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You can find the current article at its original source at https://www.theguardian.com/healthcare-network/2016/aug/17/real-time-data-reducing-a-and-e-waiting-times
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| How real-time data is reducing A&E waiting times How real-time data is reducing A&E waiting times | |
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| In many trusts, the only way to find out something like how long people are waiting in accident and emergency is to phone the department and ask. “There are not many people at any one time who know what’s going on,” says Marc Farr, director of information at East Kent hospitals university NHS foundation trust. “A hospital has lots of people phoning people all day for information,” he says. | In many trusts, the only way to find out something like how long people are waiting in accident and emergency is to phone the department and ask. “There are not many people at any one time who know what’s going on,” says Marc Farr, director of information at East Kent hospitals university NHS foundation trust. “A hospital has lots of people phoning people all day for information,” he says. |
| The trust has ended the need for such phone calls. It displays live average emergency waiting times, as well as the number of people waiting, at each of its four hospitals, on its website. As well as informing the public, the business intelligence system helps the trust know when to redirect emergency patients to manage demand. | The trust has ended the need for such phone calls. It displays live average emergency waiting times, as well as the number of people waiting, at each of its four hospitals, on its website. As well as informing the public, the business intelligence system helps the trust know when to redirect emergency patients to manage demand. |
| Farr tells of one situation where they arranged for ambulances to be diverted from one hospital. For six hours, some ambulances that would normally have used Margate’s Queen Mother hospital went to Kent and Canterbury hospital. “You need that type of data and those types of predictions to make those kinds of decisions,” he says. | Farr tells of one situation where they arranged for ambulances to be diverted from one hospital. For six hours, some ambulances that would normally have used Margate’s Queen Mother hospital went to Kent and Canterbury hospital. “You need that type of data and those types of predictions to make those kinds of decisions,” he says. |
| Chris Dodgson, head of information for the Royal Bournemouth and Christchurch hospitals NHS foundation trust, says that real-time information also helps meet the target for 95% of patients to be seen by emergency departments within four hours. This is often affected by other wards being full, preventing patients being moved on from an emergency bed. “You want to know roughly where your blockages are, and this is where real-time information really helps to unpick those questions.” | Chris Dodgson, head of information for the Royal Bournemouth and Christchurch hospitals NHS foundation trust, says that real-time information also helps meet the target for 95% of patients to be seen by emergency departments within four hours. This is often affected by other wards being full, preventing patients being moved on from an emergency bed. “You want to know roughly where your blockages are, and this is where real-time information really helps to unpick those questions.” |
| East Kent shares data with external organisations, including a nursing agency which it pays to support those leaving hospital to return home. “Having a data flow between us prompts us to discharge patients more quickly ...”, Farr says. “Having a mobile, real-time view of how many patients they can take at any one time is really helpful.” | East Kent shares data with external organisations, including a nursing agency which it pays to support those leaving hospital to return home. “Having a data flow between us prompts us to discharge patients more quickly ...”, Farr says. “Having a mobile, real-time view of how many patients they can take at any one time is really helpful.” |
| East Kent sells the information-sharing systems it has developed through Beautiful Information, a company jointly owned by the trust, Farr – its founder – and other individuals. Its customers in the NHS and private healthcare sectors access up-to-date data on areas such as bed usage, finance and the workforce through online systems including a smartphone app. | East Kent sells the information-sharing systems it has developed through Beautiful Information, a company jointly owned by the trust, Farr – its founder – and other individuals. Its customers in the NHS and private healthcare sectors access up-to-date data on areas such as bed usage, finance and the workforce through online systems including a smartphone app. |
| Providing data through smartphones means managers can react quickly, but small screens require clear and simple presentation. The information dashboards use the common traffic light code, with green indicating few problems, amber some and red a serious situation. | Providing data through smartphones means managers can react quickly, but small screens require clear and simple presentation. The information dashboards use the common traffic light code, with green indicating few problems, amber some and red a serious situation. |
