PATIENT CARE
Unblocking the beds – morethanjustwaittimes
Neil Griffiths, managing director at TeleTracking UK asks how can a modern health service justify the continued reliance on teams of nurses roaming wards in the hunt for an empty bed?
Last winter bed occupancy was dangerously high at about 99% of capacity,1
raising
further calls for additional acute escalation beds and more staff. This happens year on year, driven mainly by increasing demand. It is understood that delays in social care2
and
a general lack of investment are significant problems, however, current acute hospital bed utilisation models have remained largely unchanged for decades.
Why are highly skilled and motivated staff comparing paper based notes three, even six times a day, in a desperate bid to match patient needs to bed availability? This is a stressful and very inefficient way to manage a very complex problem.3
The silent epidemic of waste created by a lack of visibility of current real-time bed capacity inhibits getting the right patient into the right bed. This is because the entire process is unmeasured, unmonitored and overlooked, resulting in “idle bed time.” Evidence4 suggests that there is, in most cases, inherent capacity in a hospital system which, if unlocked, would enable the NHS to
do far more with current resources. Highlighting and then tackling this fundamental measure of “idle bed time” will improve bed utilisation and is estimated to save on average at least £3 million to £5 m per Trust. Moreover, it will reduce occupancy, improve patient safety, experience and outcomes and bolster staff morale by removing pressure and driving efficiency. With the pressure on hospitals at unprecedented levels, matching demand to capacity requires a fundamentally different and far more robust approach to bed management. The NHS needs to move from “find and fix” to a “predict and prevent” model. Fortunately, the solution is both straightforward, easy and proven to deliver benefits at a scale few imagine.
Measuring what matters
It is clear that the demands on the healthcare industry are reaching new heights, and
With the pressure on hospitals at unprecedented levels, matching demand to capacity requires a fundamentally different and far more robust approach to bed management. The NHS needs to move from “find and fix” to a “predict and prevent” model.
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hospitals across the world are struggling to cope with a growing population that is living longer with increasing numbers of long term conditions (LTCs) and co-morbidities. Within the NHS, this demand has been recognised, raising calls for additional funding and support. Every year the NHS opens 3500 - 4000 escalation beds over the busy winter period to accommodate extra demand. Every year, NHS Trusts spend between £2 m and £7 m adding capacity. Yet, this is in a scenario where the average bed in the NHS is left ‘idle’ between a patient being discharged and a new patient being admitted for six to eight hours, when proven best practice shows that it should be significantly less and as little as one hour and 45 minutes.
This would unlock at least one ward of additional capacity per district general hospital in the NHS.5
There are 152 acute
hospitals in the NHS. Just consider the implications for patients, for Emergency Departments (ED), staff morale and, of course, operational costs. It’s important to say this is not a criticism
of the efforts of staff or an issue of a particular profession, but a result of the system. Things can change. But change has to start with
understanding the bed management process; understanding the delays inherent in the system; and understanding how some current performance measures are potentially contributing to the issue.
OCTOBER 2019
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