FLEXIBLE ESTATE
the simulation was computer-based. At Slade Road, for instance, a walk-through simulation with imagined patients (staff playing real patients based on case notes) was used to work out the capacity of the centre, and the scope for increasing throughput. Julie Andrews waxed lyrical about
starting at the ‘very beginning,’ which might be ‘a very good place to start,’ but it is not a very easy place to find. We will never know quite how a group of people with overlapping aspirations managed to weave a coherent vision together and deliver it, so there isn’t a ‘very beginning.’ Instead, we will identify starting points for each story, and follow it through from there: the piloting, the information, the modelling.
Nor is this the end of the story or
stories. If we had to, we might guess that this drive-through clinic relates to future delivery, in the same way that a 1930s passenger aeroplane related to a modern jetliner. Although the aircraft were noisy and uncomfortable, they established that it was possible to move people and goods (often the mail); routes were pioneered,
‘‘
A walk-through simulation with imagined patients (staff playing real patients based on case notes) was used to work out the capacity of the centre
1. Barrier and vehicle entrance 2. Hot cabin 3. Green cabin
4. Reception/Pre-COVID check 5. Pedestrian entrance/tent 6. Toilets
7. Reception/admin 8. Pre-COVID check compound
Figure 5: The layout of the Hobmoor Road (above) and Slade Road (right) sites. Note the emergence of common features, such as a ‘hot cabin’ in red for those with COVID, and a green cabin for everyone else.
and a map of the future started to stitch itself together.
Drive-through diagnostics Similarly, once you can design a drive- through clinic, you can deploy drive- through diagnostics, or drive-into day case treatment centres. Once you can track and schedule patients as they arrive (or even once they have left home), you can ease the surges and dead times experienced by a demand-led service. These elements of logistics and knowledge management are key to success in a healthy future. The rest of this article follows the three
narratives – piloting, information, modelling – and, finally, looks forward to what is coming next.
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Pilots and prototypes At the heart of this series of developments is the concept of Agile: a flexible, customer-focused approach that emerged from software engineering. The language of scrums, sprints, and minimum viable products has spread quickly – and because of its versatility, definitions are sometime a little fuzzy. So, how was Agile adapted for this project? Agile encourages teams to focus on
short-term goals, see what the customer makes of the output, and then push on quickly with the next. The implementation used here is shown in Figure 3, which presents an example of two sprints, creating something and then testing it. If it is good enough, the process moves on to
April 2022 Health Estate Journal 25
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