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Improving joint expeditionary medical planning tools based on a patient flow approach by edward w chan heather krull beth e lachman tom latourrette rachel costello don snyder mahyar a amouzegar hans v ritschard d scott guermonprez. Improving joint expeditionary medical planning tools based on a patient flow approach by edward w chan heather krull beth e lachman tom latourrette rachel costello don snyder mahyar a amouzegar hans v ritschard d scott guermonprez. 8 improving jo int expe ditionar y medical p lanning tools base d on a patient flow a pproach in this chapter w e explain the principles of the step rate and ho w it integrates the plan. Iv improving joint expeditionary medical planning tools based on a patient flow approach management program of rand project air force this report should be of interest to medical planners and programmers in the air force and in the joint community rand project air force. This guide presents step by step instructions that can be used by hospitals in planning and implementing patient flow improvement strategies to ease emergency department crowding by megan mchugh phd kevin van dyke mpp mark mcclelland mn rn dina moss mpa