title: Health services under siege: the case for clinical process redesign.
abstract: *Public health services are struggling to cope with rising demand. *Strain on health services manifests as longer waiting lists for surgery, queuing in the emergency departments, increased rates of adverse events, and delays in discharge, particularly for older patients. *Traditional responses are not resolving these problems. *Analysis shows that the day-to-day system processes underlying clinical care are poorly designed and do not produce a well planned, well coordinated patient journey. *Numerous disconnections along the continuum of care have a cumulative effect in obstructing patient flow and causing frustration for patients and staff. *Rigorous clinical process redesign methods can significantly improve performance, even in the face of rising demand.
authors.affiliation: Health Services Performance Improvement, NSW Health, Sydney, NSW, Australia.
authors.forename: Tony J
authors.initials: TJ
authors.lastname: O'Connell
authors.forename: David I
authors.initials: DI
authors.lastname: Ben-Tovim
authors.forename: Brian C
authors.initials: BC
authors.lastname: McCaughan
authors.forename: Michael G
authors.initials: MG
authors.lastname: Szwarcbord
authors.forename: Katherine M
authors.initials: KM
authors.lastname: McGrath
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D009517:New South Wales; D010043:Outcome and Process Assessment, Health Care; D010346:Patient Care Management / Q000458:organization & administration / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*