Opinion

Unblocking patient flow starts with tasks

By Dr Jo Garland, Clinical Director, Infinity Health

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Hospital capacity is an ever-growing challenge for the NHS.

In England, total bed numbers have reduced by 50 per cent over the last 30 years and the NHS frequently runs above 95 per cent bed occupancy levels.

A contributor to the lack of capacity is the reliance on outdated processes and systems, making it difficult to move patients through care pathways efficiently.

Handwritten lists can get lost or misunderstood, patient information is difficult to access and share, and communication across teams is slow.

By digitising patient flow management, staff have an accurate picture of what is happening at the site and access to the right information to allow them to coordinate care for patients more efficiently.

Recently, the government announced funding to speed up hospital discharge ahead of winter and trusts are being supported to embed patient flow systems.

The question is how to do this safely, with what tools, and how to bring busy staff along with you.

Blockers to Patient Flow

Good patient flow requires managing the patient journey through different stages of care – admission, investigations, treatment, surgery, recovery and discharge – with minimal delays.

The latest figures show that more than 13,000 beds – out of a total of around 100,000 hospital beds in England – are occupied by patients who are medically fit for discharge.

A clinician may sanction discharge but there are often delays with medication to take home, booking transport, and ongoing community care packages.

Hospitals use outdated systems and manual processes, such as whiteboards, paper notes, and siloed systems, to manage admissions, transitions, and discharges.

Many trusts don’t have a system that tracks a patient’s journey through the hospital and alerts staff to the actions that need to be completed.

They also lack the real-time data for ward and site teams to see available beds, upcoming discharges, and what could be blocking them.

Impact of Patient Flow

Poor patient flow can result in emergency departments crowded with patients waiting to be transferred or admitted, patients being admitted to hospital wards not best-suited to their care, inpatients being moved around to different wards to accommodate new admissions, and delays to surgical procedures.

It impacts on the morale of both the patients waiting for treatment and staff as they struggle with increasing demands.

Good patient flow means the right care is delivered to the right patient at the right time, which ensures the patient has a good experience, clinical safety is high, and there is less pressure on staff.

How technology can help

Investment to increase hospital capacity and staffing, as well as meaningful social care reform, is important but we need to move from manual actions to flow technology that automates processes, provides visibility of data to allow accurate decisions, and helps staff to collaborate across teams and sites.

A 2023 study into solutions for efficient hospital-wide patient flows, based on interviews with senior managers at the world’s leading hospitals, said the best way to do this is to invest in new technologies, implement new working methods, and build a patient flow-focused culture.

It suggested that digital tools should be used to  standardise admissions; provide a real-time view of hospital capacity; and allow staff to connect and navigate to patients.

To ensure smooth patient flow through the hospital, staff need a real-time view of available beds and a forward-view of upcoming discharges.

They should have the ability to access and share patient information, including where they are located, and their treatment plan, enabling them to track them through the hospital.

Effective patient flow starts with tasks

It is futile implementing a tool that tracks patients, beds, and discharges, if it doesn’t drill down to the tasks that need to be completed.

A task such as a clinical review, specific treatment, request for a diagnostic test, or discharge planning, could be blocking a patient’s movement through the hospital and hindering their treatment and recovery.

Moving to a patient flow management tool with integrated digital task management provides a more accurate site picture, based on activity, and the site team has the ability to review from site, to ward, to patient, to task. 

Staff can see, in real-time, the actions to be carried out, for whom, their location, by whom, and when, to maintain healthy patient flow.

Providing staff with a digital task list, with access to the necessary information, integrated with relevant systems such as EHRs or diagnostic testing platforms, helps the prioritisation of patients, reduces the length of stay, and provides a better experience for both staff and patients.

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