CASE STUDY: NHS TAYSIDE
How NHS Tayside were able to tackle COVID-19 Planning head on, providing rapid analysis for flow coordinators making on-the-ground decisions and enabling them to monitor the situation and deploy staff effectively.
NHS Tayside - www.nhstayside.scot.nhs.uk
The build took three weeks and the entire diagnostics and implementation just three months.
Patient flow had been a continual area of focus across NHS Tayside and with the implementation of a new patient administration system three years previously, it was timely to start using this information to understand and plan more efficiently across the entire hospital floor. From ambulance arrivals, to the Emergency Department, to Acute Emergency Receiving Wards, General Inpatient Wards, and step down wards within local community hospitals.
But, NHS Tayside had no live patient flow view across the various hospitals, which included three acute sites and over 1,000 hospital beds.
Patient flow management was undertaken within ‘hospital huddles’. These huddles met three times a day, and nursing staff presented information on paper on their current occupied and empty beds, and admissions for the previous day to admin staff. The admin staff would then enter this information into a spreadsheet and circulate this around the hospital huddle staff, following the meeting. By the time the information was circulated, it was already out of date.
NHS Tayside became aware of the University Hospitals of Morecambe Bay (UHMBT) NHS Trust Command Centre during the summer of 2019. The look, feel and content of the dashboard had instant appeal. NHS Tayside engaged with the Chief Executive Officer and senior leadership team to determine if there was the appetite for their own Command Centre - the response was resoundingly positive. The Board considered building their own, using the internal Qlik development team resource (2 x Developers, and 1 x Support Officer). However, Catalyst BI were NHS Tayside’s existing Qlik support and maintenance partner, so they worked with Catalyst BI and UHMBT to explore all possibilities.
- Live view of their current bed state
- Analysts can now spend time working on specific research projects, rather than just telling people what the numbers are
- Health and social care partnerships now have an escalation policy which is reflected in the Command Centre regarding the number of delayed discharges i.e. patients medically fit for discharge. As this is colour-coded, when things reach ‘Amber’, wards immediately contact the health and social care partnership to accelerate processes.
- Enabled NHS Tayside to monitor the situation and deploy staff effectively across both COVID-19 and non COVID-19 pathways depending on fluctuating demand.”
- Consultants can now see the demand within the Emergency Department and identify where any bottlenecks are.
- Now able to assist in improving patient flow, support clinicians in patient centred decisions and enhance collaborative discussions and decision making
"The Command Centre enables our team working and excellent clinical and organisational skills to achieve even better experiences and outcomes for patients by providing the information necessary to facilitate this. Key statistics, metrics and graphs shared in one environment provide an immediate common understanding of the key dynamics of the hospitals."
"Importantly we did not only want to know where we had been so far in the day, nor were at a particular moment, but to have the facility to predict what the rest of the working day would look like in respect of demand and capacity. This would enable change actions which anticipated, and so provided for, challenges in the patient flow, demand/ capacity profile."
"Access to the Command Centre has been very beneficial in terms of our ongoing development of the Discharge Hub service. Specifically, we are currently further embedding sub teams within the Multi-disciplinary Team structures on key wards which promote better communication and pathways through specialisms, e.g. from Acute Receiving Wards to a Medicine for the Elderly ward. The Discharge Team staff in these areas can use the Command Centre to scrutinise demand through these pathways which helps them to plan proactively and therefore avoid delayed discharges (patients medically fit for discharge still in hospital)."
"In terms of COVID-19 planning, the Command Centre has enabled us to monitor the situation and deploy staff effectively across both COVID-19 and non COVID-19 pathways depending on fluctuating demand."
"Obviously you consider doing things in-house, as we have skilled developers and have built many dashboards over the years, but these things all take time and you have to be able to think out of the box. Once we looked at everything, we estimated that the project would take six to nine months to complete and we wouldn’t have achieved the same end result. So, we got the experts in to build it with us. Catalyst BI showed us what was possible."
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