Cambio’s May 2022 Patient Flow Summit – Feedback

Initially published by Distilled Past as ‘Patient Flow Strategy for Covid Recovery’

Cambio UK hosted their Strategic Patient Flow Summit in Belfast on May 19th with resounding success. For the first time since the pandemic began, the event brought together professionals from across the healthcare sector, from NHS C-Suite to next-generation digital teams, to discuss best practice and build patient flow strategies to support covid recovery. Keynote speakers included a wide array of specialists from Genomics leaders to acute care consultants.

Mark Thornton of Cambio UK commented:

‘I would like to thank all of our users for sharing their experiences with PFM and how our solutions have positively impacted patient flow in their settings throughout these incredibly challenging times.’

It is clear that improving patient flow lies at the heart of rising to meet the challenges of the post-pandemic healthcare landscape. Cambio’s Patient Flow Manager (PFM) has been integral to flow improvements in a number of NHS organisations including Chesterfield Royal Hospital NHS Foundation Trust, the Health and Social Care Trusts in Northern Ireland and recently the South West Provider Collaborative.

Patient flow strategy

Although life has returned to “normal” for many, the pandemic has left a lasting mark on the healthcare system. Patient backlogs have reached previously unimaginable heights and ‘catastrophic’ delays in treatment continue to make regular headlines. With the NHS fighting each day to recover from the pandemic’s impacts, any second that can be regained counts.

Traditional systems comprised of paper, spreadsheets, and whiteboards have not been able to keep up with the ever-changing needs of hospital teams during the pandemic. Wards have been regularly repurposed, staff re-assigned, and resources re-allocated – all opening up opportunities for data and vital patient information to fall through the cracks.

At Cambio’s Strategic Patient Flow Summit, consultant in acute medicine Dr Gareth Lewis spoke about the patient flow in acute care at Antrim Area Hospital. Here, the Intensive Care Unit moved seven or eight times during the pandemic, necessitating the relocation of everything from staff to equipment, presenting challenges of keeping tabs on where everybody is at one time.

Despite the stresses of the pandemic, staff worked well together to complete these reshuffles, but morale alone could not fix these huge logistical challenges. Thankfully, the trust had PFM in place to make managing this considerably easier:

‘PFM meant it was easy to rename wards and change patient locations. It was invaluable in containing the chaos and it gave staff and patients confidence that we knew where people were, who needed to be seen, and where they were with their admission. It was always a little bit of light in the darkness.’

PFM has the potential to improve quality of care in the long term by streamlining patient flow within care settings as well as reducing the time between admission and discharge. In terms of the wider picture of NHS post-pandemic recovery, this has the potential to help trusts tackle their current patient backlogs.

Delayed discharges and out of area placements

The number of people in hospitals who are medically ready to be discharged has been growing steadily, with rising long stays and delayed discharges expending valuable time, space, and energy. Reducing Length of Stay is an integral part of improving patient flow across the NHS, and only through powerful flow management solutions such as PFM can this be achieved.

Delayed discharges have contributed to a rising number of out of area placements (OAPs) which see patients being placed in hospitals that are potentially hundreds of miles away from their homes and support networks. This is a challenge that speakers Dr Jason Fee & Anne Forbes are intimately familiar with.

As part of the first wave of Provider Collaboratives, they were given the remit of redesigning and providing all forensic mental health services for people from the South West of England. As they began to explore where things could be improved, it quickly became apparent that there was no standardised idea across the south west of what made somebody in need of forensic services:

‘We saw the need for a single point of entry that enabled providers to make standardised decisions on who was appropriate for forensic services. Cambio became that single point of access and also became the single point of access for referral and assessment.’

Forensic mental health demand has grown significantly during the pandemic, making solutions to this problem more vital than ever. OAPs are heavily relied upon to meet the growing demand across the sector, but they are expensive and disruptive for patients – which can in turn lead to poorer outcomes. On top of this, they incur significant costs for providers. With clear oversight of patient flow within an individual organisation and across the entirety of an ICS, these OAPs can be significantly reduced. In fact, Cambio was recently able to support the South West Provider Collaborative in reducing its OAPs from 200 to 40 – a total reduction of 80%.

Data-driven improvements

The pandemic has given teams a licence to make some much-needed changes. The changes made during the pandemic will shape the future of care delivery and have proven what is possible when old ways of working are truly evaluated for their efficiency and adjusted to better suit the needs of clinicians and patients.

‘Unless you are able to measure something, you don’t know where you’re getting better or getting worse, or if a change that you’ve made is leading to an improvement or deterioration,’ commented Dr Gareth Lewis. ‘Without data, you are kind of flying blind – you only have opinions, feelings and individual experience.’ Using PFM to capture data on patient flow in a meaningful numerical sense opens it up to improvement, analysis, and investigation.

Improving flow is so often about communication and making sure that everybody involved is comfortable, on the same page, and on the right track. As such, a single version of the truth is essential.

The evolution of Cambio’s PFM

Nigel Austin, CIO of Cambio UK, spoke about the journey of developing PFM into what it is today. Regularly improved based on user feedback, PFM was created to support an obvious pain point among hospital staff: endlessly juggling paper notes, chasing down referral forms, and tackling heaps of admin that slow down even the most efficient members of staff.

The Cambio team believes that simplicity at the point of use is absolutely the best option; the more time that can be saved on admin, the more time staff have to spend working on the parts of their roles that matter. Nigel Austin commented he is proud of what the team has created, but noted that ‘such a simple tool’ bringing so much benefit to its users is ‘a sad reflection on the state of existing health IT infrastructure.’

Existing infrastructure has largely been centrally commissioned, resulting in systems that are designed to meet the needs of larger specialties. This has often left smaller specialties – such as genomics – stuck battling systems that aren’t suited to their needs. Speaker Dr Shane McKee and his team at Belfast Health and Social Care Trust (BHSCT) worked with Cambio to create the GenOCEANIC module which gave the team a way to query the genome and work with it in a meaningful clinical way. Backed by Cambio’s Clinical Decision Support module, this tailored solution helps them streamline the triage process and structure genomic test requests.

Based on the understanding that healthcare solutions are not one-size-fits-all, Cambio’s solutions are fully customisable to the needs of each organisation, helping them meet the needs of the unique patient populations they serve.

One of PFMs greatest strengths is how quickly changes can be made when needed. When Covid first struck, South Eastern Health and Social Care Trust very quickly realised that they were going to need help to manage it. They raised a request to Cambio on 11th March 2020; on the 12th, Cambio put the first iteration of the changes into their test environment; on the 16th, it went live. This responsiveness has made Cambio an ideal partner in the ever-changing landscape of the pandemic and will be extremely valuable as trusts work to overcome their backlogs.

One major takeaway from Cambio’s Strategic Patient Flow Summit was that, while many of the challenges facing the NHS are present across the organisation, the extent of these challenges varies between trusts and specialties. As such, a move away from central commissioning and towards the procurement of tailored and flexible solutions will be essential in building a patient flow strategy that will truly benefit the entire health service.