joined up information systems to reduce wli spend and improve theatre efficiency

Joined Up Information Systems to Reduce WLI Spend and Improve Theatre Efficiency Nuffield Trust Seminar

Perran Pengelly – Newton Europe Ltd

Ganesh Suntharalingam – North West London Hospitals Trust

Agenda

• Background to Newton and NWLH

• The Project and Goals

• Improving the Booking Process

• Live Theatre Information

• Lessons Learnt

Newton

Automotive/ Engineering

Defence & AerospaceConsumer

Deal Advisory

IT Services

Supply Chain Improvement

Operational Improvement

Core Sectors Healthcare

Page 3

Newton – Introduction

The Structure

Brief History

• Operational & financial performance improvement specialists • Deliver rapid, real, and measurable results, guaranteed • Improve efficiency and quality of care while reducing costs • Front-line focussed, integrating with client teams to transfer skills

to the organisation and embed sustainable improvement • Over 85 fully employed consultants (highly qualified engineers)

Strong Annual Growth

Example Clients

Example

NHS Clients

0

10

20

30

40

50

60

70

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

Head

coun

t

North West London Hospitals Trust

• NWLH is one of London’s largest Trusts caring for more than half a million people

• Three hospitals – Northwick Park, St Marks and Central Middlesex Hospital

• 18 operating theatres

• International referral centre for colorectal disease

• Quality of service rated as Excellent by CQC

• Strong emphasis on education of undergraduate and postgraduate students

The Project and Goals

Pilot project in Endoscopy

Theatres Improvement Project

An initial project was undertaken in 2009 to reduce WLIs in Endoscopy clinics

Improved booking processes and increased utilisation allowed all weekend lists to be absorbed into core hours

WLI spend cut by £240k

A full scale project undertaken in 2010 with aim to

• Improve theatre utilisation

• Reduce WLI spend

• Increase clinician involvement in booking

• Improve patient safety

This would involve

• Organisation wide changes to booking processes

• New theatre data capture

• Engagement and training with clinicians

Restricted ease

to accessing

WLI

Increase in

visibility of

available

capacity

Increase in

session pick

up by 25%

(4.9 sessions

per week)

Increase

in theatre

utilisation

Reduction in WLIs run (per week)

Project Results - £900k Reduction in WLI Spend

20

30

40

50

60

70

80

90

100

110

4 5 6 7 8 9 10 11 12 4 5 6 7 8 9 10 11 12

# S

es

sio

ns

Cancelled Sessions Not Picked Up

Waiting List Initiative Request Form

Consultant SpecialityDate WLI Required WLI Length (Hrs)

WLI Type (eve./wkend) Request by

WLI Session Details

Patient Name Hospital Number

Reason for WLI? Can Pt. be transferred to

another consultant/list?

Breach/Urgent? Medical?

e.g. Mr Adam Smith H4028323 DD/MM/YY

YY specify Y/N

Are upcoming lists fully booked?Can any other pts be

moved without breaching? (y/n)

List Date % Booked1st2nd Has all leave been covered?

(y/n)3rd

Spend on Inpatient WLI (per month)

Transfer of

theatre

capacity

between

specialties

Defining Utilisation AM PM

Early Start Late Start Turnaround Early Finish Late Finish

All Day List

NWLH Theatre Utilisation

Improving the Booking Process

Process Overview

Plan

On The Day

Review

Outpatients Scheduling Pre-assessment Theatre slot

Operation day

The Booking Process

Cancelled Sessions

Booking Overview

Session Details

Suggest Patients

Utilisation Meeting Report

Operation

Consultant View

User Task List

4 Weeks 3 Weeks 1 Week

Custom software developed that takes data from PAS to support the booking process • 4 weeks before session – Hospital opens up cancelled sessions to other specialties • 3-1 weeks before session – Under-booked sessions are filled by schedulers • 1 week before session – Sessions are reviewed at Session Booking Meeting

Developed with end users to ensure application is easy to use

0 Weeks

Cancelled Sessions

The Booking Process

Cancelled Sessions

Booking Overview

Session Details

Suggest Patients

Utilisation Meeting Report

Operation

Consultant View

User Task List

4 Weeks 3 Weeks 1 Week

Custom software developed that takes data from PAS to support the booking process • 4 weeks before session – Hospital opens up cancelled sessions to other specialties • 3-1 weeks before session – Under-booked sessions are filled by schedulers • 1 week before session – Sessions are reviewed at Session Booking Meeting

Developed with end users to ensure application is easy to use

0 Weeks

Booking Overview

Booking Overview

Booking Overview

Suggest Patients

Suggest Patients

Suggest Patients

Suggest Patients

Suggest Patients

The Booking Process

Cancelled Sessions

Booking Overview

Session Details

Suggest Patients

Utilisation Meeting Report

Operation

Consultant View

User Task List

4 Weeks 3 Weeks 1 Week

Custom software developed that takes data from PAS to support the booking process • 4 weeks before session – Hospital opens up cancelled sessions to other specialties • 3-1 weeks before session – Under-booked sessions are filled by schedulers • 1 week before session – Sessions are reviewed at Session Booking Meeting

Developed with end users to ensure application is easy to use

0 Weeks

Live Theatre Information

Process Overview

Plan

On The Day

Review

Outpatients Scheduling Pre-assessment Theatre slot

Operation day

Live Theatre Information

• Different systems existed in each hospital

Need one common system that allows easy reporting across the Trust

• Custom software created to record key information

• Installation of touchscreen PCs in 31 theatres and anaesthetic rooms

• Clinical input and training for all staff

Touch screen in anaesthetic room

Large screen display theatre activity

Theatre Input – Real Time Patient Data Recording

Touch screen in operating theatre

Touch screen in recovery

Live Theatres

Live Theatres

Live Theatres

WHO Checklist – Sign In

WHO Checklist – Sign In

WHO Checklist – Sign In

Live Theatres

Live Theatres

PASplus+ Live Theatres

PASplus+ Reporting

Restricted ease

to accessing

WLI

Increase in

visibility of

available

capacity

Increase in

session pick

up by 25%

(4.9 sessions

per week)

Increase

in theatre

utilisation

Reduction in WLIs run (per week)

Project Results - £900k Reduction in WLI Spend

20

30

40

50

60

70

80

90

100

110

4 5 6 7 8 9 10 11 12 4 5 6 7 8 9 10 11 12

# S

es

sio

ns

Cancelled Sessions Not Picked Up

Waiting List Initiative Request Form

Consultant SpecialityDate WLI Required WLI Length (Hrs)

WLI Type (eve./wkend) Request by

WLI Session Details

Patient Name Hospital Number

Reason for WLI? Can Pt. be transferred to

another consultant/list?

Breach/Urgent? Medical?

e.g. Mr Adam Smith H4028323 DD/MM/YY

YY specify Y/N

Are upcoming lists fully booked?Can any other pts be

moved without breaching? (y/n)

List Date % Booked1st2nd Has all leave been covered?

(y/n)3rd

Spend on Inpatient WLI (per month)

Transfer of

theatre

capacity

between

specialties