TeleTracking UK and Proud2bOps hosted a webinar on 30th January, to discuss how operational platforms can reduce length of stay. The webinar featured Sally Foy, Director of Operational and Nursing Flow at Maidstone and Tunbridge Wells NHS Trust and Carl Davies, Solutions and Strategy Director at TeleTracking UK.
Learn more: TeleTracking.uk
Stff um our webinar um on uh length of day um and sorry could we just go back to the previous slide there we go yeah sorry um I think there might be a delay thank you um so we’ve got a length of day webinar today and Mum tumbridge
Worlds are going to be presenting to us I’ve had a look at the slides and they look excellent we’ve got some really great practice to to share and hopefully to get some of those cogs wearing um so my name is um Rebecca dunkley I’m here to cover for Emma who’s on a very
Well-deserved holiday and um has asked me to chair this session uh my background is operational Management in community services and um we do a lot of non-elective stuff um and I’m really excited that this Series has kicked off because I know the success of the sharing elected stuff has had and I’m
You know equally excited to see what we can share in in this in this field so um we’re going on to introduce other people here that we’ve got um as part of the team so I’m going to pass over to Lindsay for a quick intro thank you Rebecca and apologies
For my voice um I’ve lost it somewhere over the last few days so my name is Lind I’m a project manager with NHS Horizons um and work with various other colleagues on the Proud to be Ops program so it’s lovely to be here with you all
Today thank you Lindsay um and um I just also wanted to point out that we’ve got um I guess part of the uh the that we’ve got on our fourth slide I think there might be someone with your mic on I can get a lot background noise so you could
Just check you’re muted thank you that’s really helpful um so I just wanted just to share with you um what we have already showcased as path of sharing non-elect stuff and what we’ve got coming ahead so you’ve got date for your Diaries here um we did virtual Awards um
On the 23rd of January so that was lead teaching hospital and um if you want to get some of the slides or get information I’m sure if you just put it in the chat that we can make sure you’ve got the the content um we’ve got length
Of stfe day um impatient flows on the 29th of February and that’s being presented by our colleagues at East Lancashire hospitals um and that we’re going to listen and understand about how improvements have been made to flow and then our next item on the on the
Calendar is on the 5th of March and that’s single point of access and that’s by sanell and West Birmingham hospitals um and there will’ll explore opportunities around the single point back there so um I’d like to thank uh teletracking who are also part of today’s session and um are with us here
On the call so um just wanted to go through our values and behaviors um prior to Bops is a network that um is is all around having safety uh psychological safety in particular so trust respect um compassion we’ve got mentorship um ac across the the network and we value inclusion and
Diversity uh we’ve got our value around um development and being open and curious to learn um to generate ideas so sharing uh this this type of um session uh and Leadership and Improvement and finally recognition where we focus on positivity passion we celebrate the good stuff um we have energy we reward and
Above all else I know Emma wants us all to have fun so um I guess if we just maintain those ethos um and and you know remember that that’s why we’re here but on to the next slide just a bit of a background so some of you may be new to
Proud to the Ops um or just may be wondering where we’re up to um 15 members started around October 2017 primarily focused in the Midlands where Emma founded the network and I guess if you can just see that sort of spread on the scale um we’ve got over 1500 members as at December
23 and um you know really rich and diverse Network now nationally um the color codes there are around the local Regional networks that we’ve got um and now there is one in every single part of the country so um on to the next slide so
We’ve got a QR um code for you to um scan so I’ll leave that on the screen um just a little bit um just so you to get your your phones out if you need to and um this is a good example I guess of Ops innovation in the non-elective space so
If you want to share anything with with us then please scan the QR code and and get in touch um because we really want to hear about what’s going on out there I’m based in community and I’m really Keen to hear about what’s going on outside of theuts um because I know
There’s lots of really rich stuff going on out there and it would be great to hear from from you all okay I think we’ve had that there long enough so we’ll move on to the next slide um so we’ve gone through um some of the sharing non-elective stuff series
That I’ve listed just a few slides ago but we’ve also got the following items we’ve got training sessions um and then sessions that are targeted around other um areas so emotional well-being and um and sorry wellbeing and emotional Fitness we’ve got an engagement session in February as well there’s some
Learning and Development sessions um around data information and financial management so this has come around um there’s been discussions around the literacy of operational managers and being able to support the newer operational managers who maybe have had a bit less input particular around covid
Uh and that came out at our um a big exec event that we had at the end of last year and certainly Amanda Pritchard has mentioned that her her wish is to sort of really focus on that kind of bread and butter skill set for operational
Leaders um and then into May we’ve got an inperson event so please put that data in your diary and um put a hold in there so um when we hear about the venue um I’m not yet sure where it’s going to be but we do try and spread them around
The country so that we get equal access and then in November 24 a bit further ahead um we’ve got our annual Congress and awards which I believe is our first one so we’re really excited to see that in the diary and hope you can join us for that as
