Philips Design’s Healthcare Consultancy was brought in by the Belfast Trust, the largest National Health Service Trust in the UK, to optimize the flow of cardiac patients in and out of its hospitals. The Belfast Trust comprises a number of healthcare facilities into one administrative unit, and employs approximately 22,000 staff. A better patient flow would provide an improved level of service for its numerous referral sources. This was to be achieved not through the use of additional equipment, but through a strategic analysis of how to best address the issues on a human level. Already established partner
“The Trust's director of cardiology services was clear that he was looking into ways of improving the patient experience while eliminating bottlenecks," says Joe McCallum, Business Manager for Managed Equipment Service at Philips Healthcare in the UK. "We felt there were a lot of similarities between what he was looking for and the work Philips is carrying out on care cycles – the series of touch points a patient experiences – screening, diagnosis, treatment, management, surveillance, prevention – for a particular medical condition." “Although the original intention was to present an overview of cardiac care cycle solutions, it soon became apparent that helping improve the flow of cardiac patients through the hospital was of significant mutual interest," continues Joe. “With this in mind I invited involvement of our strong Design for Healthcare Consultancy.” The Belfast Trust was impressed by the people-centric design approach adopted by Philips and saw in it a greater chance of achieving lasting improvement. Patients are not 'boxes'
“Cardiology care is largely dependent on the ability and flexibility of hospital personnel to address challenges immediately," says Marlies Bielderman, Research and Innovation Consultant at Philips Design. "Patients simply can't be treated like boxes on a conveyor belt. A lot of the identified issues have no relation to the treatment received by patients, but involve facilitating tasks such as arranging beds and transport, bringing data together and scheduling in an unpredictable working environment. So we knew that concentrating on the people with the responsibility for these tasks was vital to improve workflow.” Extensive information gathering
In 2009 Philips Design visited Belfast in order to create a clear picture of what the main 'bumps in the road' were. "Our two main focus areas were to analyze both how care was delivered and how it was experienced by both the patients and the care providers," says Marlies. A series of highly-interactive workshops were carried out involving representatives from every department linked to the 'patient pathway', the name given to the journey a patient has to undertake before, during and after treatment for cardiac disease. Understanding the wider context
The team also carried out numerous one-to-one interviews, particularly with departmental managers and clinical consultants. A variety of personnel were also interviewed, observed and 'shadowed' to get a more accurate picture of the challenges they face on a daily basis. "It was important to involve both staff and management in interactive sessions, because they are the ones who need to understand and implement the recommended changes," says Marlies. Visits were even made outside the hospital, for instance to referral centers and the regional ambulance headquarters, to better understand the wider context of the situation. Unique tool
The findings were visualized using various methods to show the inter-relationship between people, places and other enablers in the process over time. For this case the team of the Philips Design Healthcare Consultancy team used a very simple, interactive but unique tool to help participants identify and eliminate bottlenecks; a board with various tracks on it for a marble to run down, not unlike a pin-ball table. The marble symbolized a patient’s journey through the hospital care cycle. When the marble met physical obstacles (representing ‘non-clinical’ activities) on the tracks, it was possible to come up with ideas about improving the whole patient flow in a very hands-on and engaging way. This also helped management better understand the daily realities of providing care. Implementing changes
Many potential issues and opportunities were identified in areas ranging from transport and scheduling to communication, teamwork and improving the patient experience. Based on the recommendations, changes are already being implemented to help simplify workflow and increase efficiency. Holistic solutions
"We are very excited about this project because it shows we are capable of addressing latent yet unmet needs of our customers in a variety of ways," says Joris Van Den Hurk, VP Cardiology Care Cycles at Philips Healthcare. "We're solving problems that transcend products or even individual hospitals, providing care solutions. This is the first time that we've been involved at such a high strategic level in improving cardiac workflow, and we are enthusiastic with the results so far. The Philips Design Healthcare Consultancy team has been able to recommend valuable improvements to the workflow and overall experience for the hospital staff as well as the patients. ”
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