Managing Patient Flow Across an Acute Tertiary Care Hospital Through A Centralised Coordination Hub: Technological and Cultural Change – A Case Study

Abstract

Aim: A centralised Coordination Hub was implemented at a large tertiary health service in Queensland, Australia to address problems associated with a fragmented, reactive and manual approach to patient flow. Approach: The Hub was developed through challenging traditional ways of working, breaking down divisional silos, and developing technological enablers to manage patient flow as a whole-system issue. The Hub is a centralised space within the health service, where staff involved in patient flow are co-located and provided with real-time visibility of end-to-end data. Context: This case study describes the implementation and early operation of the Hub, outlining the critical design features and some of the early challenges and how they are being addressed. Main findings: This approach was designed to manage patient flow as a whole-system issue – co-locating staff, providing them with visibility of real time data, and accountability for decision-making to address flow blockages. Conclusions: Greater visibility of data and co-location of staff is not sufficient to manage long-standing patient flow challenges. This must be accompanied by appropriate accountability and authority to ensure that those who see and understand emergent flow issues are equipped with the authority to act and respond.