Does process flow make a difference to mortality and cost? An observational study

International Journal of Health Care Quality Assurance

Volumn 27, Issue 7, 2014, Pages 616-632

  Silvester, Kate ^a   Harriman, Paul ^b   Walley, Paul ^c   Burley, Glen ^d  

^a UNIVERSITY OF WARWICK   (United Kingdom)

^b ROYAL HALLAMSHIRE HOSPITAL   (United Kingdom)

^c OXFORD BROOKES UNIVERSITY   (United Kingdom)

^d SOUTH WARWICKSHIRE NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

Accident and emergency; Cost; Delay; Flow; Mortality; Patient safety; System thinking

Indexed keywords

ARTICLE; ECONOMICS; EMERGENCY HEALTH SERVICE; HEALTH SERVICE; HOSPITAL COST; HUMAN; MORTALITY; NATIONAL HEALTH SERVICE; ORGANIZATION AND MANAGEMENT; PATIENT SAFETY; RETROSPECTIVE STUDY; TIME; UNITED KINGDOM; WORKFLOW;

EMERGENCY SERVICE, HOSPITAL; GREAT BRITAIN; HEALTH SERVICES NEEDS AND DEMAND; HOSPITAL COSTS; HOSPITAL MORTALITY; HUMANS; PATIENT SAFETY; RETROSPECTIVE STUDIES; STATE MEDICINE; TIME FACTORS; WORKFLOW;

EID: 84907795446     PISSN: 09526862     EISSN: None     Source Type: Journal    
DOI: 10.1108/IJHCQA-09-2013-0115     Document Type: Article

References (67)

