The public hospital of the future

Jeffrey D Zajac
Med J Aust 2003; 179 (5): 250-252.


  • Public hospitals designed for the past are not changing rapidly enough to meet the needs of the future. Changing work practices, increased pressure on bed occupancy, and greater numbers of patients with complex diseases and comorbidities will determine the functions of future hospitals.

  • To maximise the use of resources, hospital “down times” on weekends and public holidays will be a distant memory. Elective surgery will increase in the traditionally “quiet times”, such as summer, and decrease in the busy winter period.

  • The patient will be the focus of an efficient information flow, streamlining patient care in hospital and enhancing communication between hospitals and community-based health providers.

  • General and specialty units will need to work more efficiently together, as general physicians take on the role of patient case managers for an increasing proportion of patients. Funding needs to be adequate, and system management should involve clinicians.

  • Safety will be enshrined in hospital systems and procedures, as well as in the minds of hospital staff.

  • If these changes are not implemented successfully, public hospitals will not survive in the future.

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  • Jeffrey D Zajac

  • Department of Medicine, University of Melbourne, Austin Health, Heidelberg, VIC.


Competing interests:

None identified.

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  • 2. Malcolm L. Primary health care and the hospital: incompatible organisational concepts? Soc Sci Med 1994; 39: 455-458.
  • 3. US Institute of Medicine of the National Academies. Crossing the quality chasm: a new health system for the 21st century. Available at:" (accessed Jul 2003).
  • 4. Shortell S, Gillies RR, Devers KJ. Reinventing the American hospital. Milbank Q 1995; 73: 131-160.


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