Improving efficiency and safety of out-of-hours Secondary Care
For more than 75% of the week hospitals operate in an ‘out of hours’ mode with a small number of doctors covering a very large number of patients. In one hospital there are typically 5-7 doctors covering up to 36 wards (excluding emergency admissions). These doctors are working in a stressful environment, performing complex tasks and making difficult task prioritisation decisions. They must simultaneously navigate a large often unfamiliar site to locate wards, patients, other staff and equipment.
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The Wayward project
The Wayward project (funded by the Health Foundation) investigated the use of ‘locative and tasking’ informatics to learn more about clinical behaviour in out-of-hours secondary care settings, in order to drive improvements in safety, efficiency and effectiveness. The overall aim of the project was to reduce mortality in out-of-hours secondary care and improve patient outcomes.
The informatics system developed by the University of Nottingham team captured data on clinical tasks, including the type, timing and location of activities, without the need for traditional direct observation. Alongside this data collection, a series of qualitative interviews with staff were conducted to provide a perspective on the context in which Out of Hours works is conducted. The project aimed to understand the relative value of the different data collection and analysis methods.
The team linked the informatics system with additional hospital datasets to provide clinicians and service managers with high quality information. In partnership with the Royal College of Physicians, WayWard has helped identify how the data can be used to deliver impact including:
- Allocation of hospital staff in out of hours care
- Managing allocation of tasks
- Redesign of ward layouts
- Supporting junior doctors’ training
- Enabling innovation and development within hospitals
Read more about Wayward in the Summer 2019 edition of the University of Nottingham's Vision magazine
For more information, see the
Wayward project website