As the challenges to the NHS continue to grow, it’s clear that having a holistic view of the whole care system helps healthcare professionals improve care and efficiency. This is sometimes known as the Hospital Without Walls model. In this article, ExtraMed looks at what this means and how it helps frontline staff and hospital managers take the broadest possible view.
What is the Hospital Without Walls concept?
The Royal College of Physicians proposed an alternative to the traditional model in its Future Hospitals paper. Known as Hospital Without Walls, the principal objective was to reimagine how the software, systems and solutions used by the NHS should integrate all aspects of care provision, across acute, community, social care, health and social services.
Considering patient experience
Hospital Without Walls doesn’t just benefit the care providers. From the patient’s point of view, the number of separate departments, consultants and even organisations involved in their care can be overwhelming. The authors of the Future Hospital envisaged a system whereby patients are not “discharged” – care should be seamless both in and out of hospital. Delivering shared patient records and visibility of care plans can benefit and inform both patients and healthcare professionals. If everyone involved in a patient’s care can see who they are caring for, when, where, and the basic information required to complete each patient’s care, patients will feel like everyone they come into contact with is fully informed about their needs and issues.
Integration and information
The Future Hospital paper recommends that responsibility for care be shared between patients, practitioners, hospitals, social care and community hospitals, and be “continuously supported by a virtual dialogue.” This dialogue relies on the effective use of IT systems to share and update information outside the hospital boundaries. Systems must be designed to facilitate a shared view of patient care and where they are on their journey. The flow of information is key and solutions need to be interoperable and flexible so that staff ideally only need to look at one system to identify at what point in the care journey the patient is at and what the next steps are.
One way to support HWW, both operationally and strategically, is to share critical information with the wider health community via a Clinical Co-ordination Centre. It enables informed decision making that supports the patient’s journey in an efficient and effective way. This helps to minimise delays to the patient care by providing both health and social care services with the visibility of current status and therefore the ability to make decisions and take actions proactively.
The right information, where it’s needed
Presenting the information required by all staff involved in the patient’s care, in meaningful ways, requires not only software solutions but also hardware that can display it clearly. It also needs to place the information in the hands of relevant staff when and where they need it – at the bedside, in handover meetings, with the consultant, at the GP, in social care and so forth. Having a digital health platform that is efficient and open to integration will support future development without the need for each section of the system to be updated independently or for staff to re-key information.
Is it possible?
Achieving the “Hospital Without Walls” model is possible and, more importantly, is crucial to the transparency of care given to patients across the wider care community, but, of course, there will be hurdles to overcome. Usability, flexibility and interoperability are the keywords, and having systems that can integrate and share data is a priority to deliver hospital without walls.
This article first appeared in National Health Executive magazine.