Inpatient flow management: a systematic review

Windi Winasti*, Sylvia Elkhuizen, Leo Berrevoets, Godefridus van Merode, Hubert Berden

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Purpose In hospitals, several patient flows compete for access to shared resources. Failure to manage these flows result in one or more disruptions within a hospital system. To ensure continuous care delivery, solving flow problems must not be limited to one unit, but should be extended to other departments - a prerequisite for solving flow problems in the entire hospital. Since most current studies focus solely on overcrowding in emergency units, additional insights are needed on system-wide patient flow management. The purpose of this paper is to look at the information available in system-wide patient flow management studies, which were also systematically evaluated to demonstrate which interventions improve inpatient flow. Design/methodology/approach The authors searched PubMed and Web of Science (Core Collection) literature databases and collected full-text articles using two selection and classification stages. Stage 1 was used to screen articles relating to patient flow management for inpatient settings with typical characteristics. Stage 2 was used to classify the articles selected in Stage 1 according to the interventions and their impact on patient flow within a hospital system. Findings In Stage 1, 107 studies were selected. Although a growing trend was observed, there were fewer studies on patient flow management in inpatient than studies in emergency settings. In Stage 2, 61 intervention studies were classified. The authors found that most interventions were about creating and adding supply resources. Since many hospital managers these days cannot easily add capacity owing to cost and resource constraints, using existing capacity efficiently is important - unfortunately not addressed in many studies. Furthermore, arrival variability was the factor most frequently mentioned as affecting flow. Of all interventions addressed in this review, the most prominent for advancing patient access to inpatient units was employing a specialized individual or team to maintain patient flow and bed placement across hospital units. Originality/value This study provides the first patient flow management systematic overview within an inpatient setting context.
Original languageEnglish
Pages (from-to)718-734
Number of pages17
JournalInternational Journal of Health Care Quality Assurance
Issue number7
Publication statusPublished - 1 Jan 2018


  • Hospital
  • Inpatient units
  • Patient flow management
  • System-wide
  • CARE


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