1. Allder, S., Silvester, K. andWalley, P. (2010a), "Managing capacity and demand across the patient journey," Clinical Medicine, Vol. 10 No. 1, pp. 13-15.
2. Allder, S., Silvester, K. andWalley, P. (2010b), "Understanding the current state of patient flow in a hospital," Clinical Medicine, Vol. 10 No. 5, pp. 441-444.
3. Andersson, G. and Karlberg., I. (2001), "Lack of integration, and seasonal variations in demand explained performance problems and waiting times for patients at emergency departments: a three year evaluation of the shift of responsibility between primary and secondary care by closure of two acute hospitals," Health Policy, Vol. 55 No. 3, pp. 187-207.
4. Aylin, P., Yunus, A., Bottle., B, Majeed., A. and Bell, D. (2010), "Weekend mortality for emergency admissions. A large multicentre study," Quality and Safety in Health Care, Vol. 19 No. 3, pp. 213-217.
5. Bagust, A., Place, M. and Posnett, J. W. (1999), "Dynamics of bed use in accommodating emergency admissions: stochastic simulation model," British Medical Journal, Vol. 319 No. 7203, pp. 155-158.
6. Begley, C. E., Chang, Y. C., Wood, R. C. and Weltge, A. (2004), "Emergency department diversion and trauma mortality: evidence from Houston, Texas," Journal of Trauma-Injury Infection and Critical Care, Vol. 57 No. 6, pp. 1260-1265.
7. Benneyan, J. (2001), "Design, use, and performance of statistical control charts for clinical process improvement," available at: www1. coe. neu. edu/Bbenneyan/papers/intro_spc. pdf (accessed 1 June 2012).
8. Benneyan, J. C. (1998), "Statistical quality control methods in infection control and hospital epidemiology. Part 2: chart use, statistical properties and research issues," Infection Control and Hospital Epidemiology, Vol. 19 No. 3, pp. 265-277.
9. Berwick, D. (1996), "A primer on leading the improvement of systems," British Medical Journal, Vol. 312 p. 619.
10. Brailsford, S. C., Lattimer, V. A., Tarnaras, P. and Turnbull, J. C. (2004), "Emergency and ondemand health care: modelling a large complex system," Journal of the Operational Research Society, Vol. 55 No. 1, pp. 34-42.
11. Breen, A. M., Burton-Houle, T. and Aron, D. C. (2002), "Applying the theory of constraints in healthcare: part 1-the philosophy," Quality Management in Health Care, Vol. 10 No. 3, pp. 40-46.
12. Cameron, P. A. (2006), "Hospital overcrowding: a threat to patient safety?," Medical Journal of Australia, Vol. 184 No. 5, pp. 203-204.
13. Carey, R. G. (2002), "How do you know that your care is improving? Part II: using control charts to learn from your data," Journal of Ambulatory Care Management, Vol. 25 No. 1, pp. 78-88.
14. Chan, L., Reilly, K. M. and Salluzzo, R. F. (1997), "Variables that affect patient throughput times in an academic emergency department," American Journal of Medical Quality, Vol. 12 No. 4, pp. 183-186.
15. CHKS (2001), CHKS Risk-Adjusted Mortality, CHKS, Alcester, pp. 1-11.
16. Clark, D. E., Cushing, B. M. and Bredenberg, C. E. (1998), "Monitoring hospital trauma mortality using statistical process control methods," Journal of the American College of Surgery, Vol. 186 No. 6, pp. 630-635.
17. Cooke, M., Fisher, J., Dale, J., McLeod, E., Szczepura, A., Walley, P. and Wilson, S. (2004b), "Reducing attendances and waits in emergency departments: a systematic review of present innovations," SDO report, Coventry, available at: http://wrap. warwick. ac. uk/134/(accessed 14 October 2012).
18. Cooke, M. W., Wilson, S., Hallsall, J. and Roalfe, A. (2004a), "Total time in English accident and emergency departments is related to bed occupancy," Emergency Medicine Journal, Vol. 21 No. 5, pp. 575-576.
19. Darzi, E. E., Vasilakis, C. and Chaussalet, T. (1998), "A simulations modelling approach to evaluating length of stay, emptiness and bed blocking in a hospital geriatric department," Health Care Management Science, Vol. 1 No. 2, pp. 143-149.
20. Derlet, R. W. and Richards, J. R. (2000), "Overcrowding in the nation's emergency departments: complex causes and disturbing effects," Annals of Emergency Medicine, Vol. 35 No. 1, pp. 63-68.
21. Dr Foster (2011), Understanding HSMRs, AToolkit on Hospital Standardised Mortality, Version 6, Dr Foster Intelligence, London, pp. 1-33.
22. Estey, A., Ness, K., Saunders, D., Alibhai, A. and Bear, R. A. (2003), "Understanding the causes of overcrowding in emergency departments in the capital health region in Alberta focus group study," Canadian Journal of Emergency Medicine, Vol. 5 No. 2, pp. 87-94.