Well okay so I’ve done enough talking um please use the chat um as you have been doing to sorry I think someone’s accidentally muted me because possibly um somewhere else but um I was just going to say please use the chat um um for for live
Q&A um save your questions for hands up at the end if you prefer a hands up approach um and I will hand over D and Carl to introduce yourselves and take over thank you um I’ll start Carl should I um so I’ve also got a technical Gremlin so I
Can’t see what you can see so I am moving the slides along myself so apologies if it comes across as being a a little bit um out of sync um so I’m I’m going to move on to the next slide because we can cover off the next slide if that’s okay with
Everybody okay okay so um first of all thank you very much for taking the time to join this um if you’re anything like us it’s a busy time of year challenging time of year so I think that t tracking um and mtw um would like to thank you
For taking the time to come and listen to some of the Innovation that’s happening um particularly um with partnership between telet tring and uh Maidstone I Sally Foy I am a nurse um by background as you can see um but for the purposes of this presentation I’m going
To call myself an Urgent Care um director which is my job title but first and foremost um I am a a nurse Carl will be able to introduce himself my background is obviously nursing and operational flow for many many years um too many years to to talk about really
Great thanks s um yeah just to say I’m I’m KL Davis I’m the solutions and strategy director for tet tracking Technologies um I am actually a clinician by background as are many of our our team um and I worked then for about 10 years in operational strategic
Roles through acute icbs ics’s um before joining T tracking a couple of years ago um to help with this kind of mission of supporting acutes and and the community with patient flow Improvement and Productions in L of State okay I’m I’m moving on the slide now I feel like I’m in control
Uh okay so um I’m going to give you a really quick overview um of M and suage Wells so you know what we’re we’re talking about um so as you can see on the slide we are a large acute trust um down in Kent we’ve got two uh main acute
Sites um masstone hospital and tumbridge Hospital tdge World Hospital interestingly both with um uh fully functioning itu and both with fully functioning Ed departments which is is quite unusual um they’re about 20 minutes apart 25 minutes apart um and we are very used to transfer in patients
From hospital to hospital to to support our um operational operational flow um we see probably about 750 uh patients a day across um both of our sites um and we are also home to the uh Kent the large Kent oncology center where we service about 1.9 um million um patients
We’ve got 700,000 staff um and um and yeah that’s probably it uh yeah call want to yeah so um T tracking essentially are a a company that’s 30 years old and and has a strong history in terms of working supporting um acute hospitals mainly and then broaden out
More recently into uh more kind of system based Solutions we have a large footprint in the US but also through Europe and around um 30 contracts in the UK with around five of our Command centers uh coordination centers in the UK um so we work with key Partners across the UK on
That we range from a a a a large number of single point products that we then combine into a series of solutions that tackle some of the key issues around patient flow fundamentally um and so what you’ll hear about today is how we’ve kind of combin find a number of
Those single point solutions to support a care coordination Center um how that’s kind of benefited the staff and the patients in terms of the ways that they may work the importance of the partnership between telet tring and and mtw and and how that’s kind of evolved
And where that will go in the future and then how we’re looking to broaden that out to support the more system based working and the recent developments around that um and our role in in doing that so um yeah look forward to the rest of the presentation
Okay so just as an example of where we go and how we support when we started with MCW you you may all recognize the kind of historical way of managing the communication of information across the system as to current state situation situation awareness was based in in sort
Of pen and paper and people physically chasing information around the system and what that does is introduced consistent pressure within the system and has a negative impact in terms of the way we kind of continue through activities so we had a loss of um bedtime so when we talk about bedtime
We’re talking about the time between one patient um leaving a bed and the next patient entering we call that a lost bedtime um and then impact on length of stay patients were staying longer than they needed to for um activities that we could expedite through improvements in a
Range of workflows that obviously added increased administrative burden there was decreased use of optimization of operational staff and so it resulted in a lot of pressures across the system that need be there that were adding into the daily workflows of the staff and the conditions um in the system and that
Then obviously had a significant impact on a range of key indicators around performance RT impact on the Care Quality um and patient experience so what we did is the first phase of work was to look really at how do we make some rapid improvements that benefit both staff and patients in terms of
Where the greatest pressures lie within the system um so we can go to the next slide this I think is perhaps the easiest way for people to visualize how we have the impact and I think what we wanted to do today is talk about how technology can be enaer for improvement
And organizational development and change and actually releasing value from the system so there are two main areas that we try and focus there’s the time the patient spends in the bed so the length of stay and I’m not talking physically in the bed just about the
Length of stay and the time out of the bed between those patients and and we refer to that length of stay as everyone does and the idle bed time or the Lost bedtime between that and what we do is we have a range of single point Solutions then that can provide support
