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The missing link

Alex Knight - Wednesday, November 30, 2016

Quality of care and productivity improvements 


In my recent blog, ‘Cutting costs, costs more than you think’, I explain the importance of balancing flow and not capacity. I also show the importance of this in driving productivity improvement. In this blog I highlight the important link between improving patient flow and improving the safety and quality of patient care. 


If we look at patient flow through a health system it is easy to recognise that patients’ lengths of stay vary considerably – from a few hours to many days. A deeper review reveals that this variation is not simply down to the severity of the clinical needs of the patient or the individual patient’s recovery time. Many patients experience delay in waiting for care, during their passage of care and often towards the end of a particular stage of their care. 

Staff are pulled between the need to provide ongoing care for the patients they are treating now and the need to reduce the waiting time of other patients. And nowhere is this easier to spot than in a busy A&E department or assessment unit of a large acute hospital. But this pull is not too far away from the surface in many steps of the health system.


Extensive research and the common experience of health professionals indicate that safety, quality and timeliness of patient care rapidly deteriorates when staff are overstretched. Catastrophic failures most often occur during extended periods of unreasonable pressure.  


This highlights the critical importance of improving patient flow by identifying and removing the underlying causes of disruption and delay rather than simply asking already stretched staff to work harder and put quality of care at further risk. It is this disruption and delay that is consuming a vast amount of our precious front-line clinical staff time and energy, and sucks away their available time to treat patients and improve quality of care. 


We should take heed that this is a caring profession dedicated to patient safety and care and yet currently so many patient complaints focus on the lack of basic care. Rather than assuming the worst of staff we should see the all-important step of improving patient flow in delivering safe and high quality care. 


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