Structured approaches improve patient flow

Frontline healthcare professionals can use structured quality improvement processes to improve patient flow.

This study aimed to reduce the time taken to transfer critically ill people between the emergency department and the medical intensive care unit at one hospital in the US. The team used the clinical microsystems approach to map out existing practice. They determined the causes of delays and used PDSA cycles to test changes. Causes of delays included poor coordination between transport and nursing services in transferring patients and delays in identifying and transferring people out of ICU. The interventions put in place reduced transfer time from four hours to two hours. Average hospital length of stay decreased from 10 to eight days.

Reference: Cohen RI et al.  A quality improvement project to decrease emergency department and medical intensive care unit transfer times. Journal of Critical Care. 2015. 30(6): 1331 – 1337


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