For a range of different workflows across the system so whether that’s the time that the patient spends in the Ed how long it takes us to allocate beds portering or movement of patients or equipment to support patient flow um board and Ward management time and the
Way we function on the ward to help patients Move Along their Journey um whilst on the ward and then around the discharge processes themselves and how do we then automate and improve those processes and support bed cleaning along the way and so what we do is we start with the workflows first and
Foremost it’s around thinking about where does the current way of working add pressure into the system what are those workflows look like and how can we improve them where we can improve them and automate them we will do so where we can make them more streamlined we will
Do so but it’s all built around trying to release the pressure from the staff now what’s really really important on this is that that time that we release from the system can be used in a number of different ways we know that and that’s really about a leadership
Decision around how that Improvement in Effectiveness we’ll call it um can be used and huge credit to mtw because what they continue to do in partnership with us was look at how they use that time to benefit more broadly the organization and so they looked at the Quality improvements the performance
Improvements and really the cost improvements came second and we know that we they will shortly follow if we need to but it was really much driven by quality uh and performance Improvement and so they’ve managed to reallocate that time that’s been improved to Key activities around performance and
Quality improvement and then we have committed to a long-term partnership both parties to continue cycles of change for the foreseeable future until we continue to release benefit and improve um so there’s some big Visions for the future which we’ll allude to later but let Sally just talk about the
Kind of impact that it’s had on the shop floor first and foremost next slide always some on it’s never normally me um okay so I think that anyone in Ops will will recognize what I’m going to talk about now um so prior to T track in and and that
Partnership um we had escalation wards that we opened in probably November and didn’t close until June um they weren’t funded there was a obviously a financial um issue around that but also a quality issue they were poorly starved with not subst Ive staff um and that caused
Caused us a problem for many many years I think what one of the things that we’re proud of is that for the last three years um this year well we’re not in March yet but we have closed already some of our escalation beds we have
Managed to hold on and not open any of our escalation beds until probably I think about the 7th of January um and we are which which was 45 beds um we had been able to kind of crew over the Year by not escalating into them because of
Um our improved performance and we’re on track to close all of those beds um by the end of March you know we’re in February and we’ve already closed um 2third of one of our escalation wards that we were unable to do um previously um everybody has seen a um
Growth in Ed uh so like most of you we’ve seen a 20% increase um in um Ed growth um and the saving of 15 beds per day has actually allowed us to manage that increase in Ed without having any significant effects on Flow um and and outcomes for
Patients um the other thing that you will recognize all of you in Ops is that um historically um every winter a surgical Ward or certainly for mtw a surgical Ward was almost turned over um into a medical ward um so it was difficult for um electives to continue in the same way
That they do throughout the rest of the year um for mtw in particular um we had a large turnover of nurses nurses just did not go into to work in surgery to look after medical patients um and as I said we had a large turnover of surgical
Nurses um and we’re very pleased to say that we have now recruited and we’re retaining them because we don’t have medical outliers in surgical beds I think the most we’ve had thus far this winter is about nine medical patients um sitting in surgical beds in fact quite
Often it’s the other way around um surgical patients are sitting in um in in medical beds um I won’t boy you with all the details so uh the effective way of working so we have um with the introduction of Tey tracking um introduced a care coordination uh centor
Um if any of you get the opportunity to come to mayone and look at it please do um it’s a collocated area where everybody that has a part play in flow is collocated so um if we needed a bed cleaned very quickly on more 12 the um
Facilities team are there and can can facilitate that much quickly our integrated discharge team sitting there we’ve got a tactical commander in there that overseas flow for the day um so it’s just really improved the effectiveness of of the way we work here at mtw um we have um much more lifetime uh
Information visibility of information to share at um at Bed meetings um we have got a very clear sop um for our bed meetings and um and tell tracking into links with that really successfully um what we haven’t had previously um I think is a clear visibility of all of our discharge
Pathways pathway 0 1 2 3 it almost used to be like a a bit of a guess work we think we’ve got 10 patients on pathway 3 we may have had 20 we would never know um but with the tracking system um we can now very easily identify a push of a
Button how many patients on each of those Pathways we’ve got and where they’re situated and what that has Meant For Us in terms of improving flow is that we can now have daily ptls so we have pathway zero ptls every day and pathway 3 ptls every other day um
Pathway two uh we’re working on but we never had that TR the one version of the truth um prior to to having um tet tracking um I think I’m a nurse so probably one of the most important things for me to talk about and we don’t
We don’t talk about it enough when we’re talking about electronic bed Management Systems we talk about efficiencies and of course we know with efficiencies comes quality Improv movements but I wanted to be just to highlight some of the things that it has given us in terms of
Quality um much about the pathways um we never had a clue how many patients we had that were being held under mental health section or being held under a deprivation of Liberty section you we we just never knew that again it would be like I think we’ve got 10 I think War 12
Have got two but but we never knew um but what we get now is in my inbox every morning and lifetime a kind of report that tells me exactly where those patients are um which kind of helps us when we’re allocating patients from Ed to make sure that we we’re not
Overwhelming one particular Ward um same with Falls and you know it’s the same with Falls we can very easily now recognize a ward that has had a high number of Falls or patients you know so so it helps um FS reductions um and the other one is um tracho is a next
Breathers um it’s it was quite a problem for us um we never knew where they were people would talk about Acuity of patients and we never knew where I sickest patients was where they were um but now a tou of button we’ve got all that visibility of where our patients
Are and we can then make sure the our Ed patients are placed in the right place the first time because we know that’s that that’s better outcomes um for patients so now I’m saying next slide I’ve got to do myself up not everyone next slide
Um okay I’m I’m not going to um this is this is self-evident obviously with with improved flow um we we we have’t improved um emergency department performance um we continue to be in the top 10 i’ would like to say top 10 um performing trusts um in the country we
Very rarely have 60-minute handovers probably maybe one or two a week um if that um and the interesting thing is is this opal four um so we very rarely declare opal level four and if we do declare opal level four it’s probably on a Monday um after a a tricky weekend but
We recover very quickly so if you look at um us as a system we are um outli in terms of very rarely um declaring um that we are in opal level for um and of course we know the longer patients are Ned um the the higher mortality rate is
So um you know we’re really proud of um the work we’re doing to get our patients out the department quicker um and in line with that our continued um good improvements in terms of um Ed next slide I’ve got to myself okay so I think I I I I I don’t
Think I mean the Carl talked about releas in time um I can’t put my hand on my heart and say these these improvements to talk about now are based on a an electronic bed um system but it is about releasing time for managers are no longer running around chasing Beds which gives them
Head space to do the improvement work which obviously is going to lead to to to these these improvements so you you’ll see there um we’ve got no um long waiting patients um in mtw um and and and haven’t had for about 18 months now that’s allowed us then to then look at
Patients waiting at 40 weeks um and again we’ve got about 60 600 patients waiting at 40 weeks theater utilization um normally about 86% um and our dmo1 position is 97 um% and as I said you can’t correlate that particularly with a with the bed management system but you can with the
Time that it’s released to give people headp space to do the improve work needed to deliver to deliver that those improvements um it’s it’s the same for it’s the same for cancer um we’ve consistently delivered the 62 day referral first treatment um always above 85 um with a backdrop of um incr
Referrals um and since the 28 day the new Target faster diagnosis has been introduced um we are consistently meeting the 75% standard and are working hard to um make further in improvements with that uh next slide mine or mine or yours Carl over to you I’ll chip
In thank you so yeah just to just to run through because I think what we’re trying to say is that technology is never just a single point Panacea for every every problem but what we commit to as part of the approach from tracking is that we recognize the importance of
Understanding on the ground the work that is being done and the challenges that everybody faces um which is why the team fundamentally is driven um by former clinicians or senior leaders within NHS everybody has experience within working within the NHS and and helping understand the challenge that
We’ve got and so what we try and do is say this isn’t about just a technical roll out of a solution this is about how we continue to engage in Partnership along the life of that contract to continue to drive benefit from the system and what we do mtw and what works
Really well is we have consistent conversations around the Strategic Ambitions for the year how does T truck in support and enable those Ambitions and then our optimization team kind of work in partnership with them around how we might maximize the benefit and support those kind of strategic
Ambitions and we’ve got some really good objectives for the for the next year to really push on and drive major benefit from this system so I suppose the first lesson that we kind of put in there is don’t underestimate the technical roll out and the importance of the cultural
Change we talk an awful lot about people process and Technology but quite often Technologies drop in and then it’s kind of seen as it either works or it doesn’t and that that really isn’t the case we’ve got to commit both parties to continue to do that and we certainly make that
Commitment um better understanding of user profiles and roles what we’re in process of doing right now is making sure that we understand each user profile across the whole of the system how do all of those individual workflows need to work for the client how do we support them with easy ways to manage
And drive benefit from the system so what we’re trying to do is is make sure that we drive benefit from that and we better understand the profiles make sure that we understand who the biggest users are where is the biggest impact because I think Zally would say that we were
Most surprised perhaps we thought a certain user might be the biggest user of the technology but we found benefits elsewhere and efficiency came from those areas in this first phase and then as with any system you know there’s a lot of energy to start with people are committed to actually driving benefit
And then that starts to fall off what again mtw to their credit have really well is go back to draw board and say right where have we understood that there may be work arounds people have dropped off with with the process and first and foremost why is that not
Necessarily just to drive it if it’s not working for people let’s understand why it’s not working for people let’s think about how as partners we can kind of adapt and change things make that easier and so that consistent relook to as a continuous process of improvement as and
The technology as an enabler of that becomes really really important um so I mean our key key message fundamentally is that we commit to this as a partnership whenever we do this we don’t see this as a technological solution the reason we come from NHS background is because we care about driving the
Outcomes and the benefits for patients so um I’ll leave there s you got anything to add um I’m just going to say yeah well no I’ll just give you an example of um how we’ve worked together um I think we I won’t go into in detail
But we introduced um some new roles um so the wards gave up a clinical support worker and we introduced um a uh flow coordinators whose sole responsibility in in reality or one of their main roles was to um update um the telet tracking system um livetime livetime so we
Thought that was a good idea um we had a recruitment issue we had a lot of nurse vacancies and thought that was that was the right way right way to go um we have learned subsequently we’ve looked actually that’s great until 4:00 but at 4:00 those people go home um those
People and we have got a problem then with our tet tring performance after 4:00 so that’s what car means around you know we we think we have a solution we review that solution and work atively to see how we can make things better it’s a you know we did circumnavigate the
System these badges that the patients or badges the the watch the badges they’re called badges but they’re like a eye watch that patients um wear um has to be dropped into a Dropbox to get the efficiencies that that automates portering bed turnaround teams etc etc
And to be really honest um they’re a bit clunky car don’t tell they’re a bit clunky and patients with Dementia or patients with challenges Behavior would pull at them pick them off uh and we would we’d lose them so we kind of circumnavigated the system and said okay
For some patients we’ll still get the benefits of using the Dropbox but we’ll put the badge on the patient’s door or on the patient’s Locker or whatever that might be so initially we thought great we’ve got a solution to that but actually one of the next steps for us
With with with our partnership will be tracking patients through endoscopy the cat lab in the theaters and that won’t work the patients need to have the badges on so again we’ve had to go work collaboratively go back to the drawing board and think actually how can we work
Together and come up with a solution that means the badges are easier to to navigate or easy for patients to wear so I think I would Echo what Carl has said I mean uh our relationship has almost started off as a business relationship and ended up almost as a friendship
Relationship we we know we are talking all the time um so yeah that’s probably it for me Carl thank you yeah no great I think it’s a really good example and I think what we what we try to do there s obviously think about how we can help
Tackle that problem we’re looking at different size badges what can we do about kind of rules based systems that might make things easier there’s work to be done with that that that isn’t easy and so we like I said we don’t just kind
Of lead you to it but we um I agree in into of the Friendship it’s been it’s been a really good working partnership and there’s lots to come hopefully this next year thank you I think that is next slide that’s just a picture of the care coordination Center in yeah that’s the
Care yeah that’s the care coordination it’s probably um it’s probably a bit different now what we’ve tried to do just so everyone what we’ve tried to do is the care coordination Center initially was about just about flow um but now we’ve got a quality dashboard in there cuity dashboard so we can actually
Incorporate quality with all of the uh the operational flow conversations that we um that we need to have um yeah it’s probably a bit different now questions any questions thank you so much Sally and Carl um I just wanted to say that that office space looked amazing I’ve noticed
The sort of the the P the foot tracker thing you know the sort of pedler standing desks everyone’s got a massive amount of visibility I mean it looks ideal for what you’re trying to achieve just to keep people on it and uh and moving those patients through so um I’ll
Open the floor to questions so either pop them in the chat to raise your hands I’ve got a couple myself to kick us off if I just pause there to see if any hands come up okay I will kick us off so you’ve mentioned um you know so really
Impressed I suppose just to say with your sort 5% uh performance it must be really nice for staff to come and work in a place where a performance is counter to what we know the national kind of narrative is is always and I think that must have a big impact on
Staff resilience and you know General wanting to be at work and and and be happy at work um I guess I’m just wondering you’ve mentioned some of the unintended consequences around being able to free up operational managers to do some of the other improvement work um and I imagine that was unintended unless
Unless that was something that was sort of explicitly thought about in the beginning but I was wondering what other the sort of strands are you starting to tease out is there anything exciting in in the pipeline that you might want to share that I guess has has been enabled
By the fact that staff can focus a bit more on the rather than that burning building on the more what’s going on behind the scenes yes yeah no that’s fine so I think we um are particularly try I think so what happens is so one of the downsides of
Tet tracking or or not t tracking of a bed management system is that um there’s a there’s a there’s a there’s a loss of social interaction a little bit um you know so uh one patient goes you drop your badge it frees the bed up the beds clean very quickly incomes your
Next patient um and when you speak to um some of the nurses it has released time for them in terms of the phone calls um and all those kind of things but it hasn’t it hasn’t helped if you talk to them and they talk about cultural change
They don’t have time sometimes now to talk about well you drunk last night you know what’s your have you got a new boyfriend you know whatever whatever the kind of social interactions were in between patients um so our next steps we haven’t done it yet Carl and I are
Really talking about this recently is how we can perhaps support the wards with all of our improvements to almost have a 30 minute social huddle or something um because I think we recognize that with technology you do lose a little bit of social interaction
So uh in terms of that I think think we are looking to try and think about how nurses and other users can socialize um in between patients probably Carl anything else that we’ve well I think I mean yeah there’s one there’s one piece on that kind of MDT work and enjoy at
Work and and making sure that we create the space for engagement and interaction that’s definitely one piece then you’ve got the um work around the discharge processes that we’re looking fundamentally about how we understand those Pathways and support those pieces of work there is the IND ual user
Profile work which we we’re working on um and there is the potential outpatient need how do we kind of create use from an outpatient perspective so we’re right at the kind of precipice now of we’ve done that first bit that’s created the space now what can we do that’s really
Exciting how do we support discharge process with something really exciting so as an idea things like delivery of tto into the community so you don’t wait before discharge we’re exploring opportunities around that um and then working with other partners around that how we might enable that um but we’re
We’re very much in the infancy aren’t we s it’s kind of setting up the Strategic boards getting the right governance structure in place and once we’ve got that we can then start to think about the really exciting piece of Works which which really is an exploration for all
Partners you know this is a kind of acceptation is how do we use what we know to drive benefit in one area for other benefits that we might not really understand and do that as a partnership and explore it together so we’re starting off on that journey and I think
In 12 months time it would be really interesting to reflect on what we’ve achieved at mtw again as the second cycle of work thank you that’s really really interesting to hear about um I’ll just um check if anyone’s got any questions to ask um raise your hands or pop them
In the chat uh please um I don’t imagine any question is too sort of small it’d be really interesting to hear what your thoughts are or even if you just want to just find out a bit more about one of the slides that’s already been discussed um so I’m I working community services
And I’m just wondering what the engagement with Community teams has been for safe discharges out and I’m just wondering if you could could talk us through a little bit about that often that’s where the interface of that Handover and the trust of trusted assessor roles and and any other of that
Risk management in the community so we are not um we’re not an integrated um bus so our community hospitals are managed separately um we have um deployed or t tring have deployed the system um so in the community so we have got visibility of the community community beds so that has
Been helpful um I think the um and we’re at the beginning of like everyone else is introducing a transfer of of of care Hub that we haven’t quite got a head around yet um so I think that um we are now much more um cited on community
Provision um have we nailed the trusted assessor model probably not um I would like to speak to anybody who who has got that model um so although we’ got visibility of the beds we still have that to in and fro in you know our physio says one thing that Community
Physio has a different idea so we haven’t actually corrected that however we do have on site Our Community Partners Social Services um and the voluntary sector so we we do integrate in terms of our conversations but in terms of the I would say it’s not a
Slick process at the moment to get our patients out onto a pathway um Pathway to bed um despite having visibility of those visibility of those beds I wish we could I think there’s um there’s two parts to it really isn’t there as well there’s there’s the opportunity to have genuine interaction
Around a single point truth and You’ both got clear pictures and then the time it takes to build trust and start to develop the work that comes off the back of that I think what we’ve done in the first instance is create the opportunity for the interaction make
Sure that we’ve got a clear sight of the right picture so that there’s no kind of bounded rationality both part both parties aren’t arguing over um what is true and what isn’t and what you see locally is a really good relationship between those Partners I mean we have
Very little interaction with you guys but from what we do we seen really good interaction between the two of you and a really genuine commitment to improving that part of the process um and so I think it’s going to be really beneficial we’ve started the process there as we
Have in some of the sites but um it’s again it’s a development as we broaden that out to kind of what we call boundaryless Beyond The Four Walls of the acute into the community Sport and ICS Vision essentially I think I think what is what is positive is that um we
Are now that that kind of partnership is spreading out to our community organizations we are doing a collaborative piece of work aren’t we car to kind of unpick um all those pathway delays um which we wouldn’t have been able to do previously I don’t think
So um we were on a journey with our um discharge pathway improvements I would say thank you that’s really really useful to hear and and I’m glad you haven’t cracked it because I certainly don’t know anywhere that’s correct The Trusted assessor model um actually Lindsay would you mind if we stop screen
