Using electronic data to identify bottlenecks in secondary care at weekends and improve patient flow Royal Derby Hospital

At acute hospitals at weekends, severely unwell patients are prioritised and potentially routine tasks often do not occur. This results in less efficient delivery of health care and use of resources compared with weekdays, as important step-downs in treatment are less likely to happen. These delays can increase length of patient stay as the step-downs are implemented on Mondays once regular clinical staff resume ward rounds, and then a period of observation of clinical response is often needed prior to discharge.

For example, data from the Royal Derby Hospital show that the frequency of switching from IV to oral antibiotics is 68% higher on weekdays than at weekends.

This project aims to improve patient flow at weekends by identifying and removing bottlenecks in the throughput of patients in secondary care.

A clinical epidemiological/health economics team will be embedded within the busy acute hospital and routinely collected electronic prescribing data will be used to identify and prioritise potential bottlenecks. These analyses will be used to target interventions aimed at removing those bottlenecks with the largest potential financial savings. Advanced clinical practitioners will provide a weekend ward round to facilitate stepping down of clinical care, at the request of the responsible clinician.

By introducing interventions that facilitate patient flow, length of stay will be reduced, there will be more efficient use of hospital beds, patients will receive more timely treatment and less exposure to the risk of hospital acquired infection, and cost savings will be made.

Contact details

For more information about this project, please contact Dr Nigel Sturrock, Medical Director, at Royal Derby Hospital.