Steve's Principles for Healthcare Flow

Patient flow - What is the problem?

Over the last 12 years I've invested a lot of time and effort in thinking about and understanding patient flow in a healthcare environment. Before this I spent 25 years thinking about the same problem in electronics, automotive, general manufacturing, office furniture and a whole bunch of different industrial type environments. This includes primary care, ambulance service, acute trusts, mental health trusts and commissioning.

I thought it was about time I started to share my thoughts and experiences throughout the professional community so here we go.

It is all about lean and waste and even though now lean thinking is not fashionable the principles are still valid and can make a huge difference to patient experience. The thing they always taught me that by focusing on outcomes the customer and the patient is the key to achieving effective value and change. So the start and end of the process always is with the patient and the outcome. You can never think about flow, waste and added value unless you think about the patient the service user and the outcome first.

Here are some pathway design principles to consider:-

Key Principle #1

Every patient is an individual but the pathway is a system and process.

Key Principle #2

Bottlenecks are everywhere and they move all the time.

Key Principle #3

The performance focus is on the front door but the flow is constrained by the back door.

Key Principle #4

Adopt the single patient flow principle (patients are not batched for group treatment).

Key Principle #5

Always defer to clinical expertise, these are the process owners.

Key Principles #6

Consider outcomes not only treatment and care.

Key Principle #7

Everyone is busy, often overburdened with no free thinking time.

Key Principle #8

Map the current process and assign activity value.

Key Principle #9

Take your time, observe and understand.

Key Principle #10

Triangulate anything you believe, and what you observe with measured data points.

Final Point:-

Over the next few months I will share deeper experiences on each of these.

Anyone want to add any? Are my principles MECE ?