Does process flow make a difference to mortality and cost? An observational study
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 5 August 2014
Abstract
Purpose
The purpose of the paper is to investigate the potential relationships between emergency-care flow, patient mortality and healthcare costs using a patient-flow model.
Design/methodology/approach
The researchers used performance data from one UK NHS trust collected over three years to identify periods where patient flow was compromised. The delays’ root causes in the entire emergency care system were investigated. Event time-lines that disrupted patient flow and patient mortality statistics were compared.
Findings
Data showed that patient mortality increases at times when accident and emergency (A&E) department staff were struggling to admit patients. Four delays influenced mortality: first, volume increase and mixed admissions; second, process delays; third, unplanned hospital capacity adjustments and finally, long-term capacity restructuring downstream.
Research limitations/implications
This is an observational study that uses process control data to find times when mortality increases coincide with other events. It captures contextual background to whole system issues that affect patient mortality.
Practical implications
Managers must consider cost-decisions and flow in the whole system. Localised, cost-focused decisions can have a detrimental effect on patient care. Attention must also be paid to mortality reports as existing data-presentation methods do not allow correlation analysis.
Originality/value
Previous studies correlate A&E overcrowding and mortality. This method allows the whole system to be studied and increased mortality root causes to be understood.
Keywords
Acknowledgements
This work is supported by the Health Foundation, an independent charity working to continuously improve UK healthcare.
Citation
Silvester, K., Harriman, P., Walley, P. and Burley, G. (2014), "Does process flow make a difference to mortality and cost? An observational study", International Journal of Health Care Quality Assurance, Vol. 27 No. 7, pp. 616-632. https://doi.org/10.1108/IJHCQA-09-2013-0115
Publisher
:Emerald Group Publishing Limited
Copyright © 2014, Emerald Group Publishing Limited