Optimizing Patient Flow by Minimizing the Patients' Movements in the Accident and Emergency Unit : A Case Study from Teaching Hospital Batticaloa

Background: Unnecessary patient movement within healthcare settings can lead to delays, inefficiencies, and dissatisfaction, particularly in high-pressure areas like Accident and Emergency (A&E) Units. At Teaching Hospital Batticaloa—the only tertiary care teaching hospital in Sri Lanka’s Eastern Province—a significant delay in patient registration, Patient Health Number (PHN) issuance, and visitor’s pass processing was observed due to the physical separation of administrative counters from treatment areas.
Objective: To streamline the patient admission process in Accident and Emergency Unit in Teaching Hospital Batticaloa.
Methods: A mixed-methods evaluation was conducted using time-motion studies, patient movement mapping, staff interviews and review of HHIMS data to assess the impact of the intervention.
Intervention: The hospital decentralized the registration process, PHN issuance, and visitor’s pass processing by assigning responsibilities to on- site Medical Officers and Nursing Officers in the Resuscitation Unit, Treatment Unit, and Booked Admission Counter. Laptops, printers, and desktop syste ms were provided at Doctors and Nursing stations to enable point-of-care documentation.Results: Patient movement was reduced by over 70%, and admission processing time decreased from an average of 50 – 60 minutes to 10–12 minutes of category 3 and 4 patients. Staff reported improved efficiency a nd ownership of tasks, while patients and bystanders experienced higher satisfaction due to reduced physical burden and delays.
Conclusion: This low-cost, context-sensitive intervention demonstrates how Kaizen principles can be effectively applied in resource-limited settings to streamline workflow, enhance patient experience, and optimize healthcare delivery in emergency settings.