Patient flows as a key driver of university hospital modernisation: Lessons for other transitional countries from the Serbian case

Abstract This paper describes the planning and implementation of patient flows as a key driver of university hospital modernisation in four large tertiary-care institutions in the Republic of Serbia. The project, supported by EU funding, aims to support the interrelated processes of health service delivery changes and major infrastructure investment. Together, the four clinical centres host over 2 million outpatients, 220,000 inpatients and 120,000 operations each year. All four have complete or partial pavilion (standalone) structure (from ten to more than 30 buildings) and fragmented patient flows (eg interrupted patient flow due to limitations of infrastructure and poor service organisation). A main project goal is to centralise facilities and to separate patient flows into four major patient groups (outpatients, day-patients, emergency patients and inpatients) and patients for surgery/intensive care. This paper will provide insights into the challenges and successes of a major hospital infrastructure investment project that combines organisational changes to meet healthcare reform targets for improved health service delivery to patients.