18 July 2024
The green zone
We can usually measure how long patients spend waiting in A&E before a bed becomes available once the A&E bit of their treatment has been completed. This can be useful if we want to get a clearer picture of the extent to which exit block is a problem for patient flow.
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18 May 2024
Red herrings
Was it Colonel Mustard with the lead piping in the Study? Or was it Miss Scarlett with the rope in the Conservatory? I was in Hatfield yesterday, teaching my Arguing with Numbers course to a group of people from Hertfordshire and West Essex Integrated Care System. One of the questions we grappled with was this: when you're using data to find out an underlying cause of something, and one of your investigations leads to a dead end, should you include or exclude that dead end when you write your final report?
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28 April 2024
The beds/data mismatch
Hospitals have specialties. And specialties have beds, which we tend to call 'bed allocations' or 'bed complements'. We gather data on the admissions, stays and discharges that take place in these specialty beds. But when we want to look at the inpatient activity in individual specialties, the bed allocations and the data often don't match up. It's important to address this mismatch. I believe that when we report inpatient data to inpatient specialties, we need to make clear the relationship between - on the one hand - the activity and - on the other - the space that activity is supposed to fit into to.
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27 February 2023
When to act on data
There's a diagram Nick Tordoff and I use in our Data Conversations course, and which I've now started using in my Using Data to Make Business Decisions course. It shows what it might feel like to be a decision-maker who has to make a decision (or take an action) based on data, and it's a representation of how they'd decide whether or not to trust the data, and how they'd evaluate the risks and benefits associated with any action they might take.
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23 December 2022
Operational versus strategic
It often feels as if we only ever address patient flow at an operational level. Our focus is on the hospital front door. Our attention is devoted to moving individual patients more quickly. Our actions are intended to speed up—rather than change—existing processes. But patient flow can only really be fixed if it is addressed at the strategic level. Less emphasis on what we do about Patient A and more emphasis on how we change the processes in place for dealing with all of the patients like Patient A.
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4 November 2022
Flavours of fullness
Whenever we use data to describe the fullness of a ward (or a specialty or a hospital), we usually reach for an average bed occupancy figure. The trouble is, this average figure is hugely deficient. Bed fullness is too multi-faceted a phenomenon to describe using just one number. Let's see if we can find a better way to capture all the dimensions of bed fullness.
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