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Book: The Emergency Flow Concept – Patient First. Provider First.

Emergency departments are the calling cards of a hospital and significantly contribute to the reputation formation. Hotels know how important the first impression is and place great value on an impressive reception. As a reflection of the entire hospital, the emergency rooms show considerable weak-points. Emergency rooms need a professionality boost. The book “The Emergency Flow Concept – Patient First. Provider First.” by Daniel Walker and Patrick Betz demonstrates how the emergency room can be developed into a performance center, which meets today’s requirements substantially better than previous models.

Flow of patients versus process flow

Emergency rooms often demonstrate no flow of patients, but rather serial process flows. This deficit leads to communication problems, slow decision-making, lacking transparency and  hence also to great dissatisfaction of employees as well as great wastage. As a countermeasure, the Emergency Flow Concept offers the process of Medical Team Evaluations (MTE), directing the emergency room as a system as well as an effective patient management. The principles of patient orientation, immediate processing and standardization serve as the basis for this.

The Emergency Flow Concept removes barriers in the current emergency process. In the process of the Medical Team Evaluations (MTE), patients are examined by a qualified doctor and a caregiver and a further approach is planned as soon as they enter.  In the further course, the services of the different professional groups are coordinated. That way, the frequency of interaction can be reduced to less than half. The results are shorter processing times, higher productivity and not least improved employee satisfaction.

Radical change as a proven approach

So far, there is no single, correct way to implement an emergency center based on the Emergency Flow Concept. Based on the experience of numerous projects, a dominant procedure model has established and proven itself: you cannot effect a system change in small steps. A radical change is required for the introduction of the Emergency Flow Concept. Nevertheless, it makes sense to tackle certain topics in time, as the dependencies in the total hospital system are considerable and a system change for the entire house at once would be unrealistic. Orienting the entire emergency on the Emergency Flow Concept ideally follows a step-by-step concept.

Emergency rooms are not the same everywhere and there are lots of reasons, why an ideal solution cannot be implemented in all emergency rooms. The Emergency Flow Concept can and has to be adapted to the specialties of the individual emergency rooms. It is important, however, to understand the basic principles of patient orientation, immediate processing and  standardization, to identify the possible room for action.


In 2013, the Emergency Flow Concept was distinguished with the “Business Engineering Award” by the University St. Gallen. This award is issued annually to development teams, who have produced excellent innovations. The jury, consisting of professors from different universities and industry representatives, was impressed by the improvements for patients and employees. HSG Business Engineering Award
The team of authors is made up of nine, in part former, consultants of walkerproject, who pass on their practical experience and acquired knowledge in this book. The goal is to improve the situation of the emergency rooms across all of Switzerland.

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