Patient Flow: Design to Improve Patient Flow through Acute Medicine
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1
Helen Hamlyn Centre for Design, United Kingdom
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2
Imperial College, CLAHRC NWL, United Kingdom
Rationale
Acute Medicine is the unplanned urgent care an adult patient receives when presenting to the hospital with a medical condition. When patients need to be admitted into hospital, they are likely to move into an Acute Medical Unit (AMU). These are highly resourced environments, staffed with multidisciplinary teams, to investigate and manage patients’ conditions to determine the best care plan for them in a timely manner. AMUs have the potential of reducing the need for hospital beds if patients can be discharged directly home from this department. Nonetheless, AMUs are facing capacity and demand pressures.
Could the design of communication tools that enhance the priority of discharges from AMUs result in a behaviour shift of hospital staff to the benefit of patient flow improvement?
Aim
‘Patient Flow’ is a project to improve patient flow by reducing unnecessary delays through design. Initial research indicated that communication tools could use routinely collected data to visualise patient progress and overall ward status to relevant stakeholders, and enable timely discharges from AMUs, improving the experience of patients and staff.
Methodology
The project followed the Double-Diamond process(1), employing Inclusive Design methodologies.
In the discover phase research included literature about Acute Medicine, interviews with clinical and non-clinical hospital staff, and over 150 hours of ward observations.
During the define phase we synthesised the key challenges in AMUs, and prioritised areas of intervention against its impact and ease of implementation.
During the develop phase we established design briefs for interventions through ideation workshops. Working closely to stakeholders we gradually distilled concepts into communication tools and conducted three phases of design testing to develop the visual language.
Later in the deliver phase, the 'Patient Flow Board' went through iterative development, rapid prototyping, and coding development through a participatory approach that allowed for the co-design of solutions for real user needs and incremental improvement. 'Patient Flow Board' is being assessed for impact.
Results
Based on research and feedback from stakeholders we designed 'Patient Flow Board', that will improve information sharing amongst the multidisciplinary team for a more focused and timely discharge from AMUs.
The software developed integrates with the hospital's current patient administration systems, and presents existing information in a more visual way. The main item of this visual language is the Care Journey Diagram that visualises the iterative investigation cycle until a differential diagnosis is achieved. This allows for stakeholders to acknowledge the patient's progress in the investigation cycle, it prompts the team regarding outstanding tasks, and allows them to plan ahead.
The benefits of graphical tools have been broadly acknowledged by the multidisciplinary teams involved in their co-design and validation. They believe these can lead to more integrated care provision and directly improve patient flow. This tool is being prepared for a larger scale trial for impact measurement.
Conclusion
Evidence to date is that the communication tool under development will help hospital teams to prioritise discharge while improving patient flow through the system. Current evaluations will provide crucial evidence toward the adoption of the resulting tool.
Acknowledgements
With thanks to Royal College of Physicians Edinburgh, our research partner.
And thank you to all the hospitals and teams involved in the development of the project.
References
1□ Design Council UK. Introducing Design Methods [internet]. London: Design Council UK. [cited 2015 Jan 13]. Available from: http://www.designcouncil.org.uk/news-opinion/introducing-design-methods.
Keywords:
Acute medicine units,
inclusive design,
Communication tool,
Behaviour Change,
co design
Conference:
3rd UCL Centre for Behaviour Change Digital Health Conference 2017: Harnessing digital technology for behaviour change, London, United Kingdom, 22 Feb - 23 Feb, 2017.
Presentation Type:
Research abstract
Topic:
Digital Health
Citation:
De Almeida
L,
Matthews
E,
Fusari
G and
Bell
D
(2017). Patient Flow: Design to Improve Patient Flow through Acute Medicine.
Front. Public Health.
Conference Abstract:
3rd UCL Centre for Behaviour Change Digital Health Conference 2017: Harnessing digital technology for behaviour change.
doi: 10.3389/conf.FPUBH.2017.03.00072
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Received:
22 Feb 2017;
Published Online:
22 Feb 2017.
*
Correspondence:
Ms. Laís De Almeida, Helen Hamlyn Centre for Design, London, United Kingdom, lais.dalmeida@gmail.com