We recently surveyed a cross-section of management representing over 200 hospitals about the biggest challenges faced by their hospitals.

This random sampling yielded a somewhat different take on the problems than the hospital CEO surveys which hit the media around this time every year. Presumably, that’s because our sampling included people whose daily roles take them closer to the bedside than the typical CEO.


The titles ranged from medical director to chief nursing officer to VP administration and director of imaging services. In between, there were two members of hospital boards, a VP of quality, some nurse managers, a “director of Lean,” some process improvement leaders, patient logistics managers, three CFOs, and a manager of business development, just to name a few.

Their responses fell into three chief categories:

  • The financial outlook – this included concerns about reimbursement under reform, claims rejection, revenue generation, and loss of market share.
  • Length of Stay – The issue here was balancing quality care with a need to reduce LOS.
  • Getting a patient from Point A to Point B – These were issues of throughput efficiency, wait times, ED boarding, diversion and capacity.

Unlike a typical C-Suite survey, the financial outlook ranked second, with a little over 15 percent of respondents pointing to a finance issue as their institution’s biggest challenge.Length of Stay placed third, with just over seven percent agreeing that it was the biggest challenge they faced.

The number one challenge involved various dimensions of patient throughput, from ED boarding to diversions to overall wait times to finding enough capacity. Thirty six percent of the respondents cited the problem of getting patients from Point A to Point B as their biggest problem.

Granted, unless you’re paid to take the long view, you generally perceive the problem in front of you as the problem everyone should be fixing. But many of our respondents have multiple responsibilities, with patient flow being just one aspect of their daily activity. What this suggests is that there is greater awareness now in the healthcare community that efficient patient movement is a fundamental part of delivering timely, quality care.

The physical tasks of care delivery evolved randomly, much like the patchwork of building additions in which they are often carried out. Now, the knowledge and technology is available to engineer these tasks into smooth processes that get the right patient to the right place at the right time –every time.

Real-Time Capacity Management does just that, through an overlay of patient flow automation, business analytics and real-time location technology which delivers control of the physical hospital environment from the front door to discharge.

Below is a sampling of some of the responses we received.


What are the biggest challenges you face in your hospital? Do they match what we uncovered from our survey?


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