23. Fletcher, A., Cummings, J., Cooke, M. and Black, S. (2004), Emergency CareWaits: Survey Using a National Representative Sample, Department of Health, London.
24. Gilligan, S. andWalters, M. (2008), "Quality improvements in hospital flow may lead to a reduction in mortality," Clinical Governance: An International Journal, Vol. 13 No. 1, pp. 26-34.
25. Goulding, L., Adamson, J., Watt, I. and Wright, J. (2012), "Patient safety in patients who occupy beds on clinically inappropriate wards: a qualitative interview study with NHS staff," BMJ Quality and Safety, Vol. 21 No. 3, pp. 218-224.
26. Grol, R. (1997), "Beliefs and evidence in changing clinical practice," British Medical Journal, Vol. 315 No. 7105, pp. 418-421.
27. Haraden, C. and Resar, R. (2004), "Patient flow in hospitals: understanding and controlling it better," Frontiers of Health Service Management, Vol. 20 No. 4, pp. 3-15.
28. Haraden, C., Nolan, T., Resar, R. and Litvak, E. (2003), Optimizing Patient Flow, IHI, Boston, MA.
29. Hoot, N. R. and Aronsky, D. (2008), "Systematic review of emergency department crowding: causes, effects and solutions," Annals of Emergency Medicine, Vol. 52 No. 2, pp. 126-136.
30. Jha, A. K., Prasopa-Plaizer, N., Larizgoitia, I. and Bates, D. W. (2010), "Patient safety research: an overview of the global evidence," Quality and Safety in Healthcare, Vol. 19 No. 1, pp. 42-47.
31. Jones, P. and Schimanski, K. (2010), "The four-hour target to reduce emergency department 'waiting time': a systematic review of clinical outcomes," Emergency Medicine Australasia, Vol. 22 No. 5, pp. 391-398.
32. Junhavasdikul, D., Theerawit, P. and Kiatsaboonsri, S. (2013), "Association between admission delay and adverse outcome of emergency medical patients," Emergency Medicine Journal, doi: 10. 1136/emermed-2011-200788, Vol. 20 No. 4, pp. 320-323.
33. Kelman, S. and Friedman, J. N. (2009), "Performance improvement and performance dysfunction: an empirical examination of distortionary impacts of the emergency room wait-time target in the English national health service," Journal of Public Administration Research Theory, Vol. 19 No. 4, pp. 917-946.
34. Kosnik, L. (2006), "Breakthrough demand-capacity management strategies to improve hospital flow, safety and satisfaction," in Hall, R. W. (Ed.), Reducing Delay in Healthcare Delivery, Springer-Verlag, Los Angeles, LA, pp. 101-122.
35. Lambe, S., Washington, D., Fink, A., Laouri, M., Liu, H., Scura Fosse, J., Brook, R. H. and Asch, S. M. (2003), "Waiting times in California's emergency departments," Annals of Emergency Medicine, Vol. 41 No. 1, pp. 34-44.
36. Lawton, R., McEachan, R., Giles, S., Sirriyeh, R., Watt, I. and Wright, J. (2012), "Development of an evidence-based framework of factors contributing to patient safety incidents in hospital settings: a systematic review," BMJ Quality and Safety, Vol. 21 No. 5, pp. 369-380.
37. Limaye, S. S., Mastrelangelo, C. M. and Zerr, D. M. (2008), "A case study in monitoring hospital-associated infection with count control charts," Quality Engineering, Vol. 20 No. 4, pp. 404-413.
38. Litvak, E. (2005), "Optimizing patient flow by managing its variability," in: Berman, S. (Ed.), Front Office to Front Line: Essential Issues for Health Care Leaders Joint Commission Resources, Joint Commission Resources, Oakbrook Terrace, IL, pp. 91-111.
39. Litvak, E. (Ed.) (2009), Managing Patient Flow in Hospitals: Strategies and Solutions, 2nd ed., Joint Commission Resources, Oakbrook Terrace, IL.
40. Mango, P. D. and Shapiro, L. A. (2001), "Hospitals get serious about operations," McKinsey Quarterly, May, pp. 74-85.
41. Mayhew, L. and Smith, D. (2008), "Using queuing theory to analyse the government's 4-h completion time target in accident and emergency departments," Health Care Management Science, Vol. 11 No. 1, pp. 11-21.
42. Millard, P. H. and McClean, S. I. (1996), Go With the Flow-A Systems Approach to Healthcare Planning, Royal Society of Medicine Press, London.
43. Miro, O., Antonio, M. T., Jimenez, S., De Dios, A., Sanchez, M. and Borras, A. (1999), "Decreased health quality associated with emergency department overcrowding," European Journal of Emergency Medicine, Vol. 6 No. 2, pp. 105-107.
44. Mohammed, M. A., Cheng, K. K., Rouse, A. and Marshall, T. (2001), "Bristol, Shipman, and clinical governance: Shewhart's forgotten lessons," Lancet, Vol. 357 No. 9254, pp. 463-467.
