Over a year after implementing the region’s first integrated Care Co-ordination Centre, we sat down with Nick Sinclair, Director of Central Operations, at Maidstone and Tunbridge Wells NHS Trust (MTW), to discuss the Trust’s digital journey, lessons learned and the expansion of MTW’s Care Co-ordination Centre into the community care setting.
For many NHS Trusts, the Care Co-ordination Centre is a new concept. Can you explain a Care Co-ordination Centre and how MTW embarked on their journey?
Until relatively recently, a Care Co-ordination Centre was a new concept for the NHS, but as part of MTW’s digital strategy, we implemented TeleTracking’s operations platform and went live with our Care Co-ordination Centre in November 2020. MTW is a large, 712-bed Trust, located across Maidstone Hospital and Tunbridge Wells Hospital. Prior to adopting an integrated operations platform, we relied largely on manual and paper-based processes to manage capacity. Now, with shared visibility and automation around staff workloads, and centralised capacity management, we have been able to drive operational improvements and give nurses thousands of hours back to care for patients.
The Care Co-ordination Centre provides a centralised hub from which our staff manage capacity. It operates in a similar way to an Air Traffic Control Centre at an airport, and is live 24/7, every day of the year. Our team of dedicated professionals have full visibility of the Trust’s bed capacity, enabling them to manage beds and resources efficiently and effectively in real-time with the flexibility to transfer patients between sites based on staffing and demand levels.
Since implementing the integrated operations platform, could you tell us about some of the most significant outcomes?
From admission to discharge, we have managed to streamline the whole process and have experienced fantastic results since implementation. We now perform more elective procedures per day and MTW is the only organisation in Kent where no patient waits more than 52 weeks for an elective procedure. Patient flow is more streamlined with shared visibility around bed availability and resource management and on average, we complete over 3,000 patient transfers per month. We’ve also increased our portering capacity, with 12,000 dispatcher-less portering jobs completed each month.
The combination of electronic wristbands, which immediately alert the Care Co-ordination Centre when a patient is discharged, and a dedicated Bed Turnaround team, has drastically reduced bed turnaround time and given nurses thousands of hours back to care for our patients. TeleTracking’s platform also provides a wealth of data and information on performance, allowing our staff to address challenges proactively and in real-time, whilst continually evaluating processes over time to ensure we are continually meeting best practices.
Following your recent research trip to the US, where you visited Co-ordination Centres at leading healthcare systems, Carilion Clinic (Virginia, USA) and Broward Health (Florida, USA), what are some of your key takeaways?
We went live with our Care Co-ordination Centre around 18 months ago, so it was interesting to visit organisations at a later stage of the digitisation journey. It was great to see first-hand how the US healthcare providers have evolved with technology and the different approaches they’ve taken to setting up Co-ordination Centres. In many aspects we’re naturally aligned with Carilion Clinic; the Co-ordination Centre has oversight of capacity and manages where to place patients. Broward Health has developed a very high-tech centre and it was fascinating to learn about the use of lighting and white noise to create an optimal environment for staff to work in.
Was there anything that Carilion Clinic and Broward Health are doing that you would like to replicate at MTW?
As we progress with our digital strategy, we’re certainly keen to develop our dashboards and analytics capabilities. The US visit highlighted how we could continue to build on our system in a phased approach to fully utilise TeleTracking’s technology, so that when staff enter the Care Co-ordination Centre they can gain an instant picture of the real-time situation, with a variety of interactive dashboards showing the entire patient journey. We currently have a fantastic overview of information, but we’re working to show more detail in real-time, without staff having to look for it. From an operational intelligence perspective, we’re also looking more closely at patient flow across different wards, enabling decision making to be truly driven by data.
The final step we’re interested in replicating is the integration with our EPR system. While the systems have individual functions – TeleTracking is designed for cohorts of patients and EPR allows clinicians to understand the needs of individual patients – integrating the interfaces is naturally complementary and ultimately gives staff yet more time back to care.
MTW is one of the first Trust’s in the country to integrate Acute and Community Care settings, can you share with us some next steps for the Trust and the Care Co-ordination Centre?
We’re currently building a new Care Co-ordination Centre at MTW which has given us the opportunity to redesign the layout, making sure teams that regularly interact sit near to each other to improve patient flow. We’re also bringing staff into the centre who haven’t previously worked there, such as Ambulance Transfer Managers. This again reduces the need for phone calls and empowers staff to be proactive in their role.
Another key focus is expanding our patient flow platform into community health. In collaboration with Kent Community Health NHS Foundation Trust (KCHFT), we are expanding our TeleTracking platform into KCHFT’s four community hospitals. It will be one of the UK’s first examples of operational decision making and strategic capacity planning across an integrated health system, so it’s an exciting time for the Trust.
Finally, progressing with our digital strategy remains a priority, as is the case for many NHS Trusts. Digitisation is vitally important, enabling healthcare professionals to reduce manual processes, supporting the provision of care across care settings, and ultimately improving patient outcomes.