Despite the challenges of operating an accident and emergency department that services approximately 320 patients every day, a number that is steadily increasing, Luton and Dunstable NHS Trust have consistently exceeded the 4 hour A&E waiting time standard. In fact, over the last 12 months their figures have been between 2% and 4% higher than the target – a significant achievement in the current climate. So, how are they doing it?
Luton and Dunstable NHS Trust is rated the best hospital in the East of England and currently has the best A&E 4 hour target results. It has led the NHS in patient safety since 2004 with some of the lowest infection rates in the country. Luton’s forward thinking approach to the A&E 4 hour target, and their focus on patient flow as a whole-organisation responsibility, has produced an emergency department that is second to none.
Streams and hubs
Luton found that the traditional method of managing all patient flow within the A&E department wasn’t getting the results they wanted. Efficiencies were created through the introduction of multiple streams, each with their own staff teams, to flow patients into more specialised areas that could meet their needs quickly and effectively.
Situated between A&E and the Emergency Admissions Unit is Luton’s first-class Operations Centre (OC). Similar in execution to the Clinical Coordination Centre concept set out in the Future Hospitals report, Luton’s OC is the operational command facility for the whole organisation.
Staffed 24 hours a day, 7 days a week, the OC steers the hospital through the management of hundreds of emergency attendances each day. Paper-based processes are kept at a minimum; real-time data is key to the running of the OC, giving staff chance to change course as necessary to keep the hospital running efficiently. Hospedia’s Patient Flow solution and access to views of CAMS (Ambulance Service systems) allows the OC to monitor capacity and demand, not only in A&E but also throughout the hospital.
“We take a proactive approach to ensure that the flow of patients across the hospital is smooth, directing them to the right place first time. Patient Flow is like an extra member of our team supporting this process.”
Martin Jagedo, Deputy Director of Operations, Luton and Dunstable NHS Trust