Patient Flow Scoping Exercise: Mexico

Patient flow management is a universal challenge for hospitals across all countries regardless of income level, and poor management can negatively impact hospital operations, finances, and clinical outcomes. One way to assess flow patterns and potentially initiate improvements is through patient flow analysis (PFA), which applies qualitative and quantitative tools to analyze the throughput of patients in a hospital, specific department or clinic. PFA entails the movement of patients, information or equipment across staff, departments or facility services as part of a patient’s care pathway. Its objective is to maximize resource use and minimize patient discomfort and wait times.

With support from Metrics for Management, Aceso Global recently conducted a rapid assessment of patient flows in nine Mexican public hospitals in order to identify patient flow problems and their causes, determine how hospitals measure patient flows, and gauge key stakeholder demand for improved patient flow management. Through site visits, focus groups with managers and staff, and review of available data, the Aceso Global team found that patient flow management is a major problem for the sampled hospitals, resulting in patient dissatisfaction, reduced quality and patient safety, staff burnout, and higher costs.

While hospital directors initially cited lack of infrastructure and staff as the primary cause of these problems, additional probing revealed other administrative and process-related challenges, such as: poor scheduling; lack of standardized processes for admissions, discharges and transfers; deficient human resource management; and poor coordination and communication with primary care providers. Further, assessment of hospital registries, statistical reports, and information systems demonstrated that while the sampled hospitals regularly collect numerous metrics, they have infrequently employed this data for problem identification or decision making purposes to improve care or patient flows.

Taking these findings into account, the Aceso Global team has concluded that there is considerable demand for patient flow improvement from hospital management and staff in Mexico; this demand is likely mirrored in other low- and middle-income countries facing similar problems. Moreover, in Mexico there is a distinct opportunity to use existing hospital data to inform patient flow management improvements, and also develop and collect new patient flow-specific metrics.

Optimizing patient flows is a persistent challenge across hospitals. To address this problem, facilities in upper-income countries often introduce expensive technologies or additional infrastructure and staff; yet for most hospitals in low- and middle-income countries, budget constraints preclude these options. However, by adopting innovative patient flow management interventions—tailored to the hospital-specific context and implemented through a bottom-up approach—these hospitals can achieve similar improvements without added costs. Aceso Global continues to work to design and implement patient flow management interventions in collaboration with emerging market hospitals to improve quality, increase patient and staff satisfaction, and lower hospital costs.