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In July 2025, Alcidion Managing Director and CEO Kate Quirke presented to the annual Director General Breakfast in Brisbane. The theme of the day was the Queensland Health budget, with which the government aims to tackle some of the biggest challenges faces healthcare for the state.
In her speech, Kate presented insights into the challenges impacting acute patient flow, one of the most pressing issues for Australian health systems. This article has been produced for those not able to attend on the day and includes a review of the key levers available to tackle the challenges with patient flow.
Key Takeaways
- Real-time system visibility can transform patient flow from reactive to proactive care coordination
- Early discharge planning from admission can reduce length of stay by over 12%
- Resolving outlier patients alone can unlock 6-10% of total bed capacity
- System-wide coordination, not individual facility efforts, is the key to sustainable improvement
Picture this common scenario in hospitals: ambulances queue outside the ED while upstairs, patients who are medically ready for discharge remain stranded, waiting for aged care placements or community support packages.
Recent Queensland research aptly described these challenges using the metaphor of “a banana in the tailpipe”—just as this unexpected obstruction completely disrupts a car’s performance, unforeseen barriers create cascading disruptions throughout our healthcare system. The frustration isn’t that clinicians don’t know what to do—it’s that in many busy healthcare facilities, the right thing can be incredibly difficult to do.
There is a strong opportunity in Queensland to transform patient flow by making system-wide coordination the easy choice through connected intelligence that addresses these systemic obstructions. The focus on flow isn’t just about efficiency—it’s fundamentally about improving progression of care, enhancing patient outcomes and experience, and delivering greater value to every patient.
Understanding the Patient Flow Challenge
Three key statistics illustrate the systemic coordination challenges faced in healthcare systems globally, with Queensland working actively to address these issues.
First, Queensland’s top 26 reporting hospitals finished treating people in emergency departments within 4 hours in only 51.9% of cases – well below the 80% target, with ambulances losing approximately 160,000 hours annually due to patient off-stretcher delays. There is a strong commitment in Queensland to improving these numbers.
Second, the Emergency Medicine Foundation’s comprehensive study of 25 Queensland hospitals confirms that the main bottleneck lies at the hospital exit, not the entrance. Slow discharge processes and the large number of ‘maintenance care’ patients in hospitals contribute significantly to access block.
Third, from further afield, research from John Hopkins in the US showed a trend in outlier patients increasing by 50% while consuming 6.7% to 9.8% of total bed days. This is a trend we see in many geographies, though there is limited specific research in Australia on this subject.
These challenges stem from three interconnected categories:
- Population pressures including aging population and increasingly complex conditions
- Capacity constraints
- Inefficient bed management processes, information sharing, and care transitions
The result is predictable: progression of care slows down, increasing length of stay and impacting system performance and patient experience.
Four Levers to Transform Patient Flow
Addressing these challenges requires a strategic approach focused on four key areas.
1. Real-time Capacity Visibility
Technology has evolved to the point where real-time visibility of the entire health system is achievable.
Real time visibility transforms patient flow by creating transparency of demand across the entire patient journey. Where hospitals deploy integrated real-time electronic patient journey boards, clinicians have instant access to patient status, treatment progress, and bed availability. This in turn allows healthcare teams to anticipate and address patient needs more effectively rather than reacting to crises.
The power lies in moving from fragmented information to shared operational intelligence. When discharge coordinators can see which patients are medically ready for discharge, when bed managers have real-time visibility of actual capacity across all wards, and when clinical teams can track treatment progress in real-time, decision-making shifts from reactive to proactive. Real-time visibility eliminates the phone tag, the double-checking, and the delays that currently slow patient flow.
2. Early Discharge Planning: From Day One to Hour One
Queensland Health admits over 1.6 million patients into hospital annually, with presentations increasing faster than population growth.
International studies confirm that early discharge preparation can significantly decrease hospital length of stay, readmission risk, and mortality risk. When we embed predictive analytics and early discharge planning tools into existing clinical workflows—alerts that identify at-risk patients and streamline care coordination without additional clicks—we make proactive planning the natural workflow.
