Experience shows that technology works best when the human factor is taken into account. For sustainable patient flow improvement, process change and technology implementation must occur simultaneously. This requires an in-depth analysis of current practices, consensus on attainable goals and effective employee involvement. Many hospitals think they should fix the process before they add technology. But analyzing a process and implementing a plan without considering technology as an integral part of change is short sighted and not fiscally prudent. Understanding how to incorporate technology in the first few steps of this journey is vital. One can not begin to list the steps which can be eliminated without knowing the capabilities which technology can provide. Hence, analysis must be done in light of what tools can help streamline the existing manual processes. Yet, sustaining the changes requires more than technology. It requires understanding, acceptance and enthusiasm from employees. These are the reasons why we created the Division of Patient Flow Services, with a team of patient flow specialists who excel at process improvement. Following on-site and off-site analysis, these specialists engage the appropriate staff in the project, develop custom blueprints designed to meet or exceed key metrics, help employees understand and accept the changes, and help assure metric goals are regularly achieved. Ironically, while hospitals are quick to adopt new clinical and diagnostic technologies, they are among the last industries to implement information technology, including flow measurement systems which can assign accountability for operational goals. Those which have are discovering that they can “add” capacity without major capital investments. They also recognize that success not only superior technology, but a top-to-bottom review of how things are done. In the process, they can also realize significant cost savings justifiably say they’re doing more to save lives.

Ironically, while hospitals are quick to adopt new clinical and diagnostic technologies, they are among the last industries to implement information technology, including flow measurement systems which can assign accountability for operational goals. Those which have are discovering that they can “add” capacity without major capital investments. They also recognize that success not only superior technology, but a top-to-bottom review of how things are done. In the process, they can also realize significant cost savings justifiably say they’re doing more to save lives. Hospitals that have maximized existing capacity begin with an understanding of how people, processes and tools drive capacity constraints and opportunities. The first step is to measure performance in key areas that affect patient flow and capacity. This is done by bringing together key participants from disparate disciplines to focus solely on analyzing current processes and implementing changes. The goal is to eliminate waste in order to achieve continuous improvement without adding money, people, space or inventory. Two key principles should remain foremost in the process. The patient drives everything because the patient is the customer. The patient as customer has been a hard notion for healthcare to accept. Because of its structure and complexity, internal customers, like physicians, insurers, government, payers often drive process. It’s vital that the patient be “first” as the driver for all processes. In “Going Lean in Health Care “ author James P. Womack suggested that "Lean principles hold the promise of reducing or eliminating wasted time, money, and energy in health care, creating a system that is efficient, effective, and truly responsive to the needs of patients—who are the 'customers' at the heart of it all." The only way to sustain a process is to involve participants in improving it. Constant improvement, by definition, never ends, and the fuel which can keep it going is organizational brainpower. While the commitment must start at the very top, a range of staff should be involved in redesigning processes. To sustain success, leaders must create an organizational culture that participants believe in. The best way to do this is for participants to see it in its entirety and to understand its logic and vision. It helps if the process is led by facilitators who are neutral, yet have enough experience within the hospital setting to have credibility with process improvement participants.

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