What has now become one of the most exclusive annual healthcare planning calendar dates, The Draper & Dash hosted Executive Patient Flow Summit is indeed a work of art, led by its charismatic and straight-talking CEO and former NHS executive – Orlando Agrippa and his care-oriented team. The summit gathers the best in healthcare from across the country and globally to really solve the patient flow challenges being faced by providers and systems.
This year’s summit was hosted with Sir James Mackey, Ian Smith and Natalie Douglas with a strong focus on transformation. In a discussion with Orlando, he said “this is heavy duty stuff as we are not an events company, however we want the experience for our colleagues to be tangible and explosive – straight talking and getting things done.”
Things to know about the exclusive executive summit – you can’t get in without being explicitly invited, the quality of the content is unmatched, there are no vendors trying to sell you things at booths – no it’s not that type of summit, it is all about creating a positive space for executives to co-create solutions.
The year’s Executive Patient Flow Summit again was fantastic. Lots of healthy discussion, ideas, passionate people and focus. An event to improve patient flow.
Building on last year’s successful event, the 2019 annual Executive Patient Flow Summit created a space for several of the most forward-thinking senior leaders from across the NHS to share, reflect and plan. Over the course of the day, through facilitated group sessions delivered by Subject Matter Experts, participants explored the most urgent and enduring challenges facing Trusts in the current climate.
The group discussions provided spontaneous masterclasses in how to develop initiatives across a range of areas covering: policy, processes, access, quality, workforce, cost saving opportunities, operations, vertical/ horizontal integration and infrastructure. From the discussions held over the course of the day, it is clear that:
- Senior leaders benefit from being given the space to explore, with their peers, the problems they face and to develop new solutions or adapt proven ones.
- The knowledge, skills and experience needed to transform our system already exists, in a large part, within the NHS.
- There are numerous examples of initiatives that deliver transformative outcomes across multiple areas. e.g. a better work environment for staff, improved patient outcomes and better value-for-money for the taxpayer – these should be priorities in any transformation processes.
- The NHS cannot afford to continue doing the same things and hope for a different outcome. Turning insight into action, and action into improvement, requires a willingness to do things differently, learn from best practice and take measured risks.
The opportunity to come together and work with other senior leaders to plan for the future, created an impetus and energy amongst attendees that was palpable. Being able to go back to their Trusts on Monday morning, with solutions to the problems they face daily galvanised a sense of purpose. Perhaps most importantly, the summit provided a sense of renewed hope and confidence in the face of the biggest challenges Trusts have seen since the inception of the NHS.
HTN spoke with GE Healthcare, Attain, Servelec, Ampersand, Synertec and DrDoctor, the summit strategic partners to hear some of the insights and learnings from the day, from the sessions they steered.
Steve Wightman, Sales Director at Servelec, a patient flow and bed management provider, supporting hospital teams to deliver the right care to the right patient, at the right time, hosted an engaging round-table workshop:
“We found that everyone had common issues around patient flow. Because the event was so targeted and focused, that’s what made it really good.”
“As part our discussions we asked each team to consider what are the challenges you are facing with patient flow, what are the barriers to change and then what are the critical success factors we need to have in place to actually succeed.”
“There was a lot of common understanding; such as lack of trust from staff on the ground when making change resulting in the live bed states not being kept up to date. It was agreed that the management of the change when introducing a new patient flow solution was one of the biggest challenges to overcome.”
“One impact, that everyone was in agreement, was the cost of having the wrong patient in the wrong bed.”
“We then started to go through some of the barriers, again there were some common themes. Often people on the wards see a new system is coming in but they do not understand the context of why it is being introduced and the benefits to them on a personal level. Traditionally, people have historically been risk adverse in the NHS, but it’s clear that this attitude is changing and people are rapidly becoming more willing to try new things to fix problems. Everyone seemed very positive, to try something new on the wards, and see if it works or not.”
“We talked about critical success factors – user engagement and user sponsorship to sell the vision of what we could achieve together is critical to the success in implementing any change in the NHS.”
