University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), which provides hospital and community services for 365,000 residents across a thousand square miles and which has to cope with 100,000 A&E and 40,000 emergency in-patients visits a year, says a special new in-house ‘Command Centre’ is proving invaluable in its fight to deliver services.
What that looks like in physical reality: five large touchscreen displays that are constantly displaying different aspects of the emergency care journey for the Trust’s many patients.
Offering instant access to a range of performance metrics about all that’s going on in its busy healthcare environment, from the current state of ambulance journeys to the latest load in the emergency department, the room acts as a vital resource in terms of helping its hard-pressed staff prepare for the arrival of patients by letting managers get the best real-time picture they can of needs and available hospital resources.
In the words of one of the main drivers behind the Centre, Rob O’Neill, Head of Information at UHMBT:
It’s crucial that we deliver the highest standard of patient care as efficiently as possible. Advanced analytics is helping us achieve this by immersing employees in real-time data, allowing them to pre-empt and react quickly to changing demand, and the Command Centre is a really good example of a tangible solution that's delivering really positive, useful change.
With three main hospital sites and a range of around 40 community sites across the area, the Trust also has to deliver an assortment of outpatient and surgical services and district nursing and therapy support across South Cumbria and North Lancashire area.
A key KPI: bed management, something that hospitals traditionally find difficult - but which analytics at Morecambe is claimed to now support much better, managing bed stock for changing demand.
In terms of who’s using the resource, the short answer is the staff that will most benefit from it: clinical, operational and estate staff alike all visit the Centre for patient flow meetings at least four times daily. O’Neill told diginomica/government, that this highly useful live data allows staff meetings to be shorter, more focused and more evidence-based, and so frees up time to spend doing what they want to do - improving the patient experience, and saving lives.
In terms of measurable benefits out of the system so far, O’Neill says there’s been an increase in the number of patients that get triaged by the emergency department under 15 minutes, as well as improved visibility which patients end up being treated in a non-medical ward.
O’Neill sees the Centre as part of an on-going commitment by UHMBT to exploit the power of technology for patient good.
I joined UHMBT in 2013 as I was so interested in how data was being used to transform the way care was delivered and the exciting things that are happening at the Trust with technology and digital. I am always looking to bring together both traditional IT and also information and data management, and so I joined the team to lead on both the data side and on the analytics side.”
A dramatic improvement in terms of patients being cared for in the right place
The Trust used software from data analytics supplier Qlik to help build the Centre, which came on-stream in just 10 weeks from initial conversations to go-live only as recently as September 2018.
Actually, O’Neill and his team moved so quickly to try and deliver what eventually became the Centre because of what they heard at that meeting:
We had the requirements gathering session with the operational clinical teams, so this was entirely business led; it was never an IT project, it’s a business project supported by the Informatics team. And the conversation quickly turned to why they needed help; they were really worried about demands on capacity and about patient flow.
The sentence that really decided this for me was when they described themselves working at Winter pressure levels throughout the year now - which means that have to approach the normally very demanding Winter period, as it now is for the NHS, as being sort of like ‘Winter++’.
Things are now looking a lot better for Winter 2019-20, however, as a direct result of data being better handled, says O’Neill:
When a patient arrives, there's a national standard to say they should be triaged within 15 minutes. Performance on that very important aspect of what we have to do has just risen drastically since go live. We’ve also seen a dramatic improvement in terms of patients being cared for in the right place.
The other key metric we're measuring is around better, timely patient discharge, too. So the Command Centre has been a pivotal point in our journey towards moving towards improving patient care, here at Morecambe.
It’s important to realise that frontline use of analytics isn’t just limited to that one on-site capability, however. O’Neill’s also rolled out a mobile app with similarly useful data feeds to the many field staff the Trust needs to keep informed, too:
We've got a large geographic area with staff working across multiple sides who are not always connected to our network but you can access this information on their phones/iPads or laptops, wherever they are. we have a challenging geography, a thousand square miles, three main hospitals sites and between the two largest, which are in Barrow-in-Furness and Lancaster, you’re looking at an hour and a half road journey.
Next steps, O’Neill told us, include a feed for patients and visitors so they too can have live updates on wait-times and bed availability.
He is also investigating integrating Machine Learning and Natural Language processing capabilities, as well as exploring the potential of building predictive analytics solutions to help support not just the work the Trust needs to do at the acute hospital but also at the community level, as data could identify patients in possible risk of escalation of their condition.