South Tyneside NHS Foundation Trust

Harnessing analytics for strategic planning, operational decision-making and end-to-end improvements in patient care

Published on 08-Jul-2013

"If you can join together data from different systems and gain end-to-end visibility of how patients move through your hospitals, the possibilities for both strategic decision-making and operational improvements are nearly limitless." - Martin Alexander, Head of Information Services, South Tyneside NHS Foundation Trust

Customer:
South Tyneside NHS Foundation Trust

Industry:
Healthcare

Deployment country:
United Kingdom

Solution:
BA - Business Analytics, BA - Business Intelligence, Smarter Planet

Smarter Planet:
Smarter Healthcare

IBM Business Partner:
Bidetime

Overview

South Tyneside NHS Foundation Trust is a provider of acute and community health services in the northeast of England. It runs four hospitals with a total of 380 beds, operates a number of walk-in centres and provides district nursing services for a community of approximately 900,000 people.

Business need:
In the UK, patients can choose to access healthcare services from any local NHS trust. As a relatively small trust in an area that is also served by several larger ones, South Tyneside needs to ensure that its services score as highly as possible in all performance metrics in order to win patients and build a case for investment.

Solution:
South Tyneside saw the potential of using analytics technologies not only to automate the reporting of performance metrics, but also to support strategic planning and day-to-day operations. Working with Bidetime, the trust used business analytics software from IBM to create reports and dashboards that track patient activity from end to end and enable predictive decision-making.

Benefits:
Supports service-line costing (also known as activity-based costing), which improves control of finances and cash-flow. Puts the trust in a stronger position to negotiate with NHS commissioners by predicting the volume of patients likely to use each service. Enables the trust to build compelling business cases for investment in new services, based on data from thousands of patient visits. Provides accurate insight to support operational decision-making: for example, predicting future bed occupancy helps medical staff plan surgery and emergency admissions more efficiently.

Case Study

Smarter Healthcare: Improving strategic decision-making with advanced analytics

Instrumented
Data from electronic patient records, hospital management and financial systems is collected in a single central platform for analysis. Reports, dashboards and scorecards provide an accurate picture of activity throughout the trust’s hospitals and clinics.

Interconnected
By mapping data flows across the whole organisation, the trust can track a patient’s journey through every area of the trust – from admissions through the operating theatre to discharge and outpatients.

Intelligent
With a joined-up view of patient activity and service utilisation, the trust can measure performance and predict future demand. At the strategic level, this helps the trust increase financial control and hit performance targets. At the operational level, it supports medical staff in providing a higher level of patient care.

South Tyneside NHS Foundation Trust is a provider of acute and community health services in the northeast of England. It runs four hospitals with a total of 380 beds, operates a number of walk-in centres and provides district nursing services for a community of approximately 900,000 people.

The challenges of choice

Although a comparatively small provider of hospital services by today’s standards, South Tyneside NHS Foundation Trust is nonetheless consistently ranked as one of the best in the UK by the organisations that inspect and regulate it. Achieving high ratings is becoming an increasingly important goal for all NHS trusts for two main reasons.

First, since 2004, the NHS has operated on a “Payment by Results” model, which means that government commissioners set each trust’s annual budget based on the number of patients they treat and the types of services that each patient requires. In most cases, each type of service will have specific fixed costs associated with it – for example, a breast cancer screening service will require investment in specialist mammography equipment and the technicians to operate it. To make this cost-effective for the trust, it is therefore important for each trust to attract sufficient patients to offset the cost of running the service.

Second, attracting patients is becoming more challenging. Patients now have the right to choose which NHS trust provides their care, and the “NHS Choices” website (www.nhs.uk) gives them access to a wealth of information to guide their decision. The website allows patients to search for local hospitals, view the services they offer, and compare their performance, based on metrics drawn from a combination of official statistics and customer and employee surveys.

Martin Alexander, Head of Information Services at South Tyneside, comments: “As a relatively small trust in an area where there are several much larger ones, we have to provide an excellent level of service and keep our ratings as high as possible. This will help us to attract patients to our hospitals, which in turn will mean we can offer a wide range of health services to the local community without losing control of the costs.

“We realised several years ago that to achieve these goals, we needed to gain a better understanding of how our hospitals worked, not only on a broad, strategic level, but right down to the level of individual wards, beds and patients. We had implemented an electronic patient records system in 2001, so the data was available; we just needed a way to analyse it effectively.”

The right solution and the right partner

South Tyneside decided to create a business analytics capability based on IBM Cognos Business Intelligence software. Since the trust did not have much experience of analytics software at the time, it recognised the importance of working with a partner that could provide the right skills. After evaluating a number of options, the trust selected Bidetime, an IBM Business Partner.

“We were impressed with Bidetime, not only because of their technical expertise, but also because of their knowledge of the healthcare sector,” comments Martin Alexander. “The NHS poses unique challenges for analytics projects because of the sensitivity of most of the data and the highly complex policies that cover its usage. Bidetime were absolutely the right choice to guide us through the initial implementation and to help us develop the skills to manage the solution ourselves. After seven years, we’re now mostly self-sufficient, but Bidetime still help us with upgrades and technical support, as well as more complex analytical problems.”

Joining the dots on patient care

With the solution in place, South Tyneside has been able to develop a wide range of reports, dashboards and scorecards that provide users at all levels of the organisation with insight into day-to-day operations.

The ability to combine information from electronic patient records, hospital management systems and financial systems allows the trust to trace patients all the way through their healthcare journeys. For the first time, it can get a joined-up picture of how patients arrive at Accident & Emergency, get admitted as inpatients, undergo operations and procedures, recuperate on the wards, get discharged, and attend subsequent outpatient appointments.

