Hospitals are under constant pressure to treat more patients with limited resources. But efforts to improve efficiency in one part of the system often create new bottlenecks somewhere else. In his doctoral thesis, Philip Åhlin investigates why hospitals struggle to achieve swift and even patient flows across the entire organisation and explores new ways to overcome these systemic barriers.
What challenges do you focus on in your research?
“My research focuses on the growing mismatch between rising healthcare demand and the limited capacity of hospitals to meet it. Across Europe and other OECD countries, aging populations, more chronic illness, and a shortage of staff have created a situation where waiting times are increasing while productivity growth has stagnated. Even well-funded healthcare systems are struggling to keep up, and further expansion of resources is not always possible. This makes it essential for hospitals to treat more patients with the resources they already have. One way to do this is by improving patient flow, but this is difficult because hospitals are highly complex organisations with thousands of interdependent processes. Units and clinics often work toward their own goals rather than coordinating across the hospital as a whole, which leads to inefficiencies and bottlenecks in the patient journey from admission to discharge. These systemic barriers are the main challenges my research sets out to explore.”
How do you address the problem?
“I look at patient flow from a hospital-wide perspective rather than focusing only on single units or departments. I conduct empirical studies that investigate how flow problems arise in practice, identifying not just the visible bottlenecks but also the underlying root causes. I also draw on and extend established theories from operations management to better explain the unique dynamics of healthcare. Based on this, I develop frameworks that connect barriers to root causes and then to possible solutions, making it easier for hospital leaders to diagnose and address their specific challenges. In addition, I introduce new ways of thinking about hospital governance, showing how hospitals can balance centralised and decentralised decision-making to stay responsive to changing demand. In short, my research combines theory and practice to create practical tools and models that hospitals can use to improve patient flow in a systematic and sustainable way.”
What are the main findings?
”My research shows that the main barriers to patient flow are not just about a lack of staff or beds, but also ineffective organisational structures and work methods, and that these are systemic and interconnected. Inefficient routines, weak coordination, and the absence of hospital-wide management structures reinforce each other and create bottlenecks that local initiatives alone cannot solve. I also found that current hospital management systems are underdeveloped when it comes to patient flow. Without central coordination, predictive planning, and shared metrics, hospitals remain stuck in short-term, local decision-making that may benefits individual patients but harms overall performance."
"A central finding is that improving flow is not about choosing between centralisation or local autonomy. Hospitals need both: centralised functions for bed management, planning, and policy-setting, combined with decentralised clinical and quality decisions. This works best when the central role is supportive and trust-based rather than command-and-control. My research also shows the importance of separating simple, high-volume patients from complex ones, since blending them slows down throughput and creates unnecessary congestion. Finally, while new technologies can help, real improvement requires cultural and structural change: building trust, aligning units with hospital-wide priorities, and developing governance models that allow hospitals to continuously coordinate and adjust to dynamic demand.”
What do you hope your research will lead to?
“I hope my research will inspire hospitals and policymakers to see patient flow as a hospital-wide responsibility rather than a local problem to be solved within individual departments. By using the frameworks and models developed in my thesis, hospitals can identify the real causes of their flow challenges and implement solutions that last, rather than repeatedly treating the symptoms. My ambition is that this work helps hospitals reduce overcrowding, shorten waiting times, and improve the working conditions for healthcare professionals, who often experience stress and burnout. On a broader scale, I hope the research encourages health systems to invest in better governance models, where central coordination supports but does not replace local expertise. Ultimately, my vision is that smoother patient flow will not only make hospitals more efficient, but also ensure that patients receive timely, safe, and equitable care — strengthening both the quality and sustainability of healthcare.”
Read the thesis: Achieving swift and even hospital-wide patient flows
Public defence: 23 October 2025 at 13.00, see link above.
Contact, supervisor
- Associate Professor, Supply and Operations Management, Technology Management and Economics