TECHNOLOGY


Balance and utilisation come from centralisation


My view is that we need to realise that services operate in complex ecosystems of providers and populations – and not alone. Each local change can impact positively and negatively on many other parts of a system. Five rehab beds closed in one organisation, due to short term staffing problems, might mean 20 more ED breaches a week to another provider. Two extra sessions of MRI capacity in one provider to meet a backlog can inflate the demand for new outpatient appointments in another. The COVID-19 pandemic has disrupted referral volumes and introduced large scale virtual patient appointments and created the need for NHS providers to cooperate and provide mutual aid.


The new normal has to involve the integration of care across networks and systems, while addressing and overcoming the organisational boundaries that still exist. It has to stream and balance activity across acute services, work dynamically with community and social care services, and help patients find services based on their need – without going through the GP. But trying to do this, without the centralised real-time visibility of what that system’s demand and capacity is right now, is near impossible. There is no view of a multi-service ‘single-point-of-access’ or the ability to operationally manage and balance patient flow operations across this network. But this is, in fact, the missing first step. You would not build and open a new


airport, with all its complexity and all its moving parts, and think about ground operational control and air traffic systems later? In UK healthcare that is exactly what TeleTracking is doing.


The new operating model To move forward and address the pressing need to provide treatment to large numbers of waiting patients with limited resources safely, I recommend the following: lCentralise command and control for patient flow into a system wide function – and create the regional patient flow command centre.


lProvide the regional command centre with visibility of real time data of demand and capacity generated from its system providers.


lStaff the command centre with senior decision makers – whose role is to make live decisions to balance activity across the system and create mutual aid.


lDeploy command centre technologies to manage and coordinate patient movement across its network, including, patient flow, capacity planning and bed management software.


lAdopt and manage a single policy for patient flow at a regional level.


SEPTEMBER 2021


lDeploy to each provider organisation capabilities to visualise and manage their own patient flow in real time at a bed level, OPD slot level and individual case level in the operating room, cath lab and interventional radiology.


The regional patient flow command centre


Centralising operations is not unknown in complex organisational functions. It is common to centralise control in the power industry and other critical infrastructure; in aviation, rail, and road systems, for the emergency services (fire, rescue, ambulance, and policing) and in the military. Centralisation of operations in a command centre is seen as an essential component to effective working where lives and livelihoods matter. So, centralising operations should be essential for one of the most complex undertakings, health and hospital care.


The centralisation of information, data, and decision makers in one place brings the following benefits: lCreates whole system visibility (to beds, patients, assets and staff workflows).


lCreates live data. lCreates live situational awareness. lCreates command and decision structures for leaders to make choices in real time.


lMakes for the effective use of resources (balancing demand against capacity).


lProvides data for improvement and long- term planning.


Provider level real-time flow There is a need to deploy and operate patient flow system technology at a regional level and remove all responsibilities for bed management from the ward level into the responsibility of the operational teams. I suggest this for two reasons:


lTo release clinical time from managing WWW.CLINICALSERVICESJOURNAL.COM l 77


patient flow that can be redirected into managing patient care.


lRemoving patient flow management from each ward will support organisational teams in smoothing discharge and admission activity evenly across the day and not in the peaks of discharge and admission we now see in late afternoon across all hospital services in the UK.


The management of patient flow should also include the adoption and recording of new data points that support operational improvement – like the time it takes for a bed to be turned around from being vacated to being reoccupied.


Over the coming months and years, the NHS will have to make a step change to its operating model and leverage capacity planning solutions that can support Trusts with centralised and real time operations management. To rebalance and achieve this, it will have to work regionally and will require a laser-like focus to ensure that no patient has to wait for the care they need.


CSJ About the author


Stephen Boyle RN Dip (HE) BA (Hons) MSc is a clinical executive with TeleTracking UK, which specialises in patient flow, capacity management and health system command centre technology. He has extensive clinical expertise in the development of Artificial Intelligence in healthcare organisations. A qualified nurse, Stephen recently returned to the front line of care, during the first lockdown in 2020, and has first-hand experience of how command centre technology can help unlock hidden capacity within the system.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88