Clinical process redesign for unplanned arrivals in hospitals

Med J Aust. 2008 Mar 17;188(S6):S18-22. doi: 10.5694/j.1326-5377.2008.tb01669.x.


*Emergency department performance had been deteriorating in NSW Health facilities and at Flinders Medical Centre before a fundamentally new approach involving a redesign method, additional bed capacity and more rigorous hospital performance management was applied. *Redesign was undertaken in over 60 hospitals in New South Wales. *Numerous disconnections and misalignments in the process of care delivery have been uncovered during the diagnostic phase of this redesign. *Solutions addressed the entire patient journey through the hospital, to produce smoother patient flow along the continuum of care. *To achieve a sustained improvement in performance, numerous solutions must be simultaneously implemented in each hospital. *With this multipronged approach, a turnaround in NSW emergency access performance has been achieved in the face of rising demand for services; the improvement has continued over 3 years. *This article reports on our findings from system-wide redesign for unplanned hospital attendances.

MeSH terms

  • Continuity of Patient Care
  • Emergency Service, Hospital / organization & administration*
  • Emergency Service, Hospital / statistics & numerical data
  • Health Services Accessibility / statistics & numerical data
  • Health Services Needs and Demand / statistics & numerical data
  • Hospitals, Public / organization & administration
  • Humans
  • National Health Programs / organization & administration
  • New South Wales
  • Organizational Innovation
  • Outcome and Process Assessment, Health Care
  • Patient Care Management / organization & administration*
  • Patient Care Management / statistics & numerical data
  • Patient Readmission / statistics & numerical data