Improving patient flow: The impact of consultant work pattern on trauma ward efficiency

Divecha, Hiren; Smith, Rachel; Cairns, Chris; Bayer, J

doi:10.1016/j.surge.2010.08.008

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…190 studies underwent full-text review, and 69 studies were selected for final analysis (Figure and eAppendix 3 in the Supplement). Among the final 69 improvement programs, 49 programs significantly decreased TTS and 20 programs did not. Delayed TTS cutoffs were most often defined dichotomously as more than 24 hours, more than 36 hours, more than 48 hours, or more than 72 hours, although some studies collected continuous data.…”

Section: Resultsmentioning

confidence: 90%

“…190 studies underwent full-text review, and 69 studies were selected for final analysis ( Figure and eAppendix 3 in the Supplement ). 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 …”

Section: Resultsmentioning

confidence: 99%

“…190 studies underwent full-text review, and 69 studies were selected for final analysis (Figure and eAppendix 3 in the Supplement). Among the final 69 improvement programs, 49 programs significantly decreased TTS 33,35,38,41,[43][44][45][46][47][48][49][51][52][53][54]56,57,[59][60][61][62][65][66][67][68][69][70][71][72][74][75][76][79][80][81][82][85][86][87][88]91,94,96,97,99,101,103 and 20 programs 39,40,42,50,…”

Section: Included Studiesmentioning

confidence: 99%

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Evaluation of Systemwide Improvement Programs to Optimize Time to Surgery for Patients With Hip Fractures

et al. 2022

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IMPORTANCE Longer time to surgery (TTS) for hip fractures has been associated with higher rates of postoperative complications and mortality. Given that more than 300 000 adults are hospitalized for hip fractures in the United States each year, various improvement programs have been implemented to reduce TTS with variable results, attributed to contextual patient-and systemlevel factors. OBJECTIVETo catalog TTS improvement programs, identify their results, and categorize program strategies according to Expert Recommendations for Implementing Change (ERIC), highlighting components of successful improvement programs within their associated contexts and seeking to guide health care systems in implementing programs designed to reduce TTS. EVIDENCE REVIEW A systematic review was conducted per the Preferred Reporting Items forSystematic Reviews and Meta-analyses guideline. Three databases (MEDLINE/PubMed, EMBASE, and Cochrane Trials) were searched for studies published between 2000 and 2021 that reported on improvement programs for hip fracture TTS. Observational studies in high-income country settings, including patients with surgical, low-impact, nonpathological hip fractures aged 50 years or older, were considered for review. Improvement programs were assessed for their association with decreased TTS, and ERIC strategies were matched to improvement program components.FINDINGS Preliminary literature searches yielded 1683 articles, of which 69 articles were included for final analysis. Among the 69 improvement programs, 49 were associated with significantly decreased TTS, and 20 programs did not report significant decreases in TTS. Among 49 successful improvement programs, the 5 most common ERIC strategies were (1) assess for readiness and identify barriers and facilitators, (2) develop a formal implementation blueprint, (3) identify and prepare champions, (4) promote network weaving, and (5) develop resource-sharing agreements. CONCLUSIONS AND RELEVANCEIn this systematic review, certain components (eg, identifying barriers and facilitators to program implementation, developing a formal implementation blueprint, preparing intervention champions) are common among improvement programs that were associated with reducing TTS and may inform the approach of hospital systems developing similar programs. Other strategies had mixed results, suggesting local contextual factors (eg, operating room availability) may affect their success. To contextualize the success of a given improvement program across different clinical settings, subsequent investigation must elucidate the association between interventional success and facility-level factors influencing TTS, such as hospital census and type, teaching status, annual surgical volume, and other factors.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

“…190 studies underwent full-text review, and 69 studies were selected for final analysis (Figure and eAppendix 3 in the Supplement). Among the final 69 improvement programs, 49 programs significantly decreased TTS 33,35,38,41,[43][44][45][46][47][48][49][51][52][53][54]56,57,[59][60][61][62][65][66][67][68][69][70][71][72][74][75][76][79][80][81][82][85][86][87][88]91,94,96,97,99,101,103 and 20 programs 39,40,42,50,…”

Section: Included Studiesmentioning

confidence: 99%

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Evaluation of Systemwide Improvement Programs to Optimize Time to Surgery for Patients With Hip Fractures

et al. 2022

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When patients get stuck: A systematic literature review on throughput barriers in hospital-wide patient processes

2022

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Inpatient flow management: a systematic review

Winasti

Elkhuizen

Berrevoets

et al. 2018

IJHCQA

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Purpose In hospitals, several patient flows compete for access to shared resources. Failure to manage these flows result in one or more disruptions within a hospital system. To ensure continuous care delivery, solving flow problems must not be limited to one unit, but should be extended to other departments – a prerequisite for solving flow problems in the entire hospital. Since most current studies focus solely on overcrowding in emergency units, additional insights are needed on system-wide patient flow management. The purpose of this paper is to look at the information available in system-wide patient flow management studies, which were also systematically evaluated to demonstrate which interventions improve inpatient flow. Design/methodology/approach The authors searched PubMed and Web of Science (Core Collection) literature databases and collected full-text articles using two selection and classification stages. Stage 1 was used to screen articles relating to patient flow management for inpatient settings with typical characteristics. Stage 2 was used to classify the articles selected in Stage 1 according to the interventions and their impact on patient flow within a hospital system. Findings In Stage 1, 107 studies were selected. Although a growing trend was observed, there were fewer studies on patient flow management in inpatient than studies in emergency settings. In Stage 2, 61 intervention studies were classified. The authors found that most interventions were about creating and adding supply resources. Since many hospital managers these days cannot easily add capacity owing to cost and resource constraints, using existing capacity efficiently is important – unfortunately not addressed in many studies. Furthermore, arrival variability was the factor most frequently mentioned as affecting flow. Of all interventions addressed in this review, the most prominent for advancing patient access to inpatient units was employing a specialized individual or team to maintain patient flow and bed placement across hospital units. Originality/value This study provides the first patient flow management systematic overview within an inpatient setting context.

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Improving patient flow: The impact of consultant work pattern on trauma ward efficiency

Cited by 3 publications

References 7 publications

Evaluation of Systemwide Improvement Programs to Optimize Time to Surgery for Patients With Hip Fractures

Evaluation of Systemwide Improvement Programs to Optimize Time to Surgery for Patients With Hip Fractures

When patients get stuck: A systematic literature review on throughput barriers in hospital-wide patient processes

Inpatient flow management: a systematic review

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