Technology is helping to create bed capacity and keep surgery on schedule at Bradford NHS trust. Gill Hitchcock reports on what this means for patients and staff in what is typically a busy time of year
Credit: Lynne Cameron/PA Wire/PA Images
Another winter, and many NHS hospitals are pulling out all the stops to care for people suffering from flu, pneumonia or respiratory conditions. Bradford Teaching Hospitals NHS Trust, however, claims to be significantly reducing the seasonal pressures on its hospitals by applying digital innovation.
Since its formal opening at the start of this winter, Bradford’s ‘command centre’ has used advanced analytics and machine learning to provide staff with real-time information. It claims this is helping them to make speedy and informed decisions on managing patient flow across the trust’s hospitals.
The command centre has moved the trust on from white boards and winter control rooms to live, actionable information.
Staff in the command centre staff monitor a wall of screens displaying real-time data. Information is constantly pulled in from hundreds of different systems, ranging from electronic patient records, to radiology and surgery scheduling.
Artificial intelligence analyses this data instantly, revealing patterns and themes and helping staff to anticipate and resolve bottlenecks.
Like many other trusts, Bradford faces growing demand for its services.
Up to 400 patients are seen in its emergency department every day. During previous winters, it ran out of beds and had to cancel elective surgery.
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Managers realised that patient flow had to be managed more efficiently. The turning point came while the trust’s chief executive was on a visit to hospitals in North America. He saw command centres in action and realised this could be a solution to Bradford’s problem.
Several hospitals in North America, including Humber River in Toronto, Canada, and the Johns Hopkins, in Baltimore, US, have command centres.
The 1,000-bed Johns Hopkins claims that, since its command centre opened, patients from other hospitals are transferred 60% faster, A&E waiting times have been cut by 25% and waiting times in theatres for post-surgical beds has decreased by 70%.
Cindy Feddell, Bradford’s chief digital and technology officer, says: “We started exploring our options and what we wanted. At the time, GE Healthcare’s command centre system was the only one that had smart algorithms. All the others were just presentation of data.”
In autumn 2018 Bradford signed a contract with GE Healthcare. Feddell does not want to reveal how much it has cost, but says: “We were the first site in Europe to use this system, so it was more a partnership with GE than a straight purchase. But we did have to write a business case and prove the benefits.”
Human intervention is vital for the centre to run effectively.
“It can’t just be entirely independent,” Feddell says. “You need to validate what the machine learning is coming up with and you have to put it in context.”
Already, the initiative is delivering faster ambulance transfer times. Patients are moving through hospital faster and more efficiently, without unnecessary delays. They are getting home quicker and fewer operations have been cancelled due to winter pressures.
“Most winters, especially January and February, we open up a winter ward and cancel elective surgery,” she says. “Last winter we did not cancel any surgery. This year, I don’t think we have cancelled any yet – and it’s on the back of this work.”
Feddell adds: “And last winter we didn’t have a winter ward at all. I think we opened up a very small six-bed ward the other night, and that has been it. So, we are doing much better with our beds. One of our big wins is that it means patients who need to be admitted urgently are not waiting. This is because we are being more efficient with our beds and we have more beds available that we did before.”
When it came to introducing the new command centre, plans were made for two anticipated challenges. One was the change of culture for staff. And so, employees were involved in the project from the start, including enabling them to design their own processes and interfaces.
Data collection was the other expected hurdle.
Feddell says it was agreed that the system would operate using existing data flows.
“Most winters, especially January and February, we open up a winter ward and cancel elective surgery. Last winter we did not cancel any surgery. This year, I don’t think we have cancelled any yet.”
Cindy Feddell, Bradford NHS trust
“There was no way we were going to ask people to enter more data to facilitate the command centre,” she adds. “It needed to come out of people’s every day jobs and the information they already used.”
This is still a work in progress. The next step is to look at how the command centre could work not just within the trust, but across the local health economy, including GP surgeries and community care services.
And for other NHS trusts, Feddell thinks a command centre would be a positive next step after implementing an electronic patient record.
For her, the centre is vital: “When I consider how we ran the hospital before, I can’t believe we did it without any central escalation and oversight. Now it seems odd to think of running the organisation in that way.”