Patient Throughput Initiatives in Ambulatory Care Organizations during the COVID-19 Pandemic: A Systematic Review




Lieneck, Cristian H.
Ramamonjiarivelo, Zo
Cox, Jennifer
Dominguez, Jack
Gersbach, Kendal
Heredia, Edward
Khan, Afroza

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Multidisciplinary Digital Publishing Institute


Background and objectives: Ambulatory (outpatient) health care organizations continue to respond to the COVID-19 global pandemic using an array of initiatives to provide a continuity of care for both COVID-19 and non-COVID-19 patients. The purpose of this study is to systematically identify the facilitators and barriers experienced by outpatient health care organizations in an effort to maintain effective and efficient patient throughput during the pandemic. Materials and methods: This study systematically reviewed articles focused on initiatives taken by ambulatory care organizations to maintain optimal outpatient throughput levels while balancing pandemic precautions, published during 2020. Results: Among the 30 articles that met the inclusion criteria, three initiatives healthcare organizations have taken to maintain throughput were identified: the use (and enhanced use) of telehealth, protocol development, and health care provider training. The research team also identified three barriers to patient throughput: lack of telehealth, lack of resources, and overall lack of knowledge. Conclusions: To maintain patient throughput during the COVID-19 pandemic, healthcare organizations need to develop strategies such as the use of virtual consultation and follow-up, new guidelines to move patients along the care delivery value-chain, and ongoing training of providers. Additionally, the availability of required technology for telehealth, availability of resources, and adequate knowledge are vital for continuous patient throughput to ensure continuity of care during a pandemic.



ambulatory care, outpatient care, patient throughput, COVID-19, pandemic, Health Administration


Lieneck, C., Ramamonjiarivelo, Z., Cox, J., Dominguez, J., Gersbach, K., Heredia, E., & Khan, A. (2021). Patient throughput initiatives in ambulatory care organizations during the COVID-19 pandemic: A systematic review. Healthcare, 9(11), 1474.


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