Guiding strategic decisions

By gaining insight into the exact resources that each patient uses as they pass through the system, the trust is able to build up a service-line costing model (also known as an activity-based costing model). For example, if the hospital is offering hip replacement surgery as one of its services, it can now analyse how much the whole hip replacement process costs – not only the surgery itself, but also the time the patient spends in a hospital bed while recuperating, and any physiotherapy or other outpatients appointments required afterwards. This enables South Tyneside to gain a truly accurate picture of the cost of its services.

“If the analysis shows us that we’re particularly cost-effective as a provider of a particular service, we can find out why, and then share our best practices,” comments Martin Alexander. “On the other hand, if we see that one of our services is comparatively expensive, we can investigate the root causes and find ways to boost efficiency. The visibility that the IBM Cognos solution gives us is a vital tool for better strategic decision-making.”

The solution also gives the trust a much more robust method for measuring and predicting total patient volumes for each service, which puts it in a strong position for negotiating with the commissioners about future budget, and making investment decisions. If a particular service could be expanded by investing in a new piece of equipment, the trust can assess whether the investment would be justified by increased patient volumes, or whether the money would be better invested in another area.

Supporting operational decisions

In addition to the many important contributions the solution makes to the trust’s overall strategy, it also supports doctors, nurses and hospital managers at an operational level – providing the information they need to run their departments, wards and operating theatres on a day-to-day basis.

“Operational analytics is a huge opportunity for us to improve efficiency from the ground up,” says Martin Alexander. “To take one example, we have a report that analyses current bed occupancy on each ward and combines it with information on planned discharges. This allows us to predict future bed occupancy, and see how many beds should be available on a given future date. By giving our medical staff access to this information, we make it easier for them to deal with emergency admissions and schedule operations and procedures. Ultimately, we can treat more patients in less time and reduce our waiting lists.”

Bed occupancy analysis also helps to assess staffing requirements more effectively – for example, predicting how many nurses will be needed to support each ward. This helps South Tyneside find an effective balance that both delivers excellent care for patients and avoids unnecessary expenditure on extra temporary staff.

“Since we’ve been monitoring these metrics, we have seen an improvement in patient flow resulting in a six percent shift in bed occupancy from medical to surgical wards,” comments Martin Alexander. “This reduces the burden on our medical wards and allows additional surgical patients to be admitted and seen. It shows that we’re becoming more efficient in the way we operate. We’ve put initiatives in place to reduce unnecessary delays – for example, patients who were ready to be discharged sometimes had to wait for the pharmacy to dispense their medicines before they could leave. By giving the pharmacy more visibility of scheduled discharges, we can help them get everything ready at the right time, which has eliminated this bottleneck. As a result, the patients get home sooner – which is what they want – and we get our beds back quicker – which means we have more resources available for new patients.”

Leading the way

Martin Alexander concludes: “Almost every NHS trust is looking at issues like service-line costing and enhanced financial control. We have demonstrated that an enterprise-class business analytics platform such as Cognos can help to achieve these objectives in a very sophisticated way. If you can join together data from different systems and gain end-to-end visibility of how patients move through your hospitals, the possibilities for both strategic decision-making and operational improvements are nearly limitless.”

About Bidetime

Bidetime specialises in the development and delivery of information systems for the public sector. Its aim is to help clients manage, analyse and deploy information as efficiently and painlessly as possible. Its solutions provide control over the delivery of information by using market-leading software and industry-standard techniques.

To learn more about products, services and solutions from Bidetime, please visit www.bidetime.co.uk

About IBM Business Analytics

IBM Business Analytics software delivers data-driven insights that help organisations work smarter and outperform their peers. This comprehensive portfolio includes solutions for business intelligence, predictive analytics and decision management, performance management, and risk management.

Business Analytics solutions enable companies to identify and visualise trends and patterns in areas, such as customer analytics, that can have a profound effect on business performance. They can compare scenarios, anticipate potential threats and opportunities, better plan, budget and forecast resources, balance risks against expected returns and work to meet regulatory requirements. By making analytics widely available, organisations can align tactical and strategic decision-making to achieve business goals.

For more information

For further information please visit ibm.com/business-analytics

Products and services used

IBM products and services that were used in this case study.

Software:
Cognos Business Intelligence

Legal Information

© Copyright IBM Corporation 2013. IBM United Kingdom Limited, PO Box 41, North Harbour, Portsmouth, Hampshire, PO6 3AU, United Kingdom. Produced in the United Kingdom. July 2013. IBM, the IBM logo, ibm.com and Cognos are trademarks of International Business Machines Corp., registered in many jurisdictions worldwide. Other product and service names might be trademarks of IBM or other companies. A current list of IBM trademarks is available on the web at: www.ibm.com/legal/copytrade.shtml. IBM and Bidetime are separate companies and each is responsible for its own products. Neither IBM nor Bidetime makes any warranties, express or implied, concerning the other’s products. This document is current as of the initial date of publication and may be changed by IBM at any time. Not all offerings are available in every country in which IBM operates. The client examples cited are presented for illustrative purposes only. Actual performance results may vary depending on specific configurations and operating conditions. THE INFORMATION IN THIS DOCUMENT IS PROVIDED “AS IS” WITHOUT ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING WITHOUT ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND ANY WARRANTY OR CONDITION OF NON-INFRINGEMENT. IBM products are warranted according to the terms and conditions of the agreements under which they are provided. The client is responsible for ensuring compliance with laws and regulations applicable to it. IBM does not provide legal advice or represent or warrant that its services or products will ensure that the client is in compliance with any law or regulation.