Restructuring patient flow logistics around patient care needs: implications and practicalities from three critical cases.
To make hospitals more patient-centered it is necessary to intervene on patient flow logistics. The study analyzes three innovative redesign projects implemented at three Italian hospitals. The three hospitals have reorganized patient flow logistics around patient care needs using, as proxies, the expected length of stay and the level of nursing assistance. In order to do this, they have extensively revised their logistical configuration changing: (1) the organization of wards, (2) the hospital's physical lay-out, (3) the capacity planning system, and (4) the organizational roles supporting the patient flow management. The study describes the changes implemented as well as the results achieved and draws some general lessons that provide useful hints for those other hospitals involved in such type of redesign projects. The paper ends by discussing some policy implications. In fact, the results achieved in the three cases investigated provide interesting material for further discussion on clinical, operational, and economic issues.
Villa
Stefano
S
Center for Research in Health and Social Care Management, CERGAS, Bocconi University, Viale Isonzo 23, 20135 Milan, Italy. stefano.villa@unibocconi.it
Barbieri
Marta
M
Lega
Federico
F
D017598:Efficiency, Organizational; D006291:Health Policy; D006739:Hospital Administration / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D019982:Organizational Case Studies; D010346:Patient Care Management / Q000458:organization & administration*; D010347:Patient Care Planning / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration