How my experience in the NHS helped us create a Patient Flow solution with a difference
As 16 trusts await the release of £68m NHS England investment in Bed and Capacity Management Systems to improve patient flow and reduce waiting lists, our Head of Projects, Alice Goodwin, shares how she supported the development of Infinity for Patient Flow.
We discuss her NHS experience and how this informed the way Infinity tackles the blockers in a patient’s journey through a hospital.
What did you do before Infinity Health?
Before joining Infinity Health, I worked at an NHS trust for 13 years, working my way up from an Outpatient Administrator, to a Systems Test Analyst and Trainer, to a Digital Project Manager. The aim of our digital team was to consider how technology could help staff access the information they need, free up their time, and improve patient outcomes.
I worked with clinical and operational staff, senior leads, patients, and tech suppliers, to understand everyone’s needs and how new technologies could meet them. As part of this, I delivered several patient flow projects including implementing e-whiteboards and e-observations.
What were the patient flow challenges you saw first hand?
Patient Flow could be hindered at any point in a patient’s journey, from delays in admissions because there are no available beds, to investigations, surgery blockages, and delayed discharge because of a lack of community care.
One particular issue was with the whiteboards that supported hospital ward rounds, that detailed the patients, their conditions, locations, what was required, and any warnings or concerns. Incoming staff would use the board information to write down their task list for the day on a piece of paper. Each day the board information would get wiped off and new actions written up. Some details were difficult to understand or could be written down incorrectly. There was no integration with the patient’s records, and there was no audit trail.
How did you manage this?
We implemented e-whiteboards. Information was taken from a patient’s electronic health record and filtered through to an e-whiteboard, so staff had access to real-time information. Staff had live updates of what was outstanding for each patient, and they were able to see what was happening in other teams to prevent duplication. Staff could chase delays in patient care through the day instead of waiting for handover.
My role was to test it, implement it, and train staff on how to use it. As with most digital projects, it was sometimes difficult to change behaviours, particularly with busy staff who have been burned with ineffective tools in the past. But once embedded, e-whiteboards improved the ward processes, streamlined communication between staff, and helped to improve patient flow.
What did you take away from that?
It really made me think about what each member of a multidisciplinary team needs. It wasn’t just about patient flow leads or ward managers but everyone that was involved along the patient journey. We consulted with nurses, medical, pharmacy, administrative, and discharge coordinators to consider what they needed to do their job and unblock patient flow.
How did your experience help with your role at Infinity?
I’m responsible for project delivery within Infinity Health, including managing relationships with our customers and planning the stages of projects, through to the rollout of our digital task management technology. My NHS experience has helped me to understand what is needed on the ground and to direct our developers to ensure that we are building a solution that genuinely solves a problem.
I make sure information governance, clinical safety, operational, and financial elements of projects are managed appropriately. Always with my NHS hat on and working with the customer to understand their pain points, I keep iterating, testing, and then rolling out a solution that is bespoke to them.
Have the challenges with Patient Flow changed over time?
Increased patient demand and reduced workforce is a problem, but workload has been an issue for a long time. It isn’t a quick fix such as optimising pharmacy so that TTOs happen on time or helping bed cleaning to be more efficient, but giving everyone along the patient journey the tools to make the best use of their time and provide informed care.
Everyone in a hospital needs oversight in real-time of what is happening on-site, what is blocking movement of patients through the hospital, and what they need to do on that day to prevent delays.
What should trusts focus on when working with a Patient Flow tool?
It is important that a patient flow tool is a whole team solution rather than just designed for the patient flow team. It should focus on what each member of staff needs from a dashboard, a task, and a patient’s information.
It has to be integrated with the PAS / EHR and any other systems such as remote monitoring and diagnostics tools. If, for instance, a discharge date is inputted in the PAS, it needs to feed in to the tool, and vice versa.
Infinity is a task management solution that allows teams to track the individual tasks required for each patient as they progress through the healthcare system. Presets help staff to search for all outstanding tasks, for whom, when, and where the patients are. Most patient flow tools might tell you where beds are available but they don’t drill down to the actions that are waiting to be done - this is essential.
What is the one thing that differentiates Infinity from other solutions?
We focus on tasks. A task describes a piece of activity that needs to be done for a patient. It could be anything from a clinical review, to a specific treatment, a request for a diagnostic test, or planning discharge, and any of these tasks could be blocking a patient’s movement through the hospital and hindering their treatment and recovery.
Infinity tracks all the tasks required for a patient and whether they have been started, completed, or pending. All the team has visibility in real-time to the tasks being done, the status of each task, and the activity of all the team. It enables smart bed allocation by providing a live bed-state and task status and visibility of discharges for the day. It also simplifies the process of hospital discharge planning, by tracking the individual tasks needed to progress a patient’s journey.
How does task management help improve clinical safety?
Task management ensures that the right person is doing the right thing, for the right person, at the right time, in the right order. It drives best practice by supporting ward and clinical teams to conduct high quality handover and board rounds using tasks to review EDDs, confirm discharge plans, and critically, ensuring that no task is ever missed.
Find out more about Infinity for Patient Flow here.