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

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Presentation transcript:

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

SIMUL8 Corporation | SIMUL8.com | 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 | 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 | Simulation Model

SIMUL8 Corporation | SIMUL8.com | Parameter 1 - Admissions

SIMUL8 Corporation | SIMUL8.com | Parameter 2 – Length of Stay Number of midnight stays by hour and day of the week

SIMUL8 Corporation | SIMUL8.com | Parameter 3 – Discharge profile

SIMUL8 Corporation | SIMUL8.com | Parameter 4 - Beds

SIMUL8 Corporation | SIMUL8.com | Improvement Scenario 1 What if GP referrals arrived earlier in the day?

SIMUL8 Corporation | SIMUL8.com | 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 | Improvement Scenario 3 Patients who stay for less than 2 midnights Research suggests 65% of patients

SIMUL8 Corporation | SIMUL8.com | Move patient discharges forward to earlier in the day Improvement Scenario 4

SIMUL8 Corporation | SIMUL8.com | Improvement Scenario 5 Reduce 14 night length of stay for over 75s

SIMUL8 Corporation | SIMUL8.com | 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 | Results are in… Which would you implement first?

SIMUL8 Corporation | SIMUL8.com | 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 | 7 Day Working – Current Question Actually increases capacity required

SIMUL8 Corporation | SIMUL8.com | Why? Looking at 0-7 midnight stays – around 75% of admissions

SIMUL8 Corporation | SIMUL8.com | Impact of the weekend Number of midnight stays appear to be driven by a push to discharge on Friday

SIMUL8 Corporation | SIMUL8.com | 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 profileMonday only

SIMUL8 Corporation | SIMUL8.com | What next? Currently being tested with 3 hospitals for usability Presenting a poster at 7 Day Working event November 16 th

SIMUL8 Corporation | SIMUL8.com | 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?