Centralized vs. Decentralized Patient Transport Department

Ok, I know I know. We have discussed this point into the ground every which way possible. However, I would not be considered a reputable support service resource if I did not write at least one post over centralizing the patient transport department. I’ll do a very brief overview of what centralized vs. Decentralized is, explain my outcomes at the organizations I’ve worked, and then promise to never approach this subject again.  


In a decentralized matrix set up for patient transport, the individual employees report to the specified department. Examples could be the dialysis and imaging departments. These employees only transport the patients for these departments. The advantages of this are that there is always a dedicated employee scheduled to accommodate the department. The disadvantages are numerous. Due to the flow of patient care, these individuals could become overwhelmed due to multiple orders placed at the same time and cause a worse bottleneck. A great example is dialysis, where there are multitudes of orders at the same time as patient treatments typically run the same (4 hours). This means the transporter will have nothing to do for 3 ½ hours and then the entire department will need to turn over. Additional points, there are no additional resources if an employee calls into work sick. During downtime, the employee will have nothing assigned.  


In a centralized matrix, there is a dedicated transporter department where all transporters report. All transporters are cross-trained to accommodate service levels in all departments. This design dramatically reduces unproductive times and also increases overall efficiencies in hospital throughput opportunities. Thinking through the opportunity I presented above, consider the Dialysis Department. If there is only one transporter for each department, the bed turn over would bottleneck if it is not staggered. If the organization utilizes a centralized transport department, all of the available transporters for the organization would be available to assist in the Dialysis department when all beds turn at the same time.    

Writers Experience  

When I started my career in healthcare, I assumed the responsibility of a set up patient transport department. The employees were decentralized, in all departments and dotted line reported to the patient transport lead position. The overall transport times for 1.3 million sq. Ft. Building was averaging close to 55 minutes, employee morale was at an all-time low, and clinical team members were overall unhappy with the department. I centralized the department into one overarching department. When this occurred, after training was provided of course, the change was incredible. We are currently meeting stretch goals of an average of 25 minutes without adding additional resources for full-time employees. Employee morale is up a large amount and our customers are extremely happy.  Overall, in my opinion, centralized structures are the most efficient design. 

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