Tracking the take - Using patient flow data to improve AMU performance and safety

To create a system to co-ordinate the medical take, bed management and track patient flow. To use the system to continuously audit against Society for Acute Medicine Quality Indicators. To use the data to model patient flow and optimise working patterns to improve waiting times.

An online whiteboard and underlying database system were designed, tested and implemented. Data from this system were used to audit against SAM Quality Indicators and then analysed to optimise both trainee and consultant working patterns.

The online whiteboard proved effective and popular as a working tool. Data collection improved using the electronic system. Optimising junior doctor working patterns to match demand led to a reduction of average waiting time to see a doctor from 190 minutes to 71 minutes (p < 0.0001), and a reduction in the proportion of patients waiting over 4 hours from 40% to 10% (p > 0.0001). Optimising consultant working patterns did not produced significant changes in waiting times.

The online whiteboard improved day-to-day working and data collection, when compared to the previous paper-based system. Better data facilitated analysis of working patterns leading to a significant improvement in patient waiting times.