Title- Patient Flow Management: Issues and Solutions

Background: - Patient inflow is a major problem in the hospital, clinics, nursing homes,
primary health care(PHC). patient flow shows how hospitals are efficient and fast in
providing healthcare services. After studying about the patient flow it may help to determine
the various problems and how these problems and how these problems are affecting the
effectiveness of hospital or it's departments. It will help to use to conduct what-if analysis,
plan future reorganizations, optimize schedule and allocate optimum resources to the
hospital. It makes patient irritating and sarcastic because if hospital premises are not having
any waiting area for a patient. It may also help in determining how the patient flow change
because of any uncertain events like demonetization.

Traffic in the hospital at different places can be managed by a various hospital but it depends
on how hospital executives or managers are taking it seriously or not.

Patient inflow can be anywhere in the hospital or other healthcare premises such as outside of
OPD, Pharmacy, Waiting room.

There are two main factors in patient flow in a hospital that helps to determine the load of
departments, patient arrival rate, and the in-hospital flow. Patient's inflow defines the in-
hospital flow in each & every department and the inflow of a patient from one to another
department.

It makes patient irritating because if hospital premises are not having any waiting area for the
patient and creates the problem to the hospital too. Non-NABH accredited hospitals are not
having such facilities for the patient.

Psychology of the patient is mattered when patient is visiting first time to the hospital, a
patient creates the image in his mind for the hospital by seeing such lacking facilities.

The Patient flow also set the psychology of patient, if they are more in quantity then the
patient starts thinking hospital good and vice versa.
Patient flow in OPD: -

Referred
Examination/ to IPD
one stop Diagnosis
Registration Waiting Area/ > Lab test
Doctor
> Counter check in >X-Ray
consultancy Medicine
> Payments > ECG
collection
Etc. from
Pharmacy

ICU or
Refer to Recovery Discharge
Surgery IPD Ward
IPD Room to home
dept.

 Whenever the patient comes to the hospital he/she just has to go to the registration
desk then further processes start.
 It depends whether the patient wants to directly go to the IPD or OPD then here
differentiation starts where the patient has to go first.
 If the patient is going to OPD then the patient has to go through various ways and
depends where OPD is located and how far it is.
  Before going to the OPD chamber there should be a responsible person who can
inform that particular patient that how long he/she has to wait, so that patient flow
inside the hospital will be managed.
 After examination of the patient, has to go for diagnosis if it prescribed then here also
a concern of patient inflow from one department to another department.
 If the patient goes to IPD then there will be a chance of transferring from one to
another department such as surgery, recovery, and therapy etc.
 After the surgery of the patient, he/she must be transferred to a recovery room that is
100% certain that patient must be in the recovery room after surgery and as per the
recommendation of a domain expert.
 There are chances of happening that patient can go to the surgery room, diff. recovery
room or discharge to home whether cured or dead.
 Recovery and surgery unit is having a two-way communication because patient
moves in circular ways in these two departments.
 When a patient is discharging or going out from pharmacy to parking, so it’s
necessary to focus on the solution of parking area crowd.

Issues Regarding the flow of patient IN-Hospital: -

 Confusion
 Severity
 Time constraint
 Disability
 Pharmacy
 Traffic in parking
 Destination signage
 Traffic at a particular place
 Patient's Crowd at Outside of OPD
 Patient gathering in a waiting room
 Appointment without prior information
 Patient-doctor meeting time
 The patient gets irritated because of long waiting
 Solutions to improve the flow of patient IN-HOSPITAL
confusion is a big factor for the patient because the hospital is new premises for
everyone when he/she is going the first time, so if there is nothing like navigator
which can locate the right place to the patient.
Severity is a major concern because when a patient comes with high level of severity
then the patient needs urgent services so there will be spacious passage and locator so
that patient can reach to consultant room safely and as soon as possible.
Time is the major constraint here why it is so concerned for every hospital or manager
because it shows the effectiveness of the hospital, how they are managing time of
patient, are they providing the best services to every patient or instead of that are they
providing anything to them in this free time, the best possible solutions are
 Availability of Entraining things
 Magazine
 T.V.
 Newspaper
 Mall
 Inform prior to the patient about waiting time.
 Try to drop a message to every patient before 2hr of their consult timing.

if the patient is disabled then provide them a wheelchair with an assistant and provide
them a separate passage and give them a priority to consult with the doctor.
Outside of pharmacy, there is always a plethora of patient and they are always in the
hurry because this is the last step for getting out from the hospital and so if the
pharmacy is not available near IPD ward then in this kind of hospital there should be a
two-way pharmacy. If there is IPD pharmacy is separated, then OPD pharmacy is
getting crowded because of high flow in the OPD then the hospital should provide a
waiting area for the patient as well as token no. the system must be there.
Destination signage available in lobby or parking. lot signs help the patient to where
has to go. clearly distinguishing check-in and check-out, or help patients which type
of service they needed. It will be less stressful for them and it will save the time of
patient as well.
Traffic at particular place looks awkward to the patient, to avoid the traffic at a single
place, so designed a place in such a manner that cross path can't be there and if they
want to move from one place to another place so that sequentially they can go without
disturbance and trafficking.
The patient crowd at an outside of OPD is shown that management of the hospital is
weak and patient start thinking that there is lack of synchronization, so avoid this
behavior hospital should arrange the waiting area with large space and comfortable
sitting, it may help them.
To avoid the patient gathering in the waiting room, the Hospital should give them an
approx. time of consultation by calling or via messaging.
An Inflow of the patient is high in the hospital it may happen that doctor-patient
meeting will get affected. Here the management comes in picture and they are
managing them and how they improving them by giving the appointment of exact
time and are they informing a patient about their timing before the consultation.