therapy.
This covers the patient’s final release from the healthcare system including any necessary follow-up appointments or instructions.
How does this support patient flow management?
By taking the time to carry out patient flow mapping, and including these touchpoints in patient flow charts, healthcare professionals can gain a comprehensive understanding of their patients problems and journey through their system. This then enables them to identify any areas of inefficiency and opportunities to improve the delivery of care.
Once the areas of improvement have been spotted, they can implement changes to optimise patient flow, such as introducing new processes, improving communication or providing training to staff. These changes can enhance patient outcomes, increase patient satisfaction and reduce healthcare costs.
Improving patient flow in emergency departments
As we have discussed previously, describing the NHS as ‘under pressure’ is putting the current healthcare crisis mildly. Following the pandemic, being grossly underfunded for years, and skyrocketing numbers of vacancies, waiting lists for both essential and elective procedures have risen to unprecedented levels. With the government unlikely to deliver the help needed, hospital managers now have no choice but to become as efficient as possible through their own policies and procedures to prevent the backlog from continuing to grow, and to protect the wellbeing of healthcare workers.
Improving patient flow in emergency departments is a unique challenge due to the critical and ever-changing nature of A&E. The key to successfully improving patient flow in an emergency environment lies in first identifying where issues are arising. As attendance rates continue to increase at a dramatic rate, and bed occupation blocks admittance and delays discharge, these seem like natural first places to start.
One of the most popular ways that EDs are tackling this problem is through the introduction of RTLS; real time locating systems. Using tracking technology like GS1-compliant barcodes and RFID wristbands for patients, decision makers have a real time overview of all of their assets. In this way, clinical staff can know immediately when a bed becomes available for a waiting patient; alleviating the bottlenecks, encouraging more patients through to the consultation or treatment phase, and better moving patients through to discharge.
Which tools can NHS Trusts use to support them?
From electronic health records (EHRs) which provide a comprehensive view of a patient’s history, to real-time location systems (RTLS) which track patients movement through the hospital, there are plenty of tools at NHS Trusts disposal to help them with their patient journey mapping. At The Barcode Warehouse, we are proud to supply patient flow technology and software that empowers healthcare teams. Let’s explore some of the ways that we can help.