“Another key success factor was to try and take one problem at a time. All too often, organisations try to change too much at once and result in not implementing anything. By focusing on one key area at a time, there is room to review what went well and where we need to improve, then move on to the next problem, leaving users in a position of feeling they are making a difference all of the time.”
“It’s also important to establish who is responsible, who is accountable, who the contributors are and who is going to be informed – so we involve the right people in the right way at the right time.”
One of the partners hosting a round-table discussion, Ampersand Health, a social enterprise committed to advocating for and supporting patient self-management as a sustainable approach to improving health related quality of life and outcomes whilst reducing the outpatient pressures on the NHS, commented:
Jeremy Andrews, Associate Director, Healthcare Partnerships said to HTN “We’ve developed a digital therapeutic platform comprising self-management mobile apps for patients, along with a management and analytics portal for clinical teams. Our platform gives patients the tools and information they need to take greater control over their conditions on a day to day basis whilst enabling their clinical teams to monitor remotely, avoiding unnecessary hospital outpatient appointments and reducing the overall cost of care.”
“The morning session focused on developing solutions to balance access, quality and finance, with the afternoon spent discussing workforce, all with a view to improving patient flow across the system. We felt that there was a fantastic level of engagement from the delegates. We also heard about some great local initiatives and there was valuable cross-fertilisation of best practice and discussions around potential new innovative solutions.”
“We broadly ended up with a consensus to focus on 3 key areas for solutions to deliver better services and outcomes for patients whilst alleviating operational/financial pressures.”
“The first outcome we arrived at was about removing contractual/financial barriers that do not necessarily support collaboration within local/regional systems. Some of the delegates shared valuable insights into how they had tackled this to improve services for patients within their local health systems.”
“The second area was very much about building on local centres of excellence, and then thinking about how to be agile and replicate that success at pace in other services”
“Lastly, collaboration and developing more flexible staffing structures within local/regional health systems was discussed, making it easier for people to flexibly move between services across primary and secondary care.”
“The big thing that came out of the day was ultimately the fantastic insights generated through getting people interacting and collaborating with one another, and we’re tremendously grateful to Draper & Dash for organising and hosting the event and having us along as a strategic partner.”
Peter Hansell, Associate Director from DrDoctor, the company revolutionising the way that hospitals interact with patients to move away from a stream of information to a valuable and responsive conversation said:
“The Draper & Dash Executive Patient Flow Summit brought together an amazing group of people from across healthcare to share ideas and take a fresh look at the opportunities to improve our NHS. Exactly the sort of event that can create real innovation.”
“Together with our friends at Synertec, we hosted a 2-part workshop “From communication to connection”. The theme of the day was to come together to look at the challenges of communication through a completely new lens.”
“We aimed to use creative thinking to design the way information can begin to flow with a focus on the end user rather than a focus on existing constraints. The group arrived at some innovative new concepts with a visible consensus on putting patient needs at the heart of these conversations”
“We were thrilled by the creativity, willingness to jump into a new way of thinking and energy on the day, thank you all!”
Attain, the independent health advisory and delivery organisation to improve health and wellbeing said:
“The Attain team facilitated several workshops throughout the day. Helen Pyecroft, Director and Michael Bewell, Senior Manager, hosted a roundtable discussion on ‘transformation’, addressing where in the system patient flow challenges are and how these can be overcome.”
“The group discussions identified a series of factors key to transforming complex health systems. Solutions that have been proven to work by the experienced NHS stakeholders in the room included:
- Removing the fear to try something different – owning risk and empowering others to give things a go
- Trying something better, if not perfect
- Building a narrative that rallies the troops – something that gives people permission and space to give things a go
- Using data to ensure that everyone knows the daily plan – what do I have to do today to support patient flow?
Attain’s patient flow insights and ways to correct it
Jayshree Badhan, Senior Marketing Manager “Based on Attain’s experience patient flow is about systems, processes and behaviours working together. Our focus is on developing clinical models that support the flow of patients inside and outside of hospital.”
“Our insights and advice includes:
- Understand the dependencies and adjacencies – Patient pathways, like people, exist in a complex eco-system – looking at activity and organisations in isolation can create division and fear. Understand the exam question, the dependencies and adjacencies and develop plans to address root causes, not symptoms.
