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  • How does your Trust manage patient flow and bed management? 

    Hospital

    Every year, the winter season presents added strain to the NHS and this year is no exception. In fact, it is looking more challenging than ever given the rising number of Covid-19 patients being admitted to hospital in addition to the seasonal surge of non-Covid acute admissions. And it doesn’t end there – with a vast backlog of elective activity to catch up on, combined with NHS staff shortages and burnout, it’s not just the winter that is looking alarming, it’s the entire foreseeable future of the NHS.

    As we witnessed when the first wave of Coronavirus struck, the opportunity to adapt working practices through  digital technology within the NHS was quickly grasped because, quite frankly, there was a sudden urgency and realisation that without it, Trusts just wouldn’t cope. Some of the digital solutions that were deployed were not necessarily large scale Trust-wide digital transformation processes, but small changes that made a huge impact. So it’s astounding to consider that many Trusts still don’t have a simple automated bed or patient flow management system in place to ensure they know where their patients are, their status and where available beds may be. In fact, right now, nurses are still frantically running around hospital wards with pencil and paper, manually inputting the current bed estate.

    Paul Barrett, TeleTracking UK, explains how automating patient flow and bed management in real-time can transform hospital operations, free up time for nurses to care, reduce stress on caregivers and importantly improve patient outcomes. And it can begin with small, scalable solutions.

    Current inefficiencies 

    NHS Trusts are attempting to manage unprecedented service demand using a manual bed management approach. So it is no surprise that millions of pounds are spent each year adding unnecessary capacity, which is not only a waste of resources, but adds even more pressure to those nurses and teams attempting to manage the bed estate, or requires adding costly NHS bank staff. And the implications of poor bed management extend far beyond A&E delays; it results in cancellations of elective surgery; delayed discharge; poor infection control and increased mortality; incorrect clinical pathways and therefore extended issues around care in the community; and staff sickness due to raised stress levels.

    Currently, this manual approach involves teams of hospital staff making multiple phone calls, frequent meetings, multiple spreadsheets, and physically running from ward to ward and building to building to check on the bed status, and by the time the member of staff has returned to update the bed estate, the bed has likely been assigned to another patient. The process is completely inefficient and is not real-time. And the same approach is happening at the other end too – the discharge process. Once a patient has been discharged, the manual process happens all over again with phone calls to request bed cleaning and portering services, leaving beds lying empty for up to six hours.

    A real-time approach

    For Trusts that may have considered automating the bed management process, unfortunately, without a real-time solution, the desired outcomes just won’t be achieved. Many PAS and EPR systems claim to be able to optimise the bed management process, but these are complex clinical systems not designed for the singular purpose of patient flow. Nor are they designed around the specific day-to-day needs of  the nursing staff using them.

    For Trust executives looking to see a good ROI, and for the Chief Nursing Officer who is looking to improve staff burnout, and for all of those frontline NHS staff wanting to make a real difference to patient outcomes, it is a real-time automated solution that is required.

    A bespoke bed management solution quite simply takes the contents of those clipboards and whiteboards at the end of each ward, and makes it real-time. A small digital change that can have a huge impact – giving nurses more time back to care, reducing stress, and ultimately improving patient outcomes. And, it doesn’t end there, with a simple bespoke and scalable solution, over time, Trusts have the ability to fully transform the entire patient flow journey.

    Tracking patients in real-time from A&E through to discharge using, for example, RFID badges, hospitals can transform the way beds are managed. Creating dedicated bed cleaning teams for example, ensures empty beds are immediately prepared for a new patient while also releasing nurses from the burden of bed cleaning to concentrate on core clinical tasks and caregiving; while porters are automatically informed when patients are ready for transfer, further reducing *idle bed time. A real-time solution adds small efficiencies to every part of the patient flow process, which in turn adds up to make a huge difference.

    During the Coronavirus pandemic, some Trusts have demonstrated best practice using this type of bespoke digital technology to track the numbers and whereabouts of Covid and non-Covid patients and staff caring for them. It has enabled them to predict the numbers of PPE required, which has helped to prevent over ordering when equipment was scarce. For example, The Royal Wolverhampton NHS Trust (RWT) was able to use its patient and staff tracking solution in combination with Real-time Location System (RTLS) sensors, for data analysts to audit the number of interactions between staff and possible and confirmed Covid-19 patients. Furthermore, this type of solution supports better overall  infection control by enabling Trusts to easily identify the most at risk patients and communicate with staff so they are prepared to care for them, flagging each Covid infected or potentially infected patient with an isolation precautionary ‘tag’, and tracking staff to minimise risk.

    Conclusion

    With a real-time bespoke bed management system, Trusts have the ability to radically improve the entire patient flow journey. From more time back to nurses to care, better infection control, to reduced medical outliers, reduced length of patient stay, improved operational efficiencies, and importantly, better patient outcomes. The solution can begin with small, simple processes, but has the potential to scale up to a fully centralised, RTLS enabled, operational command centre over time and at a pace to suit Trust requirements and challenges.

    So the question remains, if your Trust hasn’t yet considered this type of scalable and bespoke bed management system, why not?

    AUTHOR

    Stuart O'Brien

    All stories by: Stuart O'Brien

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