Patient flows in Emergency and Hospital

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Much of our work over the past decade has been focused on solutions to the chronic persistent problem of moving patients safely through hospitals. Over the years the spotlight has shifted from one point of focus to the next. Periodically the light returns to the Emergency Department, where most of the pressure and pain is felt by both patients and staff. The problems described by public hospitals are similar to those experienced by individual private hospitals with significant emergency “rooms”. Indeed a colleague, Bette Gardner built a board game called Friday night at the ER, following a system dynamics modeling study of a Californian hospital in the late 1980s. This has been usefully applied to understand the hourly interactions among emergency, critical care, operating theatres surgery and ward or “step-down” areas moving people in, around and out of the hospital. See

In this section we will begin with the Emergency Department and progressively zoom out on broader patient flows through a wide-angle lens view of acute hospital, community and long term residential care services. This will highlight the different views, time frames of interest and conflicts that are inherent in the way patients move through the system.



Case Studies WIP


LaunchPad Insight for ED Workshop

Fig. 1 - Launchpad for ED Workshop May 2011 [Source]


Questions & Comments to Geoff McDonnell
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