In recent years, all the debate about hospital waiting times, queues at A&E and patients struggling to book appointments with their GPs, have made the supply of, and demand for, healthcare services in the UK an especially emotive topic.
That’s why at Ipswich Hospital NHS Trust (IHT), we recognise how important it is that we can predict demand and respond by meeting it quickly. With nearly 30,000 unplanned emergency admissions a year, we face particularly tough challenges in managing demand for A&E services. Indeed, our admissions through A&E have gone up 10% this year alone.
But in plotting a solution, we want to move away from thinking about the hospital in isolation. Instead, we are looking to ‘reposition’ ourselves as a key player in a network of integrated services, set up to meet healthcare demand across the entire Ipswich and East Suffolk community.
In doing that, we need to be working together with our health service partners to look at the wider care pathway. And we need to join forces with them to carefully manage patient flows across all healthcare services from doctor’s surgeries to community nurses to care homes to the hospitals themselves. The key is to clearly understand how this network works, pinpoint when and where things are going wrong and intervene quickly to address issues before they turn into problems.
In doing all this, it is vital that we are able to make better use of the huge volumes of data we have at our disposal. In the past, we relied on spreadsheets to address these problems but they were often difficult to use and we found that we were struggling to visualise issues and get stakeholders involved in the discussions. We urgently needed to find a better way of doing things: an approach that would drive real insight into the issues we were facing and enable us to shape future patient outcomes.
That’s why we opted to run a pilot project which combined mapping and location analytics solutions from leading B2B mapping and analytics company Esri UK, together with actuarial analysis tools. We’ve seen a huge range of potential benefits as a result.
The data gives us such a clear picture of how things are, it has allowed us to talk with patients, clinicians, managers and commissioners on an equal footing. Everyone gets the same information the same way and they can all visualise and understand it instantly – and so that makes conversations move very quickly.
Also, being able to visualise all of our data in a map format allows us to really understand our population – and start designing our services for them. We have been able to get greater insight into where hotspots are for certain diseases, admission methods and average time for treatment.
There are benefits across all areas of the healthcare pathway. Take care homes, for example, they are one of the biggest sources of patients arriving at A&E. So we need to get a better understanding of the level of nursing support in individual homes. By improving the services provided, could we have prevented that care home resident with a minor urinary tract infection from having to make the trip to hospital in the first place?
We also see a lot of elderly frail people still living at home coming to A&E with low level ailments. Often they are not treated as being high priority and they often have to wait several hours before being seen. So, could we be collaborating to ensure more money is invested into community nursing or GP practices or even the ambulance service that could allow those patients to live and be treated at home for UTIs, dizziness or falls, for example? Once again, that’s a question that Esri’s mapping and location analytics capability could potentially help us solve.
Resourcing is another area of potential benefit. If the solution tells us demand is likely to be high on certain days of the week, for example, we may be able to bring in more clinical staff to meet it and therefore alleviate resource pressure. This could help minimise costs while maintaining performance and clinical standards.
At the moment, this remains an R&D project but we think there are some exciting opportunities here. Using the Esri solution has highlighted a different way of looking at our organisation, and the demand pressures we face as a key element in a wider network of healthcare services. In addition, it has demonstrated the huge potential of looking at demand from a population rather than individual attendance basis.
It also allows us to try out ‘what if’ scenarios. In short, it has given us a whole new platform for discussion and changed the conversation at board level and beyond to focus on moving to a more sophisticated way of visualising and reporting data. The IHT board has even requested that geographic information and location is included within its business intelligence strategy.
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And looking forward, there are some clear future benefits for patients. We can pool resources with other healthcare providers and start to forecast where in the community there is likely to be the greatest incidence of certain illnesses: from diabetes to heart disease and therefore where services need to be placed to best meet demand. We can turn complex data into very accessible data that everyone can understand and we can then start to scenario planning.
Ultimately, the solution has the potential to change the whole healthcare model, moving us away from a traditional supply led service where we create new capacity and that capacity gradually comes under increasing strain to a new approach where we try to understand and influence the demand on a service and use the insight gained to keep patients healthier longer.
Sourced from Paul Scott, director of finance and performance, Ipswich Hospital NHS Trust