Exploring patient flow management through a lens of cognitive systems engineering

Area of Science:

• Healthcare Management
• Cognitive Systems Engineering
• Patient Flow Optimization

Background:

• Effective patient flow management is crucial for hospital quality, safety, and resource utilization.
• Anticipating patient trajectories and monitoring resources present significant challenges in healthcare settings.
• Understanding in situ patient flow coordination is essential for improving hospital operations.

Purpose of the Study:

• To explore how patient flow is managed, communicated, and coordinated within a large tertiary pediatric hospital.
• To apply cognitive systems engineering concepts to analyze real-world hospital patient flow.
• To identify opportunities for enhancing the efficiency of patient flow management.

Main Methods:

• Conducted five semi-structured interviews with high-level hospital managers.
• Performed shadowing observations across seven full work-shifts with management teams.
• Utilized qualitative content analysis for data interpretation.

Main Results:

• Developed an adapted Extended Control Model (ECOM) to describe patient flow management.
• Revealed communication and coordination patterns across different organizational levels.
• Identified that improved placement of authority and information closer to clinical work could increase efficiency.

Conclusions:

• Patient flow management in pediatric hospitals can be enhanced by decentralizing information and authority.
• Cognitive systems engineering provides valuable insights into optimizing hospital operational dynamics.
• Findings offer a novel understanding of patient flow coordination and its impact on efficiency.