A framework to analyze hospital-wide patient flow logistics: evidence from an Italian comparative study.
Through a comparative study of six Italian hospitals, the paper develops and tests a framework to analyze hospital-wide patient flow performance. The framework adopts a system-wide approach to patient flow management and is structured around three different levels: (1) the hospital, (2) the pipelines (possible patient journeys within the hospital) and (3) the production units (physical spaces, such as operating rooms, where service delivery takes places). The focus groups and the data analysis conducted within the study support that the model is a useful tool to investigate hospital-wide implications of patient flows. The paper provides also evidence about the causes of hospital patient flow problems. Particularly, while shortage of capacity does not seem to be a relevant driver, our data shows that patient flow variability caused by inadequate allocation of capacity does represent a key problem. Results also show that the lack of coordination between different pipelines and production units is critical. Finally, the problem of overlapping between elective and unscheduled cases can be solved by setting aside a certain level of capacity for unexpected peaks.
Department of Management, Catholic University, Rome, Italy; CERISMAS, Research Centre in Health Care Management, Catholic University, Milano, Italy. Electronic address: stefano.villa@unicatt.it.
Stefano
S
Villa
CERGAS, Center for Research on Health and Social Care Management, Bocconi University, Milano, Italy; SDA Bocconi, School of Management, Via Roentgen, 1, 20136 Milano, Italy. Electronic address: anna.prenestini@unibocconi.it.
Anna
A
Prenestini
CERGAS, Center for Research on Health and Social Care Management, Bocconi University, Milano, Italy. Electronic address: isabella.giusepi@unibocconi.it.
Isabella
I
Giusepi
D017144:Focus Groups; D006739:Hospital Administration / Q000379:methods*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic; D007558:Italy; D017146:Models, Organizational
Analysis framework; Hospital; Logistics performance; Operations management; Patient flows