Sharing and then I’ll bring Jenny in please um and just look out in the chat as well for any questions thank you Jenny thank you and thank you for your presentation yeah I’ve worked in one place that’s had an electronic sort of bedboard system and one place that
Hasn’t and it’s yeah it’s very different isn’t it um I was just going to ask about data quality um obviously what you are seeing in your screens in your control center is only as good as the data quality that people are inputting at Ward end Ed end um and I know that
You sort of said about your flow Navigators going up four so is it the nursing staff that input that data um and how how do you I suppose get assurance that everyone is putting that in in a high quality way so that the decisions you’re making in the control
Center are accurate if that makes sense no no it does um and um you’re absolutely right the majority of that information is inputed um by nursing staff whether that be Ed or or in the ward areas um and we have struggled at times um we’ve struggled at times to um
Assure ourselves that the data that’s being entered is correct there’s no Point pretending that from day one that data was was correct what we’ve had to do is kind of man it sounds really aric but um we have got groups of an integrated discharge team as an example
Um they keep a manual record still of their number of patients on on each pathway where the nurses are inputting it into tenis tracking and we’ve had to do a correlation we’ve had to actually kind of cross reference for probably weeks at a time to make sure we’re all
Comfortable with the information that was being inputed by the nursing team was um was correct um we’ve also struggled with I think and we’ve probably we’re probably okay now about how we hold people and divisions to account um for their data entry and their compliance with um the telet tring
Requirements so we have got um nursing dashboards divisional dashboards lots of dashboards uh where we’re having user group meetings holding people to account and cross referencing the data that that um nurses and other Allied health professionals are putting in but I think it’s been a labor of love
We have collected the data manually and cross referenced it and uh we think we’re at a point now where everyone’s agreeing that teletracking is the one version of the truth but it’s been but it’s been a long it’s been Jour it’s been a long long journey and people it’s
A real is it it has been a long it has been a long long journey um and I think we talked about Carl talked about cultural change you know this is a whole way different way of working for nurses um and you have to send it to them as
Having a quality input otherwise they’re just not um interested so it’s been a three-year Journey for us and I think we’re at the point where we believe our data to be correct car would you agree also I think there’s a bit of push back isn’t there um that I’ve heard
Before when I’ve been in organizations that used it that we’re asking the nurs and staff to input this data and actually like you just said they have less downtime in between like literally that bed doesn’t get cold does it so they are constantly running at 28 patient
Awards did you have to adjust Staffing at all for that no we we didn’t adjust Staffing I think as I said previously the the wards gave up a band three clinical support worker to to to to do the functionality of the um the the the flow
Coordinators um I think that we if we we didn’t go into details on Lessons Learned but the lesson learned for me was that um that particularly for nursing staff we we introduced um electronic bed management as an efficiency as an efficiency program of work um and you’re absolutely right
Jenny for nurses I’m a talk about efficiencies it doesn’t mean much it doesn’t mean much to a nurse we care about is that patient going to get fed today is that patient going to have you know whatever so we had to kind of really change tank um and we have now
These flow engagement days where we are now talking to nurses about as I said to you previously the the out the quality elements we didn’t talk about initially with the roll out but now we’re able to quantify quality outcome for patients um it’s easier to get that engagement from
From nurses but a lesson learned from me I I say I say it to everybody was don’t talk about efficiencies to nurses talk about quality um and that’s what we’ve had to do we’ve had to reind of focus our conversations yeah and and I will just
Add so what we I think what we see is a distinguishing feature is we are capturing novel data with tell track it’s one of the the the kind of benefits of that this isn’t data that we’re pulling and scraping from elsewhere in the system so that we don’t have a true
Representation of whether that’s accurate data secondly we then try and make sure that if we can automate it so it doesn’t require human imput to kind we do that we automate that kind of flow of data thirdly you take the workflows and you make sure that these aligned to
Your current workflows so that you can kind of or improve your current workflows and then you can limit additional exposure to the kind of interaction with the system so you can actually say well this becomes a fundamental part of the way we work and it’s beneficial for all parties to
Capture this data so example will be your board round if you kind of updating in a really simple way light touch minimal kind of input way but all of that dat data is captured Ed at Ward base and then fed to the system or cumulatively across the hospital in real
Time those updates that take place you’re getting a constant flow of real time uh information without a constant need for somebody to kind of stay on top of the input because it’s embedded within the practices than it’s a great question Jenny it’s really we’ve di dived over
Really deep into some of those um uh those sort of strands um we’ve got a couple of questions in the chat and then I’m aware that we we’re sort of running out of time so if anyone’s desperate to put a question in the chat then please
Do and and maybe we can do a little bit of a followup if needed um with if people want to reach out to you s and you know as you said you’ve offered visits so um if that’s open um so in experts we like Experts of visits um ing’s question is around um
