Measuring patient flow in a children's hospital using a scorecard with composite measurement.

BACKGROUND: Although patient flow is a focus for improvement in hospitals, commonly used single or unaggregated measures fail to capture its complexity. Composite measures can account for multiple dimensions of performance but have not been reported for the assessment of patient flow. OBJECTIVES: To present and discuss the implementation of a composite measure system as a way to measure and monitor patient flow and improvement activities at an urban children's hospital. METHODS: A 5-domain patient flow scorecard with composite measurement was designed by an interdisciplinary workgroup using measures involved in multiple aspects of patient flow. RESULTS: The composite score measurement system provided improvement teams and administrators with a comprehensive overview of patient flow. It captured overall performance trends and identified operational domains and specific components of patient flow that required improvement. DISCUSSION: A patient flow scorecard with composite measurement holds advantages over a single or unaggregated measurement system, because it provides a holistic assessment of performance while also identifying specific areas in need of improvement.