The SECC Intro

In June 2014, Flowopoly was showcased at two lunchtime sessions at the NHS Scotland Conference in Glasgow. 70 people. 10 tables.

Flowopoly at the SECC, Glasgow: 3rd June 2014

Flowopoly sounds like it's the name of a game. And it looks like a game. And it feels like a game.

But it's actually not a game.

Flowopoly is a re-enactment of reality.

What we're about to do is re-enact exactly what happened to the patients who inhabited and encountered the emergency care system of a medium-sized district general hospital on Tuesday 17th September last year.

Specifically, the patients who inhabited and encountered the medical emergency care flow pathways.

(We'd have included Surgical and Orthopaedics as well, but we'd have needed bigger boards. And therefore bigger tables. Oh, and more time. Which we don't have. Because we've only got 45 minutes. So we've had to cut it down in order to fit things in.)

(We also could've included the beds and patients beyond the four walls of the acute hospital. Community beds, care home beds. But-again-we'd have needed, well never mind bigger tables, we'd have needed more tables. Loads more tables. And-like I say-we don't have enough room.)

So this is abridged Flowopoly.

We're going to replay a twelve-hour period.

Between 8am and 8pm. On Tuesday 17th September.

We'll speed up time. So those twelve hours will take us about 20 minutes to replay.

We'll be seeing what happened to the patients who arrived at the Emergency Department. How long they spent in the Emergency Department before leaving. How many of them were there for longer than four hours. How many of them went home and how many of them got transferred onwards into the hospital.

We'll be seeing what happened to the patients who arrived in the Acute Medical Unit (labelled simply as "Assessment" on the boards). Some of them arrived there directly; some of them came in via A&E.

And we'll be seeing what happened to the patients who needed beds in the "downstream" specialty wards. Wards 1, 2, 3, 4 and 5. In this hospital that's Respiratory Medicine, GI/Renal, Stroke, Elderly and Cardiology.

Flowopoly at the SECC, Glasgow: 3rd June 2014

The boards on each table represent the wards and departments in the hospital. And the cards represent the patients.

In this version of the re-enactment, the cards just contain basic "demographic, administrative" information. Name, age, sex, time of arrival, time of departure. That kind of thing. Oh, and obviously, they're not real patient names. Everything here has been anonymized. Also, there's no clinical information on the cards-but obviously, there could be. If you wanted to customize Flowopoly to your own local system, you could put as much or as little information on these boards and cards as you wanted.

In fact, you've probably already realised that pretty much all of the elements of Flowopoly are customizable. You can use Flowopoly to re-enact actual good days, actual bad days and actual medium days in your own local hospital. With as much or as little detail as you desire.

Flowopoly lifts the roof off the top of a hospital, off the top of a whole system. It takes the walls and staircases away, and allows you to see how easily and freely-or not-patients move from one part of the system to another. It makes visible what is usually only partly visible. Or even invisible.

It allows you to see patient flow.

Anyway, like I say, the next twelve hours will be condensed into about 20-25 minutes, so we'd better get started.

The "rules" are pretty straightforward. You'll get the hang of them as we go along. And we've ensured that there's a highly-trained facilitator on each table to keep you right.

Oh, one last thing. I said we'd be playing out twelve hours in the life of this hospital exactly as it happened. When I say "exactly", I mean exactly as the data told us what happened. Sometimes - and I know this may come as a bit of a shock to some of you - sometimes the data isn't always spot on! So if some weird things happen in the course of the next twelve hours, chances are that yes, they really did happen but there's also an outside chance that it might just be that the data was wrong! We'll leave it to you to work out which it was!

Now then. The clock has just struck 8 o'clock in the morning on Tuesday 17th September.