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

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

Patient flow in OPD: -

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

Solution 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, 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 the 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 a consultation.