Revisualize emergency care

Flow_ology is a one-day workshop for NHS data analysts that shows how to re-visualize data about emergency care. It's about taking patient flow seriously: how we describe patient flow, how we understand patient flow, how we go about fixing patient flow.

But it's not just a series of random ideas. "Oh look! A cool way of showing outliers!" "Have you thought about visualizing A&E arrival data like this?" (Though you can use the workshop like that if you want.); no, it's more than that, it's a thought-through method that's based on techniques tried and tested with real-life managers and clinicians. It starts by describing patient flow 'properly' (with resonance) so that clinicians recognise it. Then we move onto developing these descriptions and visualizations with a bit of numerical 'theory' in order to understand the cause-and-effect relationships that underpin patient flow. Thirdly, we then use the numbers to sit down with clinical teams and formulate what their numbers ought to look like if patient flow is to improve. Finally, we look at what data we need to be using on ongoing basis to see if any changes we've made are having an impact on patient flow and then to monitor that ongoing situation.

Session 1 / REPLAY
(09:30 to 11:00)

The first thing is describing reality. We do this by taking a completely new way of describing reality: meeting room tables, A2-sized boards with numbered stickers on them, credit-card-sized cards that represent patients (more accurately: patient movements) and we physically move the cards to represent arrivals into, departures from, and transfers within the system. With the replays we are trying to get as close as we can get to what reality looks like without actually 'inhabiting' that reality. We replay a bad day (or part of a bad day), and then we replay a good day (or part of a good day), and then we discuss what we just saw, what we witnessed, and what that means for the sort of data we need to analyse and present. How can we replicate what we just saw but use data to do it instead of the huge and elaborate analogue set-up we just used? The result is a suite of graphics that describe patient flow reality with resonance. In nearly all of these graphics we can 'see' individual patients and individual patient moves. Detail and granularity. With repetition we can start to see patterns.

But of course the big picture is missing. Which is why we need the next session...

Session 2 / GRID
(11:15 to 12:45)

In the second session we develop the descriptive graphics we just created so that we can start to see the bigger picture. We move from looking at what happened on one particular bad day to what happens on bad days in general, and how that compares with good days in general. We look at how we can transition from graphics that show individual patients (and individual patient moves) to graphics that summarise large numbers of patients and patient moves. And we start to put the relationships between four-hour breaches, length of stay, activity numbers and bed occupancy under the microscope, so that we can see the important numerical and arithmetic relationships that underpin patient flow. These arithmetic relationships are vital if we want to understand how the system works.

But of course we want to understand how the individual parts of the system work and how they ought to work, which is why we need the next session...

Session 3 / FORMULATE
(13:30 to 14:45)

In this session we apply the 'theory' of session 2 to actual real life clinical directorates in a hospital. So having zoomed out in session 2, we zoom in again in session 3 to look more closely at the data we need in order to get an individual directorate in a downstream ward area to agree and formulate its 'ought-to-be' numbers. What are the steps we need to take if we want to put Flow_ology into practice with an actual clinical area and actual clinicians? Again, we go through the data exhibits that we need to prepare for this stage.

Session 4 / MONITOR
(15:00 to 16:00)

In the final session we look at how we need to feed information back to individual clinical directorates about their activity and how it impacts on patient flow in the wider system. It's not enough to just show the data for that part of the system; we also have to keep providing directorates with a strong sense of context. They need to be able to see what is happening in other parts of the system, too.

Flow_ology can be booked as an on-site workshop for £1,250+VAT, and up to 12 participants can be accommodated in each workshop session. Email info@kurtosis.co.uk to start making arrangements.

Familiarity with Microsoft Excel and Microsoft PowerPoint is necessary for this training course.