NHS Scotland – Nationwide Whole System Patient Flow Program

A global leader in patient safety, National Health Service Scotland (NHSS) has been working with the Institute for Healthcare Optimization (IHO) to reduce delays, improve efficiency and further enhance the quality and safety of care.

The 4 pilot boards have reported numerous subjective and measurable improvements from their work so far, including:

  • Created access for additional 1,072 patient admissions without adding expensive new beds or medical and nursing staff
  • Increased compliance with clinically acceptable waiting limits for unscheduled surgery from about 85% to over 95%
  • More patients are being admitted to appropriate wards
  • More patients are moving from receiving units to inpatient wards during day time hours when they can receive earlier consultant review in a more timely manner.
  • Fewer patients are being asked to come to hospital the day before planned surgery
  • Identified opportunity to increase admissions further by about 2,100 per year without adding resources. Read full article here »


CMS Partnership for Patients – New Jersey

For more media coverage and related content, please click here »

Fourteen hospitals participated in a IHO 15-month patient-flow collaborative organized by the New Jersey Hospital Association (NJHA) as part of the Center for Medicare and Medicaid Innovation hospital engagement program. Participating hospitals have demonstrated significant quality improvements, reduced ED overcrowding, shortened wait times, and provided more access to patients while reducing costs. Overall program outcomes include:

  • 11,800 to 17,300 additional patients that could be treated without adding inpatient beds or operating rooms
  • Roughly 20,000 additional patients that could be accommodated in hospital emergency departments
  • 21 percent to 85 percent decrease in wait times for emergency department patients to be admitted to a hospital bed
  • Reductions in the length of hospital stays ranging from 3 percent to 47 percent for certain groups of patients


This initiative demonstrated that with strong leadership, will, and commitment, large-scale adoption of scientific operations management is within reach. Results include:

CentraState Healthcare System, Freehold, NJ (Phase III)

  • Telemetry beds required decreased from 54 to 42 while providing adequate clinically appropriate access
  • Inappropriate telemetry admissions decreased from 18% to 1%
  • Average waiting times for incoming patients (i.e. ED boarding) decreased from 18.2 hours to about 9 hours
  • Telemetry length of stay decreased 31% from 4.4 days to just under 3 days
  • Delays in discharging patients out of telemetry decreased from 8.3 hours to 3.5 hours on average
  • Patient satisfaction increased from 56% to 73%

Monmouth Medical Center, Long Branch, NJ (Phase II)


  • Increased patient satisfaction score from the 88th to the 99th percentile of comparable hospitals
  • Decreased variability in nurse workload (number of admissions, transfers, and discharges) by over 40%
  • Significantly decreased PACU boarding
  • Increased throughput resulting in an annual margin improvement of $411K

Overlook Medical Center, Summit, NJ (Phase III)

  • ED boarding time for ICU admissions decreased by 21%
  • ICU ALOS decreased by over 14% from 3.5 to 3 days
  • 40% reduction in mortality
  • Waiting time of discharge- and transfer-ready patients in the ICU decreased by 34% and 84% respectively

Ocean Medical Center, Brick, NJ (Phase III)

  • Telemetry ALOS decreased by 6%
  • Patient waiting time (i.e., average ED boarding time) decreased 56%
  • $1.07 million cost reduction

Newark Beth Israel Medical Center, Newark, NJ (Phase III)

  • Eliminated 26 telemetry beds, resulting in a savings of over $10 million per annum while reducing cost of care and improving quality of care
  • Decreased ALOS of telemetry patients by one full day leading to fewer hospital-acquired infections

HackensackUMC Mountainside, Montclair, NJ (Phase I)

  • Improved elective OR block utilization resulting in increased capacity for 1,000 cases annually without additional resources
  • More than 95% of emergent/urgent patients can access the OR in a timely manner, thereby projected decreasing their ALOS by almost 40%

New Jersey hospitals that completed the NJHA-IHO collaborative: CentraState Medical Center, Cooper University Hospital, HackensackUMC Mountainside, Inspira Health Network Woodbury, Jersey Shore University Medical Center, Monmouth Medical Center, Morristown Medical Center, Newark Beth Israel Medical Center, Ocean Medical Center, Overlook Medical Center, Robert Wood Johnson University Hospital, St. Joseph’s Regional Medical Center, University Hospital and The Valley Hospital. For more information about IHO programs and services, please contact us.