Optimizing patient flow in Austrian hospitals – Improvement of patient-centered care by coordinating hospital-wide patient trails

Abstract

Improving the effectiveness and efficiency of healthcare services under certain quality requirements and cost restrictions is the main challenge for decision makers in hospital management. This entails ensuring that the required patients are available at each point of care while taking qualitative criteria and economic aspects into consideration. Hospital decision makers have certain priorities regarding patient flow to and through the different departments of a hospital. And the question is: What relevant levers can sustainably positively influence and control patient flow in the complex hospital system with its division of labor? Therefore, it is necessary to identify the different perspectives and needs of the relevant stakeholders (e.g. the patients, the health professionals, the management, and the hospital). In addition, important factors for the design of patient flow need to be identified and possible further developments considered. Under a modified analytic hierarchy process framework, individual and subjective cause-and-effect assessments of Austrian hospital decision makers and patient logistic service providers were carried out as part of an expert workshop in 2012. The demands, aims, and strategies of health professionals, management experts, and patients were a particular focus. It was found that the wide range of different influential factors have different impacts on the complex system and the overall objectives. It became clear that, in particular, central admission (e.g. central emergency department including patient administration), case management, and patient discharge management are seen by the respondents as the most important levers to improve patient flow logistics in Austrian hospitals.