Patient Service Pathways as an Organizational and Legal Mechanism of Public Administration in Healthcare: The Experience of a Regional Clinical Hospital

Abstract

Purpose. The study’s purpose is to provide a scientific justification for the implementation of patient service pathways as an effective organizational and legal mechanism of public management in the medical care sphere, as well as to analyse the outcomes of their practical implementation using the case of the Municipal Enterprise “Rivne Regional Clinical Hospital named after Yurii Semeniuk” of the Rivne Regional Council (hereinafter – RRCH). Materials and methods. The object of the study is the process of implementing patient service pathways within the operational activities of a multidisciplinary regional healthcare facility. The research is based on a comprehensive methodological framework that combines general scientific and applied methods. The systems and analytical approach was applied to conceptualize patient service pathways within the structure of public management mechanisms in medical care sphere. Descriptive and comparative methods were used to analyse changes in service processes before and after the implementation of the “outpatient clinic without queues” policy. Sociological methods were employed to process patient survey data and feedback, while generalization and visualization methods were applied to present empirical results. The empirical base of the study includes internal regulatory documents and management reports of the hospital, statistical data on patient visits and complaints, analytical monitoring materials, Service Contact Centre’s records, and patient satisfaction survey results collected during 2022–2025. Results. The study demonstrates that the implementation of patient service pathways as part of a comprehensive patient-cantered service model has led to significant improvements in the organization of medical care services. The reform included the establishment of a centralized Service Centre responsible for primary patient communication, implementation of IP-based contact centre technologies, standardized communication scripts, digital appointment scheduling, automated SMS notifications, and systematic post-visit feedback collection. These measures reduced the administrative burden on registration desks and “live” queues by more than 70%, improved coordination between clinical and non-clinical units, and increased transparency of service processes. Centralization of communication channels also contributed to better accounting of provided services and reduced opportunities for informal payments. As a result, the number of patient complaints related to medical care organization and medical services quality decreased by 74.2% in 2025 compared to 2022 indicating a substantial reduction in conflict situations and the service failures. The average waiting time for a physician appointment was reduced to 11.62 minutes, and 83.4% of patients rated the received medical services as high quality. Additionally, the workload on traditional registration desks and “live queues” was reduced by more than 70%, contributing to improved internal logistics and more efficient use of human resources. The findings indicate that patient service pathways not only optimize service processes but also function as a public management mechanism that enhances accountability, coordination, and responsiveness within healthcare institutions. The obtained results are consistent with international research on integrated care and service pathways, which highlights the role of standardized yet patient-cantered service processes as a key driver of medical care quality and public management efficiency. In line with European and global studies, the experience of the Rivne Regional Clinical Hospital confirms that patient service pathways complement clinical pathways by addressing organizational, communicative, and navigational dimensions of care, as well as patients’ emotional needs. The institutionalization of service pathways as part of hospital governance contributed to greater predictability of care processes, reduction of service-related errors, and improved coordination among healthcare professionals. The integration of digital tools and standardized service algorithms strengthened managerial transparency and accountability, while the observed growth in patient satisfaction and trust supports existing evidence that service pathway optimization reduces administrative burden on medical staff and enhances continuity and accessibility of medical services. Conclusions. The study proves that patient service pathways represent an effective organizational and legal mechanism of public management in medical care, facilitating the implementation of the patient-cantered principle, improving medical service quality and accessibility, increasing transparency of managerial processes, and strengthening patient trust in public healthcare institutions. The experience of the Rivne Regional Clinical Hospital confirms that the integration of organizational, legal, and digital solutions can significantly enhance service performance without substantial additional financial expenditures. The proposed model has strong potential for scaling and adaptation in other secondary and tertiary healthcare institutions across Ukraine, contributing to the development of a unified national approach to service-oriented healthcare governance in the context of ongoing health system reform.