Email updates

Keep up to date with the latest news and content from BMC Health Services Research and BioMed Central.

Open Access Research article

Exploring improvements in patient logistics in Dutch hospitals with a survey

Wineke AM van Lent13*, E Marloes Sanders24 and Wim H van Harten13

Author Affiliations

1 Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, PO Box 90203, Amsterdam, BE 1006, The Netherlands

2 Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, PO Box 90203 Amsterdam, The Netherlands

3 Department of Health Technology Services Research School of Management and Governance, University of Twente, Enschede, The Netherlands

4 Present affiliation: IZIT, Enschede, The Netherlands

For all author emails, please log on.

BMC Health Services Research 2012, 12:232  doi:10.1186/1472-6963-12-232

Published: 1 August 2012

Abstract

Background

Research showed that promising approaches such as benchmarking, operations research, lean management and six sigma, could be adopted to improve patient logistics in healthcare. To our knowledge, little research has been conducted to obtain an overview on the use, combination and effects of approaches to improve patient logistics in hospitals. We therefore examined the approaches and tools used to improve patient logistics in Dutch hospitals, the reported effects of these approaches on performance, the applied support structure and the methods used to evaluate the effects.

Methods

A survey among experts on patient logistics in 94 Dutch hospitals. The survey data were analysed using cross tables.

Results

Forty-eight percent of all hospitals participated. Ninety-eight percent reported to have used multiple approaches, 39% of them used five or more approaches. Care pathways were the preferred approach by 43% of the hospitals, followed by business process re-engineering and lean six sigma (both 13%). Flowcharts were the most commonly used tool, they were used on a regular basis by 94% of the hospitals. Less than 10% of the hospitals used data envelopment analysis and critical path analysis on a regular basis. Most hospitals (68%) relied on external support for process analyses and education on patient logistics, only 24% had permanent internal training programs on patient logistics. Approximately 50% of the hospitals that evaluated the effects of approaches on efficiency, throughput times and financial results, reported that they had accomplished their goals. Goal accomplishment in general hospitals ranged from 63% to 67%, in academic teaching hospitals from 0% to 50%, and in teaching hospitals from 25% to 44%. More than 86% performed an evaluation, 53% performed a post-intervention measurement.

Conclusions

Patient logistics appeared to be a rather new subject as most hospitals had not selected a single approach, they relied on external support and they did not have permanent training programs. Hospitals used a combination of approaches and tools, about half of the hospitals reported goal accomplishment and no approach seemed to outperform the others. To make improvement efforts more successful, research should be conducted into the selection and application of approaches, their contingency factors, and goal-setting procedures.

Keywords:
Efficiency; Organizational; Organizational Management; Organization and Administration; Patient logistics; Operations Management