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Acute Bed Simulation

Acute Bed Simulation. Russell Emeny, Fiona Lindsay, Claire Cordeaux Thanks to Terry Young, Sally Brailsford and Joe Viana. Our Aim - Driving Best Practice. Key improvement messages Demonstrated using simulation Uses default data for immediate testing Local hospital data can be uploaded.

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Acute Bed Simulation

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  1. Acute Bed Simulation Russell Emeny, Fiona Lindsay, Claire Cordeaux Thanks to Terry Young, Sally Brailsford and Joe Viana

  2. Our Aim - Driving Best Practice • Key improvement messages • Demonstrated using simulation • Uses default data for immediate testing • Local hospital data can be uploaded

  3. 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?

  4. Simulation Model

  5. Parameter 1 - Admissions

  6. Parameter 2 – Length of Stay Number of midnight stays by hour and day of the week

  7. Parameter 3 – Discharge profile

  8. Parameter 4 - Beds

  9. Improvement Scenario 1 What if GP referrals arrived earlier in the day?

  10. 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

  11. Improvement Scenario 3 Patients who stay for less than 2 midnights • Research suggests 65% of patients

  12. Improvement Scenario 4 Move patient discharges forward to earlier in the day

  13. Improvement Scenario 5 Reduce 14 night length of stay for over 75s

  14. Which scenario has the most impact? • GP referrals earlier? • Ambulatory care treated elsewhere? (25% of admissions) • Increase proportion of stays that are less than 2 midnights? • Move 50% of discharges earlier in the day? • Reduce 14 night stays for over 75s? (25% of admissions)

  15. Results are in… Which would you implement first?

  16. 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?

  17. 7 Day Working – Current Question Actually increases capacity required

  18. Why? Looking at 0-7 midnight stays – around 75% of admissions

  19. Impact of the weekend Number of midnight stays appear to be driven by a push to discharge on Friday

  20. 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

  21. What next? • Currently being tested with 3 hospitals for usability • Presenting a poster at 7 Day Working event November 16th

  22. 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?

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