- Clinical cases for change are the most persuasive to all stakeholders – From patients to Boards; these link to the NHS’ values and are critical to winning ‘hearts and minds’ at every level, across all stakeholder groups.
- Working with partners, but also focus on what you can control – The causes of poor flow are built up over several years, with inputs and impacts from across the entire system. Addressing complex issues as a single organisation will only address part of the challenge.
- Don’t duck the hard stuff – The system and your organisations are complex, asking the difficult questions, challenging norms and red lines requires insight, integrity and courage.
- Use an evidence base – Use your data, your clinicians and your operational staff to understand what is really going on – data and united clinical teams provide the foundation for sound decisions, to which people are bought in.
- Move to action – Don’t wait for perfection in planning a change to pathways; create a case for change, engage the key people and move to delivery and start to change things.”
The team from GE Healthcare attended the Summit to present its Command Centre solution. HTN asked Stephen Verdi, GE Healthcare Partners to explain the benefits of a Command Centre and the insights gained from the Summit:
“In general, Healthcare Command Centres are: (1) teams of people using artificial intelligence around the clock to support the optimal delivery of patient care, (2) hubs to monitor performance, learn and launch improvement programs, and (3) centres of gravity for transparent integrated culture.”
“Healthcare Command Centres can be pillars of high-reliability, lean, and data-driven performance journeys. Technology used in these Command Centres can include: (1) software systems used by each sub-department within the Command Centre such as EMR, scheduling, and bed management, (2) business intelligence tools, and (3) real-time decision-support AI tools like GE Healthcare’s Wall of Analytics™ (WoA). While the physical space of these new departments can vary widely, it should include a “video wall” of LCDs to create transparency and drive improved coordination of care across the enterprise.”
The workshop discussed common problems faced in the NHS and which problems most impacted day-to-day. It used the Command Centre approach at Bradford Teaching Hospitals as an example concept and the team presented 15 example ‘Tiles’ of analytics.
Stephen said “It was clear that many face challenges getting and keeping patients out of the hospital. Difficulty with “Post-Acute Transition” was our leading vote-getter in the room and was the most voted problem for most tables. Many participants flagged the fact that significant proportions of patients in hospitals could be better cared for elsewhere.”
“Visibility or “situational awareness” was another area of opportunity for many in the room, who find that significant resources go into understanding what is happening in a hospital/clinic/care home/department/etc at any given time. A simple understanding of true capacity and projected demand can take a lot of people and time to assemble.”
“Many healthcare providers find themselves capacity constrained with limited or no capital for physical expansion. Looking for ways to be more efficient and better utilise the physical footprint they have.”
“Many identified their organisation as being “data-rich but information poor.” The rapid digitisation of healthcare has left providers with a lot of data that they feel could be put to better use. In some cases significant business intelligence exists, but it can be difficult to pull the “so what?” out of a heap of charts and graphs.”
The team presented its Tile “Gallery Walk”, which helps present how real-time, actionable, easy-to-interpret intelligence could help people better manage their day-to-day operation and to work more proactively.
Stephen said “Most felt that an analytic Tile in the Command Centre that allowed discharge planning teams to see capacity of a wide variety of out-of-hospital services would significantly improve the hospital teams’ ability to plan for placement.”
“Early planning for discharge was also a key element of the solution. An A.I.-powered analytic that could predict discharge date and likely post-acute needs would allow care teams to be making arrangements far in advance, thus avoiding the challenges of waiting to address discharge needs until the day the discharge is meant to occur.”
“Significant discussion at all tables was around the cultural component of a transformation programme like the Command Centre. There was a real recognition that while A.I.-powered analytics are valuable, we will still rely on humans using that intelligence to take action. Wide agreement that the Command Centre programme must address the human side of change (which it always does).”
The D&D Executive Patient Flow Summit brought the opportunity and focused space for executives from across the country and system to collaborate and develop initiatives in response to a number of the challenges our system is facing. We look forward to hearing the outputs from next year’s summit, which we believe is set for June 2020.