When you started tracking patients did you notice any Trends so was there some analysis of the data that you were starting to get that might indicate what was happening so why was a to stay higher and and so how did you address that um what you know what was it that
You addressed and then also I guess she’s just wondering is it just an efficiency um you know you’ve just made it more efficient so was there any sort of data that you were able to get some insights into what why was L of stay higher pre intervention as it were than than
Post um I don’t think we have got that data clearly I think that um if you was the first part of the question about tracky patients I didn’t hear the first part of the question what was the so when you were when you were able to start tracking patience did you Noti
Trends tracking a track I was I can talk about tracking patience all day long I’m getting over cold I’m probably a bit nasal so apologies so did you notice any trends when you started tracking the patients that meant that you understood why length of stay was higher or was it just
An efficiency saving things that basically led to the Improvement well I think there was there was obviously an efficiency saving but I think that we all know that getting the right patient in the right place first time will support um a length of State reduction
And I don’t think we always did that I think it was quite easy for us with a pen and paper to say empty bed patient a into that bed I think now we’ve got that qualitative data around us um that we’re able to put patients in the right place
First time much more successfully than we ever were which in itself is probably one of the reasons why we have um reduced our length of stay as I said an outlier a medical outlier in surgery add three days to their length of stay don’t have an outl in surgery that patient’s
Going to go home on a Monday rather than a Thursday so I think it’s about it’s all about getting the right patient in the right place first time um for me would you agree I’m just think yeah absolutely it’s a great point and I think that so that the first phase very
Much was that what were the kind of quick winds that we could deliver where was the the key insights we’d already kind of had an awareness of the second phase of the work is exactly what you’ve mentioned in that is which is let’s get smarter and delve deeper into the data
Really understand it and how can we derive insights from it we can can make some major change to the way we work so um the the package contains a full an analytic Suite so you have all of the kind of core data capture and that will feed into an analytic Suite you can
Manipulate that and and empw um like some of our other partners create their own dashboards and so that they can drive insights in the way that they want to and focus on specific areas and we enable that so that will be the next piece of work as well right maybe you
Can come back and tell us about that once you’ve done that maybe next year um just a final question from Lindsay um who’s asking around cultural change and she’s interested around the roll out of technology and how I guess how did you make it happen because that can often be
A bit of a sticking point with new tech and then getting staff on board with that like I’m taking all the questions now um okay so I I think that um we’ve probably covered a lot of that question I think that the technical roll out was
Quite easy I think it was TW I wasn’t part of the technical roll out I think it was a 20we roll out session um uh so that was quite easy um but as you as we’ve spoke about before getting the users to actually understand the benefits was more difficult um we rolled
It out in covid which wasn’t great because we couldn’t have kind of User Group sessions it all had to be on te um so we missed a bit of social interaction interaction there but I think we have gone back I think Carl spoke about earlier to understand each
User group and what that User Group needs to deliver um to deliver the efficiency that I think we just kind of as an organization thought okay we’re going to roll it out to everybody everyone needs the same training everybody needs the same input everyone need and it was quite generic um so I
Think what we’ve done is had to sit and look at that and understand the user group profile and go meet with user groups and talk to them and engage with them in a way that makes it real to them rather than just rolling out a tech a
Technical system um is what I would say it’s User Group profiles we didn’t understand our user group profiles we assumed that trainer nurse trainer pharmacist trainer Physio and we could we could do it like that but that’s not the case you you need to understand the individual users H
Yeah okay I can’t see any more questions in the chat we’ve got a couple more minutes if anyone is W thing to know more um but I just wanted to say thank you so much Sally and Carl it’s been really interesting hearing about how you’ve managed to sort of do that
Transformation work um I guess you know I’m curious to see how many people just reach out and you know it almost feels like well why would you not do this if it’s working so well so there’s there’s something around um in now a sort of curious mindset around being open to
Learning around thinking you know what what can we take away from this to be able to sort of Drive some of the similar Improvement that you have and you you’ve had a three-year Journey so clearly you’ve done a lot of work around this um so yeah essentially um just
Wanted to say thank you very much um as I said earlier um it would really welcome others if you want to share what you’ve been doing locally and helping us all improve how we deliver for our patients and our staff then please scan the QR code get touch let us know um you
Know what You’ like to talk about and in the past in Sharing elective stuff I know that some trust did get together and they delivered sessions jointly because there was some similarities between the work they were delivering so if that’s you and you want to do that then then please please put yourself
Forward uh we can’t have the content without you but thank you very much um appreciate your time and you’ve got a few minutes back in the in the diary to maybe have a little Comfort break and get ready for your next session I’m sure many of us have to go to but appreciate
It take care bye bye thanks s thanks Rea thanks Lindsay bye