Managing patient flow using time buffers

Abstract

PurposeThe purpose of this paper is to determine how and why theory of constraints based time buffer management has contributed to improved patient flow in health and social care applications.Design/methodology/approachThe focus of the research is on the application and implementation of time buffer management by QFI Consulting. Four UK hospital implementations of the QFI Jonah software and methodology were investigated to establish how buffer management was being applied and why the reported benefits were being achieved. This involved collecting service delivery data together with semi‐structured interviews. To support this evaluation, four control functions of time buffer management have been identified as a basis for evaluation of the application designs and their implementation.FindingsCase research evidence shows significant and rapid improvement in length of stay (LOS) following implementation of the approach, amounting to a reduction in LOS of over 20 per cent and significantly improved accident and emergency performance. Sustainability issues were evident however and were traced, at least in part, to lack of adherence to one or more of the functional elements of the system.Research limitations/implicationsThis case research has considered four applications that represent some of the more successful implementations. This research is, therefore, limited by the range of applications considered and is also limited in its ability to evaluate the sustainability of the implementations in the longer term.Practical implicationsThis paper provides clearer theoretical understanding of the improvements experienced by these hospitals, which is critical to expanding the use of traditional manufacturing approaches into complex service environments.Originality/valueThis research has helped conceptualise how time buffer management control functions can be structured to evaluate the design and implementation of novel applications.