Labor divisions between hospital depts. may be efficient

New study has shown that controlling patient flow properly can make the most of existing staff and medical facilities.

By JUDY SIEGEL-ITZKOVICH
Hospital beds 311 (photo credit: Ariel Jerozolimski)
Hospital beds 311
(photo credit: Ariel Jerozolimski)
As the cold season arrives and hospital emergency rooms and internal medicine departments brace themselves for serious overcrowding, a new study has shown that controlling patient flow properly can make the most of existing staff and medical facilities.
Research at Ben-Gurion University of the Negev in Beersheba, the Health Ministry and the Hebrew University of Jerusalem, published in the November issue of the journal Health Policy and Planning of the Oxford University Press, uses the lessons of the Second Lebanon War in July 2006 to offer solutions for overworked emergency emergency departments.
Dr. Bruria Adini of the emergency medicine department at BGU’s Faculty of Health Sciences and her colleagues Robert Cohen, Daniel Laor and Prof. Avi Israeli of the Health Ministry and HU studied patient flow at three urban hospitals in the area that was exposed for a month to 80 missiles from the Gaza Strip.
Monitoring the patient flow, the ministry ordered emergency medical services, doctors, health funds and others to send victims with severe conflict-related wounds to the level-one trauma hospital in the area, and to divert others with mild injuries or non-conflict related conditions such as illnesses or birth to two smaller hospitals. A statistical analysis of the patient flow during the war revealed that there was a significant redirection of cases to the hospitals after the ministry’s announcement.
“Two important factors contributed to the ability of the health authorities to direct the patient flow – the ongoing monitoring and interventions made by the ministry, and a centralized emergency medical service system. This situation may not be common in all countries; however, the process by which the decisions with regard to patient flow were taken and implemented could be applicable to other types of health care systems,” the authors wrote.
Taking into account that the vast majority of emergency department patients walk in and are not brought in by ambulances, Adini and colleagues suggested that even greater flow control could have been achieved if the ministry had made the public aware of the different hospitals’ strengths and services.
“Effective utilization of scarce resources is a crucial component of emergency management and can directly influence on the ability of hospitals to treat casualties and save lives. Control of patient flow is an important facilitator towards achieving this goal,” she said.