Breaking Down Silos and the Bed-blocking Challenge

Providing safe, quality care and a positive patient experience are ongoing challenges, compounded by demand, staff availability and constricted budgets.

To prevent hospitals from delivering fragmented care, clinical services need to be patient-centric and connected to operate seamlessly throughout the patient’s journey. When these complex processes are managed in operational silos, without visibility across the whole enterprise, hospitals are more likely to lack care coordination – leading to ongoing bed-blocking and poor flow.

Here at Cerner, we know that technology can help break down some of these silos that exist in hospitals and address workforce, bed management (patient flow), patient tracking and care coordination. Our vision, shared by many organisations in the NHS and around the world, means working in a more integrated model to allow hospitals to deliver the right care for their patients, by the right caregiver, at the right time and in the right place.

Centrally managing throughput and length of stay

Keeping visibility of current demand and bed availability, as well as tracking patients using technology and operational dashboards, are essential tenets of efficiency. They enable hospitals to predict demand peaks and capacity issues and make necessary adjustments.

Having complete real-time visibility of capacity and bed status at enterprise level results in an optimal patient experience and safer clinical decisions. Connecting clinical, patient and staff skill information, coupled with the right technology, allows hospitals to compare expected versus actual clinical progress for each patient, from admission to discharge, predict each patient’s length of stay, and identify potential blockages to patient flow.

Clinically driven decision making = better staffing decisions

Turning clinically driven data into an informed workforce management decision has huge potential to improve safety and efficiency. Rather than assuming all patients require equal care, organisations must leverage nursing and clinical documentation from an integrated electronic health record (EHR) or clinical systems to paint a picture of each individual’s care needs. Only then can patients truly receive the appropriate care based on their current acuity level and dependency. The most effective staffing and operational decisions will be those based on the real-time evidence from the EHR, supported by intelligent predictive algorithms to highlight patient need, and upcoming pressures.

Real-time location services

Visibility of real-time location information enables staff to react quickly to deliver safer and streamlined care. Tracking a disorientated patient with dementia, for example, who has left their room will trigger alerts that can help staff act quickly to prevent adverse events. Similarly, quickly locating portable equipment when needed in emergencies – and eliminating ‘safari’ rounds – means more time to care, and helps address challenges with patient flow and workflow inefficiencies.

The complete picture

One method to address the challenge within the acute setting is through a centralised operation hub approach – designed to optimise patient flow and staffing, and to help organisations make better decisions for their patients and drive process efficiency. The visibility that this hub can offer helps the hospital to make faster decisions about where to move their patients to the next level of care, increasing efficiency and patient flow. Most importantly, as it is intrinsically linked to clinical data, the EHR and other systems, it supports safety as well as operational efficiency.

Cerner Logistics Centre

While this hub can assist within the four walls of the acute, only when the information across the entire health and care system is integrated can the bed-blocking challenge be really met.

Integrated technology and connected information is already enabling health and care systems to manage patients’ wellness and operations across the whole health continuum and activate patients as members of their care team. Health information exchange is helping inform decisions at the point of care across the system, while an intelligent population health management platform can connect data from hospitals, GP practices, community, mental health services, social care and many others into one integrated, longitudinal care record for each member of the population, helping reduce inbound pressure, avoidable readmissions and bottlenecks - ultimately to stop ‘people’ becoming ‘patients’ in the first place.

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