Challenge
A large teaching hospital in the North of England faced significant pressure to improve access to care and make it affordable. A shortage of staffed beds led to long patient waiting times, overworked staff, and increasing costs were growing concerns. Various approaches and solutions to free up beds by improving patient flow to reduce length of stay (LOS) have been tried but only provided limited results.
Solution
Flowful is a patient-centric and clinically led solution that improves patient flow across all clinical pathways. Consisting of a set of processes enabled by an easy-to-use piece of software, Flowful is based on systems thinking, providing a simple solution to a complex problem.
The core benefits of Flowful are:
- Identifying the most significant causes of disruption and delay helps leaders focus their improvement efforts on the areas with the most significant impact on care.
- Synchronizing the work of resources to improve the hospital’s performance while also making the life of staff easier.
Flowful has been implemented in hospitals worldwide, including North America, the UK, and the EU. It has consistently delivered rapid and sustainable improvements to the safety, quality, timeliness, and affordability of care, while reducing burden on the staff.
The dedicated software consists of simple tools built to drive transparency, patient-centricity, focus, and collaboration. These include visual time-based patient plans for patients, task and bed management; patient and task priority lists; and patient escalation tools. Included live dashboards and a dedicated analysis tool helps users to understand the underlying numbers behind the hospital’s performance.
The Implementation process
The hospital’s Flowful implementation consists of technical implementation and training sessions for the internal continuous improvement team, which then spreads the technical and methodological knowledge to the clinical staff. NHG provided on-site support to ensure a smooth start, followed by ongoing support in the form of coaching, analysis of progress, and instruction on how to drive a continuous improvement process effectively.
The hospital started with a technical proof-of-concept on one ward in late August 2023, and after its successful implementation, Flowful was expanded to a total of ten wards in September 2023. Further expansion of Flowful is being planned for H1 2024.
Results
Within ten weeks of the implementation, the hospital had increased patient throughput (admissions and discharges) by 13% and reduced the average length of stay (LOS) by 16% (~1 day) in the participating wards. This was achieved through increased transparency of delay on the level of individual patients, better synchronization of work, and targeted improvements in two areas causing most of the disruption and delay. The financial value of the improvement is estimated to correspond to £ 4,000,000 annually.
Flowful shows there is still potential to improve bed availability by 30% (~2500 bed days per month) and patient throughput by 36 %. This is being pursued through a focused process of ongoing improvement.