| However, it also offers black for the worst cases and blue for measures that continually meet targets, meaning “you don’t need to keep checking up on these people,” according to Farr. Users of the system can set their own thresholds for each colour code, which he says is important in getting them to trust its warnings. | However, it also offers black for the worst cases and blue for measures that continually meet targets, meaning “you don’t need to keep checking up on these people,” according to Farr. Users of the system can set their own thresholds for each colour code, which he says is important in getting them to trust its warnings. |
| Royal Bournemouth and Christchurch, which is working on developing its own data visualisations, uses business intelligence to monitor its progress on treating strokes. The Royal College of Physicians works out a grade for hospitals based on more than 50 clinical measures every four months. The trust puts the same data into the same formula to calculate the grade as often as clinicians want to check it, allowing them to redesign the service and see improvements far faster. “The impact of that over the last few months is that if you plot our scores we’ve gone from being at the lower end up to the very top end,” says Dodgson. | Royal Bournemouth and Christchurch, which is working on developing its own data visualisations, uses business intelligence to monitor its progress on treating strokes. The Royal College of Physicians works out a grade for hospitals based on more than 50 clinical measures every four months. The trust puts the same data into the same formula to calculate the grade as often as clinicians want to check it, allowing them to redesign the service and see improvements far faster. “The impact of that over the last few months is that if you plot our scores we’ve gone from being at the lower end up to the very top end,” says Dodgson. |
| The trust has just installed a Microsoft SQL 2016 data warehouse to improve its work in this area. In his previous job at Salisbury NHS foundation trust, Dodgson established a business intelligence system that greatly speeded flows of information. Demand on beds varied significantly throughout the year, so Dodgson and colleagues used three years of data to predict availability for each week. As a result, more staff were placed on-call for the weekend after New Year’s Eve: “It was a really busy weekend,” he says, adding that by publishing what actually happened as well as predictions, staff gained confidence in the accuracy of the forecasts. | The trust has just installed a Microsoft SQL 2016 data warehouse to improve its work in this area. In his previous job at Salisbury NHS foundation trust, Dodgson established a business intelligence system that greatly speeded flows of information. Demand on beds varied significantly throughout the year, so Dodgson and colleagues used three years of data to predict availability for each week. As a result, more staff were placed on-call for the weekend after New Year’s Eve: “It was a really busy weekend,” he says, adding that by publishing what actually happened as well as predictions, staff gained confidence in the accuracy of the forecasts. |
| Dodgson says business intelligence can be hit by poor-quality information if staff do not have the time to collect it. This can be tackled by using data that is already being gathered for other purposes, such as patient observations. | Dodgson says business intelligence can be hit by poor-quality information if staff do not have the time to collect it. This can be tackled by using data that is already being gathered for other purposes, such as patient observations. |
| He has also occasionally met opposition, including a consultant who didn’t like the idea that decreasing lengths of stay could lead to bed closures. He says it is vital to take all views into account: “The numbers say one thing, operationally it says something different. Where do we meet in the middle? Business intelligence from my point of view is about the beginning of a conversation, it’s not about cast-iron certainties, especially when you’re talking about service transformation and change.” | He has also occasionally met opposition, including a consultant who didn’t like the idea that decreasing lengths of stay could lead to bed closures. He says it is vital to take all views into account: “The numbers say one thing, operationally it says something different. Where do we meet in the middle? Business intelligence from my point of view is about the beginning of a conversation, it’s not about cast-iron certainties, especially when you’re talking about service transformation and change.” |
| Health and Care Innovation Expo in Manchester on 7 and 8 September will explore the Five Year Forward View in action. High profile health leaders will speak across two stages, while feature zones will explore digital health, personalised medicine and new models of care. NHS colleagues can attend free-of-charge. Click here to register. | Health and Care Innovation Expo in Manchester on 7 and 8 September will explore the Five Year Forward View in action. High profile health leaders will speak across two stages, while feature zones will explore digital health, personalised medicine and new models of care. NHS colleagues can attend free-of-charge. Click here to register. |
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