title: The Elimination of Transfer Distances Is an Important Part of Hospital Design.
abstract: OBJECTIVE
  The objective of the present study was to describe how a specific patient flow analysis with from-to charts can be used in hospital design and layout planning.
  
  
  BACKGROUND
  As part of a large renewal project at a university hospital, a detailed patient flow analysis was applied to planning the musculoskeletal surgery unit (orthopedics and traumatology, hand surgery, and plastic surgery).
  
  
  METHODS
  First, the main activities of the unit were determined. Next, the routes of all patients treated over the course of 1 year were studied, and their physical movements in the current hospital were calculated. An ideal layout of the new hospital was then generated to minimize transfer distances by placing the main activities with close to each other, according to the patient flow analysis. The actual architectural design was based on the ideal layout plan. Finally, we compared the current transfer distances to the distances patients will move in the new hospital.
  
  
  RESULTS
  The methods enabled us to estimate an approximate 50% reduction in transfer distances for inpatients (from 3,100 km/year to 1,600 km/year) and 30% reduction for outpatients (from 2,100 km/year to 1,400 km/year).
  
  
  CONCLUSIONS
  Patient transfers are nonvalue-added activities. This study demonstrates that a detailed patient flow analysis with from-to charts can substantially shorten transfer distances, thereby minimizing extraneous patient and personnel movements. This reduction supports productivity improvement, cross-professional teamwork, and patient safety by placing all patient flow activities close to each other. Thus, this method is a valuable additional tool in hospital design.
authors.affiliation: 1 SKA-Research Oy, Veikkola, Finland.
authors.forename: Sauli
authors.initials: S
authors.lastname: Karvonen
authors.affiliation: 2 The Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland.
authors.forename: Isto
authors.initials: I
authors.lastname: Nordback
authors.affiliation: 3 Consultant in Trauma and Orthopaedic Surgery, Tampere, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Elo
authors.affiliation: 4 Consultant in Hand and Microsurgery, Tampere, Finland.
authors.forename: Jouni
authors.initials: J
authors.lastname: Havulinna
authors.affiliation: 5 Department of Orthopaedics and Traumatology, The Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland.
authors.forename: Heikki-Jussi
authors.initials: HJ
authors.lastname: Laine
mesh_terms: D006749:Hospital Design and Construction / Q000379:methods*; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007297:Inpatients; D010045:Outpatients; D013503:Surgery Department, Hospital / Q000458:organization & administration; D014187:Transportation of Patients / Q000458:organization & administration*
keywords: hospital; lean; medical/surgical unit; patient-centered care; research tools