Case Study: Bradford Teaching Hospitals NHS FT Command Centre

Like many organisations across the NHS, Bradford Teaching Hospitals NHS Foundation Trust (BTHFT) has faced pressures on its emergency department, constraints on bed capacity and patient flow, and challenges with its non-elective care pathway. Without clear insights about patient and ward circumstances during the admissions and transfer processes, patients weren’t always placed in the right ward when they were admitted.

Through a collaboration with GE HealthCare and the introduction of the Command Centre, BTHFT embarked on an organisational and operational transformation programme, enabling the Trust to operate at a higher performance level. By utilising digital technology, analytical insights, redeveloped workflows and processes, and dedicated staff, BTHFT has developed an optimised operating model to maximise resources and proactively manage demand.

HTN visited the Trust to learn how the Command Centre works; what it means for operational performance; the impact on the emergency department, patient flow, discharge, deterioration management, and the hospital’s operations at night; and the Trust’s plans for the future.

To explore the programme, we spoke with members of the BTHFT team:

• Sajid Azeb, Chief Operating Officer and Deputy Chief Executive
• Sarah Buckley, Clinical Lead for the Command Centre and Patient Flow
• LeeAnne Elliott, Patient Safety Specialist
• Clare Nandha, Lead Sepsis Nurse

Operational transformation: From objectives to improved performance

Launched in 2019, the Command Centre programme is viewed as “a step change in the way the Trust operated.” BTHFT has utilised the Command Centre programme to support its organisational transformation and improve performance. Before the implementation of the Command Centre, clinical and operational teams were heavily reliant on manual, time-consuming processes such as walking the wards with clipboards to collect information on patients and capacity and holding long meetings to collate data.

Sajid Azeb, Chief Operating Officer and Deputy Chief Executive, highlighted: “The Command Centre has been a key enabler of our overall vision to deliver outstanding care, research, and education, and to be a great place to work. It helped us transform our clinical pathways.”

BTHFT has made remarkable progress in addressing the strategic objectives it established for its Command Centre:

Objective #1: Relieve pressure on the emergency department

• Rose to the top quartile for performance in the emergency care standard. Today, BTHFT is ranked fifth out of 140 Acute Trusts, a remarkable increase over their previous ranking of 119th – and, they are maintaining their new higher ranking.

Objective #2: Better match bed and staff capacity to demand

• Increased compliance with accurately tracking all patients’ expected discharge date (EDD), with 92% of patients having an EDD compared to 67% before. And, only 1.8% of patients have an expired EDD (EDD is in the past).
• Improved discharge processes, with 54% of discharges happening by 4pm, increased from 35% before.

Objective #3: Improve care and length-of-stay by getting patients to the right bed at the right time

• Large improvement in bed placement accuracy by supporting teams in getting the right patient to the right bed, the first time. Before, there were an average of 58 outliers per day, which is 10% of the bed base. Today, there are just six per day – only 1% of the bed base.

Objective #4: Improve situational awareness and support decision-making through reliable, visible data

• Reduced operational bed meetings from three down to just two, giving care givers 3.7 hours back to care every day

Objective #5: Limit unwarranted variation and waste by standardising processes

• Giving 6.5 hours per day back to clinical teams for patient care by eliminating 200 phone calls to the ward on any given day.

The operational improvements and organisation-wide transformation supported by the Command Centre deployment have also gained recognition across the NHS, including:

• BTHFT named one of the most improved digital pioneers in the NHS [1] , placing it in the top ten Trusts across England.
• The Command Centre’s input highlighted under ‘outstanding practice’ by the Care Quality Commission (CQC)[2] .

Sajid explained the Command Centre is not just about the technology – it’s about the people. “It has transformed the way we work,” he said. “People are no longer walking wards and having long meetings about sharing information – now we have meetings which are focused on key decisions and actions.”

Read more >