Understanding patient flow in hospitals

E-books

38 p.

The aim that 95% of patients attending A&E should be admitted,discharged or transferred within four hours is one of the highestprofile NHS targets, yet it is being consistently missed acrossEngland. Although the target can be over-emphasised, strugglesin meeting it are associated with deeper problems in the capacityto move patients into hospital wards. This briefing draws ontheories about congestion to look at why this has become moredifficult in the hospital setting, and what can be done aboutit. It looks at ongoing changes driving pressure on bed space,including mortality, the squeeze on bed space during years ofausterity, rising numbers of patients with multiple conditions, anddelayed discharges. It also looks at the solutions available short ofactually building enough beds to restore free space, and suggestsmanagers should focus in particular on the minority of longstayingpatients who account for a majority of bed use. Giventhe variation during the day, and with an increasing number ofpatients leaving in a matter of hours, it urges the NHS to investin IT and management systems that can track and deal with theneed for beds and patient movement in real time.