Independent research by the Digital Health CRC and Monash University of Alfred Health’s deployment of Miya Precision, demonstrates the power of early intervention: by making the planning of an Expected Discharge Date (EDD) at admission mandatory for every patient, length of stay decreased by 12.1% over 18 months.
The evidence is clear: hospitals that undertake early discharge preparation can significantly decrease hospital length of stay. As stated by Professor Hugh Grantham ASM, EMF Board Chair, the opportunity lies not in saving minutes in emergency departments but by “focussing on the hours and days we can save in the rest of the system”.
3. Outlier Resolution and Accelerated Transfers: Unlocking Hidden Capacity
The highest impact opportunity for many systems lies in resolving outlier patients – those patients who are not in their clinically appropriate target ward due to bed availability constraints.
Outlier patients consume significant hospital resources and are known to have twice the length of stay and a 40% higher chance of mortality. At Alfred Health, the DHCRC study showed that implementing digital patient journey boards achieved a 17.7% reduction in outliers at admission, indicating improved bed visibility and allocation.
4. Aligned System Incentives
Perhaps the most critical lever is shifting from individual facility metrics to system-wide flow performance.
Research consistently shows that avoidable days – when patients remain in hospital though medically ready for discharge – represent 25% of all hospital bed days, equivalent to 1.5-2 million bed days for the Queensland healthcare system. Tackling this challenge is not a hospital-level but a systemwide initiative, requiring collaboration beyond the hospital walls with community care providers, aged care providers and others. Solutions that support effective visibility and data sharing across the full healthcare network are critical enablers.
The Opportunity in Queensland
Queensland’s unique geography actually offers an advantage in tackling these broader flow challenges. Queensland has always needed to think beyond individual facilities because our communities depend on networked care delivery.
The opportunity is significant when we consider:
- That each year, Queensland records more than 180,000 potentially preventable hospitalisations—highlighting the scale of opportunity if we improve coordination across primary and community care.
- Resolving outlier patients alone can unlock the equivalent of 6-10% of total bed capacity.
- For a 500-bed hospital, reducing avoidable days by just 5% represents approximately $6.5 million in annual value.
The real transformation is for patients and families. No more explaining conditions to multiple people during transfers. No more extended waits for admission because capacity information isn’t readily available. When the right thing becomes the easy thing to do, care coordination becomes seamless rather than requiring extraordinary individual efforts.
Implementation: Making Smart Technology Decisions
This transformation is about making smart, not necessarily revolutionary technology decisions. The digital infrastructure exists – cloud platforms, real-time data integration, and predictive analytics are already being implemented successfully in healthcare systems across Australia.
More importantly, there is a strong evidence base. The Emergency Medicine Foundation’s multi-year patient flow research program, supported by Queensland Health’s Healthcare Improvement Unit, has delivered actionable recommendations based on analysis of millions of patient records. These are proven, evidence-based solutions ready for implementation.
Success requires three shifts:
- Digital solutions that enhance rather than burden clinical workflows tools that feel intuitive and save time;
- Commitment to system-wide optimisation that rewards collaboration over competition;
- And most critically, engaging frontline clinicians in co-designing solutions so technology works with them, not against them.
Most importantly, it requires accepting that patient flow is a system-wide responsibility not something that individual facilities manage in isolation.
Moving Forward Together
The patients discussed above (medically ready for discharge but caught in coordination challenges) represent thousands affected by these systemic issues. This isn’t a resource shortage; it’s a coordination challenge. Healthcare systems have the capacity, the capability, and proven, evidence-based solutions from Australian and international research.
What is needed now is the commitment to make patient flow a shared accountability across entire health systems—moving from heroic individual efforts to seamless system-wide coordination.
Ready to optimise patient flow for your health system? Get in touch to learn more about how Alcidion’s advanced Patient Flow solution can help.