SAFER-f Patient Flow Medicine Bundle


The SAFER-f Patient Flow Bundle is a combined set of simple rules for adult inpatient wards to use to improve patient flow, prevent unnecessary waiting for patients, decrease length of stay (LOS), and improve patient outcomes. If all elements of the SAFER-f Patient Flow Bundle are undertaken on a regular basis, patient care experiences will be improved by reducing unnecessary waiting.

Evidence suggests that implementation of the SAFER bundle elements together optimizes impact1,2,3.


Implementation of the SAFER-f Patient Flow Bundle can be:

  • Through board rounds1,3,4,5
    • Daily with multidisciplinary team between 8:00 and 10:00 am
    • Assess patient and prioritize patients ready for discharge
    • Discuss reasons for delayed patient flow
    • Patients with LOS > 5 days are reviewed weekly with senior leaders
    • Components of an effective board round include having a clear lead from a senior clinician, listening to, and valuing the input from all team members and ensuring everyone is prepared, with efficient discussion
  • In combination with Red to Green2,3,4,5,6
    • Involves use of a visual management system
    • Focuses on logging patient’s expected discharge date and progression towards discharge