INSIGHT Clinical Logistics has tremendous impact on the execution of the daily operations in a hospital
“Clinical Logistics are saving patients’ lives.” This remarkable statement is a quote from a newspaper post by Ole Thomsen, CEO of Healthcare in Central Denmark Region. In the post, Ole Thomsen cites a study revealing that mortality is nine per cent higher in overcrowded hospital wards compared to wards with a normal state of occupancy. According to Ole Thomsen, this problem can be solved with a clinical logistics solution. Regional Hospital Horsens has substantial and positive experiences from using INSIGHT Clinical Logistics for more than five years.
“Clinical Logistics enables hospitals to optimise the staff capacity to the current patient situation and avoid that single wards are put under too much strain,” Thomsen says. In his experience, clinical logistics used to involve telephone calls and handwritten notes that became quickly outdated in a busy hospital environment. “With Clinical Logistics, we immediately find the answer in the system which always conveys a real time overview of the occupancy of the different departments. This way we avoid patients waiting unnecessarily,” Thomsen says.
Clinical Logistics is key to an efficient hospital
Hospitals are always looking for ways to improve work-flows and operational efficiency so that throughput increases without compromising quality or safety in treatment.
Jørgen Schøler Kristensen is a medical doctor, holds a doctorate in haematology and is working as Chief Medical Officer at the Regional Hospital Horsens in the Central Denmark Region. He strongly agrees with the views of Ole Thomsen on INSIGHT clinical logistics. In an article in the Journal for Danish Health Care, he points out,” The efficient hospital is characterised by stringent logistics and coordination”. As Jørgen Schøler Kristensen puts it “this is one – if not the – essential key to securing fast and efficient high quality patient flows. Add to this that the working environment of the staff is improved at the same time.”
According to Jørgen Schøler Kristensen, logistics is an important lever in the development of future healthcare because we need to treat ever more patients in a shorter time span. At the same time more patient flows are growing ever more complex and the organisations handling the patient flows are getting larger. This demands efficient and well coordinated workflows alongside maintaining – preferably improving patient safety and overall quality.
IT for better logistics
Jørgen Schøler Kristensen is of the view that ‘the efficient hospital’ demands tools and processes, which both support and contributes to the further development of good communication, coordination and overview during the execution of daily clinical work. In his experience, INSIGHT Clinical Logistics is that kind of tool.
The system has two main user interfaces:
- Firstly the large interactive screens places strategically in the departments
- Secondly the browser based interface ‘Anywhere’ which is accessible on all PCs, laptops and so on. The ‘Anywhere’ is also available for mobile devices.
On the interactive large screens, the clinical staff is at any given time presented with a full overview of patients, staff, treatment activities, surgeries, test results and so on – in real time. The staff is at any given time able to edit informations and changes are instantly (in under one second) visible to all staff on both interactive large screens and anywere. Jørgen Schøler Kristensen points out that this is key to enhancing cooperation among staff as well as between departments and the systems’ incorporated
webcams and chat functionality supports communications. Finally, tracking is used making it possible to know where one’s colleagues are at present.
And Ole Thomsen wants clinical logistics to go further. He explains, “The vision is that the overview that clinical logistics provides today on large touch screens will ultimately be in the pockets of the healthcare professionals, where it is constantly within reach”.
Logistics is of great value
One of the departments where INSIGHT Clinical Logistics has had a tremendous impact on the execution of the daily operations is the surgical ward.
Jørgen Schøler Kristensen explains that the work flow in the surgical ward consists of a vast number of serial actions involving staff from a number of different departments. The serial nature of the workflow has the distinct consequence, that delays and errors propagates on to the subsequent actions of the surgical flow.
And Ole Thomsen adds, “Whenever a patient is in surgery, the doctors are easily and efficiently able to communicate with the staff outside the operating theatre by updating an electronic touch-screen. This is relevant in many cases, for instance if a member of the surgical team is running late or an additional specialist is needed for surgical assistance. The staff outside the operating theatre stays updated and able to effectively plan the next activities via the status changes conveyed to them from the operating theatre. “This makes sure that the patient has a good and safe course of treatment all the way from layering to anaesthesia, surgery and recovery”.
Ole Thomsen explains how clinical logistics is also of high value in the emergency departments where there is a large flow of patients. “We get an overview of the incoming patients and are able to prioritise the patients who are in the greatest need of acute care. At the same time we are able to see which doctors and nurses are attending to each patient and make sure that the right staff are assigned to the particular patient,” Thomsen says. “Furthermore the system provides us with a detailed overview of the individual patients’ flow. This makes us able to stay ahead and be prepared for the next step”.
Jørgen Schøler Kristensen points out the differences from before to after implementation of an IT-system for clinical logistics, “Before the implementation of an IT-system for clinical logistics, the overview of the surgery programme for the day only existed on a large piece of paper, which was manually updated with acute surgeries and other changes during the day. Changes and other new information had to be communicated by phone and only the staff in the OR theatre had knowledge on how far along the ongoing surgery was. Today, the complete real time overview of the programme for the day is available on the interactive large screens and staff are able to edit infomation during the day which is instantly available in all screens all over the hospital.”
The results in short
Jørgen Schøler Kristensen points out, that several actions have been taken to describe and measure the gains from implementing a joint IT-system for clinical logistics in the Central Denmark Region. “Both qualitative and quantitative studies show that clinical logistics provides better overview, improves communication and supports efficient coordination and in effect optimises the collective workflows. At the same time all users of the system say that the system has resulted in a higher quality of treatment and has improved patient safety,” he says.
The same conclusions were reached in a Medical Technology Assessment carried out by the Centre for Public Health. Finally the one evaluation done of the system in an emergency department was carried out by Regional Hospital Horsens. The evaluation showed an increase of production of 19 per cent in the course of 18 months from the system implementation.
Ole Thomsen sums up the reason for Central Denmark Region to implement a joint IT-system for clinical logistics, ”This way the healthcare regions are constantly working on improving work flows in hospitals and making them more flexible. Because we do not believe that time heals all wounds”.
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