Acute Bed Simulation Russell Emeny, Fiona Lindsay, Claire Cordeaux Thanks to Terry Young, Sally...
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Transcript of Acute Bed Simulation Russell Emeny, Fiona Lindsay, Claire Cordeaux Thanks to Terry Young, Sally...
Acute Bed Simulation
Russell Emeny, Fiona Lindsay, Claire Cordeaux
Thanks to Terry Young, Sally Brailsford and Joe Viana
SIMUL8 Corporation | SIMUL8.com | [email protected]
Our Aim - Driving Best Practice
• Key improvement messages
• Demonstrated using simulation
• Uses default data for immediate testing
• Local hospital data can be uploaded
SIMUL8 Corporation | SIMUL8.com | [email protected]
Answering Questions
• What is my bed occupancy %?
• How many beds am I using?
• What are my wait times for beds?
• How do improvement scenarios impact on these results?
SIMUL8 Corporation | SIMUL8.com | [email protected]
Simulation Model
SIMUL8 Corporation | SIMUL8.com | [email protected]
Parameter 1 - Admissions
SIMUL8 Corporation | SIMUL8.com | [email protected]
Parameter 2 – Length of StayNumber of midnight stays by hour and day of the week
SIMUL8 Corporation | SIMUL8.com | [email protected]
Parameter 3 – Discharge profile
SIMUL8 Corporation | SIMUL8.com | [email protected]
Parameter 4 - Beds
SIMUL8 Corporation | SIMUL8.com | [email protected]
Improvement Scenario 1
What if GP referrals arrived earlier in the day?
SIMUL8 Corporation | SIMUL8.com | [email protected]
Improvement Scenario 2
What if our ambulatory care patients were treated elsewhere?
•Select a percentage of
admissions classed as
“ambulatory” (default 25%)
•Select likely impact on number
of midnight stays
SIMUL8 Corporation | SIMUL8.com | [email protected]
Improvement Scenario 3
Patients who stay for less than 2 midnights
•Research suggests 65% of patients
SIMUL8 Corporation | SIMUL8.com | [email protected]
Move patient discharges forward to earlier in the day
Improvement Scenario 4
SIMUL8 Corporation | SIMUL8.com | [email protected]
Improvement Scenario 5
Reduce 14 night length of stay for over 75s
SIMUL8 Corporation | SIMUL8.com | [email protected]
Which scenario has the most impact?
1. GP referrals earlier?
2. Ambulatory care treated elsewhere? (25% of admissions)
3. Increase proportion of stays that are less than 2 midnights?
4. Move 50% of discharges earlier in the day?
5. Reduce 14 night stays for over 75s? (25% of admissions)
SIMUL8 Corporation | SIMUL8.com | [email protected]
Results are in…
Which would you implement first?
SIMUL8 Corporation | SIMUL8.com | [email protected]
7 Day Working – Current Question
• How to model this?
• Staff available 7 days a week to make discharge decisions
• Use a Monday profile (furthest from the weekend)
• What would you expect to see?
SIMUL8 Corporation | SIMUL8.com | [email protected]
7 Day Working – Current Question
Actually increases capacity required
SIMUL8 Corporation | SIMUL8.com | [email protected]
Why?
Looking at 0-7 midnight stays – around 75% of admissions
SIMUL8 Corporation | SIMUL8.com | [email protected]
Impact of the weekend
Number of midnight
stays appear to be
driven by a push to
discharge on Friday
SIMUL8 Corporation | SIMUL8.com | [email protected]
7 day compared to Monday profile
• Patients are more likely to be discharged at the weekend• Have a longer length of stay during the week
Midnight stays 7 day profile Monday only
0 3565.8 3495.8 701 2772.5 2679.6 92.92 1910.4 2125.9 -215.53 1485.4 1615.6 -130.24 1076.5 1323 -246.55 786.5 574.7 211.86 702.1 398.3 303.8
SIMUL8 Corporation | SIMUL8.com | [email protected]
What next?
• Currently being tested with 3 hospitals for usability
• Presenting a poster at 7 Day Working event November 16th
SIMUL8 Corporation | SIMUL8.com | [email protected]
Continuing the Work
• More questions emerging
• Informing national debate on emergency care and 7 day working
• Disseminate to hospitals
• Seeking support
• Link with research interests?