Using patient flow to help with NHS Winter Pressures this year

The summer heatwave may still be with us but the countdown to Winter starts here. A patient flow system could make a real difference to NHS winter pressures – your occupancy, discharge and readmission rates. It can be deployed in as little as 12 weeks so there’s still time to make a difference.

Using digital technology at the point of care is a journey but you can deploy Patient Flow in just 12 weeks – like the Royal Derby Hospital did – and start seeing the benefits in time for Winter Pressures.

How Derby made the change

Run by Derby Teaching Hospitals NHS Foundation Trust, the Royal Derby Hospital has 1,159 beds and cares for more than 180,000 people, as inpatients, outpatients, emergency cases and day patients of over 600,000 people in and around southern Derbyshire.

Previous winters had shown variable performance against the A&E 4-hour standard. Consistent patient flow issues, compounded by a high level of delayed discharges and high bed occupancy, made managing efficient patient flow difficult. It was these factors that led the Chief Executive to make winter performance the hospital’s number one priority.

A robust system was needed

Derby needed a system that would provide operational insight as well as support clinical staff with day to day activities. The Trust chose ExtraMed to help them find this solution. Our Patient Flow system replaced standard ward whiteboards with integrated digital screens, so staff could update and share information about patient locations, needs, referrals and discharge status, as well as follow patient journeys in real time.

Visibility and flexibility

A virtual wards feature allowed Community and Social Services teams to access information, to improve flow outside of the hospital and speed up discharge procedures for outpatients. Trust management could access information for each ward, for wider teams and for the hospital as a whole, providing an overview of the entire healthcare economy and allowing them to identify areas that needed further attention. The solution provided a comprehensive toolkit to manage the patient journey from pre-admission to post-discharge.

“When we saw how the system could improve the care to our patients by alerting our staff early to any delays in their treatment we were determined to get the system up and running for that winter,” said Helen Scott-South, Chief Operating Officer.

Kick-off to go-live in just 12 weeks

To ensure that the system could be fully operational, and fully embedded, by the time winter bed pressures made an impact, the system had to be implemented quickly and effectively. With support from the ExtraMed team, the Trust committed to delivering the project in 12 weeks, including hardware and software installation, training and support for clinical staff, and development of virtual wards and operational views.

Rapid, effective on-boarding

During the implementation, hands-on demonstration days engaged hundreds of staff across the organisation and included in-depth mapping and training sessions. Over 600 users began using the new system in the first four weeks, delivering high levels of engagement.

Start seeing results straight away

Following implementation of Patient Flow:

• The average length of stay across the medical inpatient wards reduced throughout winter
• There was a turnaround in the 4 hour A&E standard, achieving required performance levels in quarters 2, 3 and 4, as well as the year as a whole, demonstrating a positive trend even through a traditionally challenging time of year
• Clarity was gained on the issues affecting patient flow. It became easier to identify patients in acute beds who no longer required acute care, allowing the “Pull Team” to focus on finding faster solutions to get those patients to where they needed to be
• Front-line staff were able to maximise capacity with the resources available

Via a colour-coded, user-friendly system, Patient Flow offers immediate at-a-glance identification of patients that need specific attention, enabling staff to be responsive and focused. Over time, the system also provides more comprehensive data to enable longer-term and strategic planning. What’s more, it allows a constant flow of communication across departments and beyond the hospital to GP surgeries and care services.