Hospital Access Block: A Scoping Review.

Area of Science:

• Health Services Research
• Hospital Management
• Patient Flow Optimization

Background:

• Hospitals face challenges with patient bed flow, access block, and exit block, impacting overall patient care quality.
• Identifying effective strategies for improving hospital patient flow is crucial for efficient healthcare delivery.

Purpose of the Study:

• To conduct a scoping review of health care literature to identify hospital strategies for improving patient bed flow.
• To explore methods for reducing access and exit block while optimizing patient care.

Main Methods:

• A comprehensive literature search was conducted in March 2021 across multiple databases (PubMed, CINAHL, Embase, Proquest, Cochrane).
• Inclusion criteria focused on articles addressing causes, effects, and solutions for access block.
• Screening processes followed Joanna Briggs Institute Guidelines.

Main Results:

• The review synthesized findings from 43 references, with most initiatives focusing on access (15), care (16), and community (9).
• Lean principles demonstrated effectiveness in emergency departments and inpatient settings, including physician-led triage, point-of-care testing, and multidisciplinary rounds.
• Strategies for inpatient care included 7-day allied health services, staggered surgeries, and improved patient transfer processes.

Conclusions:

• Hospitals can adopt identified strategies to manage access block and ensure patient care.
• There is a need for government-supported research to develop evidence-based models addressing exit block and improving community care access.