Over the past half-century, the United States has experienced exponential growth in population, and life expectancy has risen.  Many diseases that were once fatal, are now chronic conditions.  Breakthroughs in science have led to vaccines and antibiotics reducing the communicable disease burden.  Engineering has improved transportation and workplace safety, eliminating many preventable deaths.  These improvements are all good news.  Along with our success, however, comes the challenge of caring for an aging population.  The challenge is acutely known to those who lead patient access, capacity management and patient flow across our healthcare systems.  Addressing these challenges depends on essential knowledge.  Our recent research is summarized into Seven Patient Flow Insights:

  1. Population is growing and getting older. The population grew from 180 million with life expectancy of 67 in 1960, to 321 million with life expectancy of 79 in 2015.
  2. Supply of hospitals and in-patient beds are decreasing. Hospitals numbered 5759 (955,768 beds) in 2006; and in 2017 number 5534 (894,574 beds).
  3. Demand for care volume is growing. Emergency department visits escalated from 120 million visits in 2006, to over 137.8 million in 2014.
  4. Workforce availability is lagging. Supply of physicians and nurses continues to lag behind the growing pace of demand. Serious clinician shortages are expected through 2030.
  5. Length-of-stay decreases have plateaued. In-patient length of stay reductions were made between 1993 and 2000, decreasing from an average of 5.7 days to 4.6 days. Since 2000, the national average length of stay has remained 4.6 days.
  6. Costs-of-care are escalating. National average cost per patient was $8304 in 2006 and grew to $10,885 in 2014.
  7. Quality-outcomes require health system coordination. Centralized and distributed situational awareness are foundational to assure patient access, choreograph care, and promote patient-flow.

On the front lines of these challenges are national patient-flow leaders who are engaged, resolute, determined and energized in their efforts.  They are Renegade-SamaritansRenegade because they are often first to the front, ready to respond when care systems are under pressure.  Samaritan because they are endlessly caring and compassionate in their mission to help others.

When systems are faulty, they work to correct the course.  They challenge the status quo and engage in improvements.  Why? Because patients, families, communities and clinicians are counting on them.  They are also counting on us.  They are counting on us for enhanced visibility and resource alignment, initiating data-driven practice change, all while achieving sustainability and growth for future generations.

If this sounds like you, welcome to the Renegade Samaritan club!  Be assured you are in good company.  You are never alone on this journey to improve patient flow.  We are with you.  Together, we will ensure no patient ever has to wait for the care they need.

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About the Expert

Scott Newton, DNP, RN, MHA, EMT-P

Dr. Newton has more than 30 years of experience in healthcare—working as an EMT, a nurse, an educator and a patient flow command center leader.

Dr. Newton has deep knowledge of the healthcare system and understands that success is tied to high reliability, just-in-time responses, and responsible solutions—that it’s about getting it right the first time for patients and clinicians.

A graduate of the Doctor of Nursing Practice program at Johns Hopkins School of Nursing, Dr. Newton built a Command Center as an output of his doctoral project and believes that as healthcare continues to evolve, patient flow will play an even more prominent role across the care continuum.

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