45. Morton, A., Whitby, M., McLaws, M., Dobson, A., McElwain, S., Looke, D., Stockelroth, J. and Sartor, A. (2001), "The application of statistical process control charts to detection and monitoring of hospital-acquired infections," Journal of Quality in Clinical Practise, Vol. 21 No. 4, pp. 112-117.
46. National Audit Office (2009), NHS Pay Modernisation in England: Agenda for Change, The Stationery Office, London, pp. 1-19.
47. Nolan, T., Schall, M., Berwick, D. M. and Roessner, J. (1996), Reducing Delays and Waiting Times throughout the Healthcare System, IHI, Boston, MA.
48. Plunkett, P. K., Byrne, D. G., Breslin, T., Benet, K. and Silke, B. (2011), "Increasing waiting times predict increasing mortality for emergency medical admissions," European Journal of Emergency Medicine, Vol. 18 No. 4, pp. 192-196.
49. Proudlove, N. C., Black, S. and Fletcher, A. (2007), "OR and the challenge to improve the NHS: modelling for insight and improvement in in-patient flows," Journal of the Operational Research Society, Vol. 58 No. 3, pp. 145-158.
50. Proudlove, N. C., Gordon, K. and Boaden, R. (2003), "Can good bed management solve the overcrowding problem in accident and emergency departments?," Emergency Medicine Journal, Vol. 20 No. 3, pp. 149-155.
51. Regan, G. (2000), "Making a difference to A&E: analysis of the operational inefficiencies in A&E departments in major acute hospitals in Dublin," Accident and Emergency Nursing, Vol. 8 No. 1, pp. 54-61.
52. Richardson, D. B. (2001), "Association of access block with decreased ED performance," Academic Emergency Medicine, Vol. 8 No. 5, pp. 575a-576a.
53. Richardson, D. B. (2006), "Increase in patient mortality at 10 days associated with emergency department overcrowding," Medical Journal of Australia, Vol. 184 No. 5, pp. 213-216.
54. Schull, M. J., Slaughter, P. M. and Redelmeier, D. A. (2001), "Urban emergency department overcrowding: defining the problem and eliminating misconceptions," Canadian Journal of Emergency Medicine, Vol. 4 No. 2, pp. 76-83.
55. Siddharthan, K., Jones, W. J. and Johnson, J. A. (1996), "A priority queuing model to reduce waiting times in emergency care," International Journal of Health Care Quality Assurance, Vol. 9 No. 5, pp. 10-16.
56. Silvester, K., Steyn, R., Bevan, H. and Walley, P. (2004), "Reducing waiting times in the NHS: is lack of capacity the problem?," Clinician in Management, Vol. 12 No. 3, pp. 105-111.
57. Sprivulis, P. C., Da Silva, J.-A., Jacobs, I. G., Frazer, A. R. L. and Jelinek, G. A. (2006), "The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments," Medical Journal of Australia, Vol. 184 No. 5, pp. 208-212.
58. Trzeciak, S. and Rivers, E. P. (2003), "Emergency department overcrowding in the United States: an emerging threat to patient safety and public health," Emergency Medicine Journal, Vol. 20 No. 5, pp. 402-405.
59. van der Wulp, I., Schrivers, A. J. P. and van Stel, H. F. (2009), "Predicting admission and mortality with the emergency severity index and the Manchester triage system: a retrospective observational study," Emergency Medicine Journal, Vol. 26 No. 3, pp. 183-186.
60. Walley, P., Mountford, S. and Silvester, K. (2006a), "Healthcare improvement decisions: a systems perspective," International Journal of Health Care Quality Assurance, Vol. 19 No. 1, pp. 93-104.
61. Walley, P., Silvester, K. and Steyn, R. (2006b), "Managing variation in demand: lessons from the UK National Health Service," Journal of Healthcare Management, Vol. 51 No. 5, pp. 309-322.
62. Weigl, M., Muller, A., Vincent, C., Angerer, P. and Sevdalis, N. (2012), "The association of workflow interruptions and hospital doctors' workload, a prospective observational study," BMJ Quality and Safety, Vol. 21 No. 5, pp. 399-407.
63. Wheeler, D. J. (2003), Making Sense of Data: SPC for the Service Sector, SPC Press, Knoxville, TN.
64. Wolstenholme, E. (1999), "A patient flow perspective of UK health services," System Dynamics Review, Vol. 15 No. 3, pp. 253-265.
65. Woodall, W. (2006), "The use of control charts in health-care and public health surveillance," Journal of Quality Technology, Vol. 38 No. 2, pp. 89-104.
66. Yoon, P., Steiner, I. and Reinhardt, G. (2003), "Analysis of factors influencing length of stay in the emergency department," Canadian Journal of Emergency Medicine, Vol. 5 No. 3, pp. 155-161.
67. Zimmerman, R. S. (2004), "Hospital capacity, productivity, and patient safety-it all flows together," Frontiers of Health Services Management, Vol. 20 No. 4, pp. 33-38.