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