HTN Digital ICS Playbook: Alcidion on patient flow?

Alcidion ’s chief medical officer Paul Deffley recently shared his thoughts on patient flow with HTN alongside healthcare consultant Dr Amanda Thornton , previously portfolio director for Lancashire and South Cumbria Health and Care Partnership.

Success in patient flow

On top of other successes across the UK, Australia and New Zealand, Paul shared how Alcidion has recently successfully deployed their patient flow solution on top of the Cerner EPR programme in East Lancashire, supporting staff with real-time information of bed availability. “Critically, it means they’ve been able to escalate that data to operational and site teams as and when they need it, so that they can make meaningful decisions about those challenges,” he said. “It prevents a situation where you have really experienced, senior people spending a vast amount of time chasing data.”

Alcidion is also rolling out their flow solution in South Tees, replacing the existing manual flow system. Currently live across the various departments including the trust’s medical assessment units, elderly care and community discharge, Paul highlighted how Alcidion is “getting some great metrics back – it’s demonstrating a colossal improvement in emergency department discharge, in understanding what people are waiting for in order to discharge, and in creating that real-time trust wide view of capacity and challenges within the system.”

Tips for the NHS in optimising patient flow

So what can NHS organisations do to support and improve their patient flow?

Having spent seven years as portfolio director for her ICS, Amanda shared her advice for NHS leaders. “You need to be able to ensure your team that flow is optimised, that best practice is best practice,” she said. “Often, working with trusts, I’ve seen over 20 percent of beds taken up by people who are ready to go home but can’t get home. Leadership teams can feel that there’s a spotlight on the trusts and their flow, but what about onward care and the organisations responsible for that? To that, I’d say you need to prove that you’ve optimised your patient flow through the hospital. You need to prove that you are doing everything you can, and if you can prove that but you’re still facing patient flow issues with onward care, then that gives you the backing that is needed to intelligently commission further support.”

She noted that recently, several core features that improve patient flow have been highlighted through research – “the factors that, when you apply them together, should generate the most optimised patient flow available. Having information in real-time is one of them; another is having embedded frameworks or patient storyboards so that clinicians and bed assigners know exactly where a patient is on their journey. Alongside that, there are a range of tasks that are important but don’t normally receive much attention, like making sure that a bed clean task can be triggered as soon as a bed is empty.” 16 trusts have been chosen to receive funding to improve these core features, with Amanda urging chief operating officers in those trusts to “use this investment wisely, and now. Use it to future-proof digital enablement for your care coordination centre. And if you are a chief operating officer in one of the trusts without that funding, I’d be asking how quickly you can get your hands on that money.”

Another tip from Amanda is to recognise that it is not just about digital; to tackle patient flow challenges, there needs to be a change in processes, leadership and culture as well as systems.

Paul agreed: “There needs to be an awareness of what digital tools are available to support flow. Organisations and leaders need to ensure familiarisation with the benefits and opportunity around digital solutions, and it needs to be framed around the change management aspect. Digital is an enabler, but in order to get best success from it, you need to change your processes and work in a different way. Taking teams through that process is how you unlock the benefits.”

In addition, he encouraged organisations to think about the key elements of real-time data that they need to surface within the system and focus on those. “Don’t tolerate what you can measure, or pseudo measures. Even within a small data set, what are the key parts of data that tell you what’s going on in your system?”

Lastly, he said: “Think about clinical teams and how you engage with them. How can you create marginal gains to drive them to use the digital tools? How do you make their lives a bit better? That’s how we ensure that engagement is high and data quality is high.”

What does great look like in the future?

“Good looks like accessible, real-time tools that are adopted and create a difference, so you have measurable impacts from your flow solution,” Paul said. “It looks like the real-time data being driven into the command centres so that site managers spend their expertise where it is needed and the leadership team have the ability to interrogate the information and drive meaningful change at system level.”

Then, he added, “We can enhance that – what does good look like, versus what does great look like? Great is adding smart technology on top of those tools to start predicting problems before they happen. The system learns; it learns to predict what happens and the impact of your interventions. You need an underpinning platform and technology that can start driving those algorithms and smart applications to think for you and surface problems before they actually create that problem.”

To find out more about how Alcidion can support you with patient flow, please click here .