Patient flow and bed management: How does your Trust manage it?

patient flow

Paul Barrett, TeleTracking UK, explains how automating patient flow and bed management in real-time can transform hospital operations, free up time for nurses to care, reduce stress on caregivers and importantly improve patient outcomes

Winter brings added strain to the NHS every year. But this year is more challenging than ever as the second wave of the Coronavirus pandemic is upon us. An unprecedented number of Covid patients are being admitted in addition to the seasonal surge of non-Covid acute admissions. And it doesn’t end there – with a vast backlog of elective activity to catch up on, combined with NHS staff shortages and burnout, it’s not just the remaining winter months that are concerning, it’s the entire foreseeable future of the NHS.

The adoption of digital technology has been a slow-burning process across the NHS, but when the first wave of Coronavirus struck, the speed at which working practices using digital technology were adopted, was incredible. A sudden urgency and realisation that without it, Trusts just wouldn’t cope, empowered many frontline workers to make small changes that had a huge impact.

Paul Barrett, TeleTracking UK, explains how many of these changes during the first wave of the pandemic were not all necessarily large scale Trust-wide digital transformation projects. And, therefore, questions why many Trusts still don’t have a simple automated bed or patient flow management system in place to ensure they know where their patients are, their status and where available beds may be. In fact, right now, nurses are still frantically running around hospital wards with pencil and paper, manually inputting the current bed estate.

Automating patient flow and bed management in real-time can transform hospital operations, free up time for nurses to care, reduce stress on caregivers and importantly improve patient outcomes. And it can begin with small, scalable solutions.

Outdated approach

The current manual approach to bed management and patient flow is completely inefficient –  it is hard to believe that teams of hospital staff rely on making multiple phone calls, frequent meetings, multiple spreadsheets, and physically running from ward to ward and building to building to check on the bed status, and by the time the member of staff has returned to update the bed estate, the bed has likely been assigned to another patient. Yet that is the stark reality. And the implications of poor bed management extend far beyond A&E delays; it results in cancellations of elective surgery; delayed discharge; poor infection control and increased mortality; incorrect clinical pathways and therefore extended issues around care in the community; and staff sickness due to raised stress levels.

Moreover, each year the NHS spends millions of pounds adding unnecessary capacity despite there already being enough capacity in the system: better management of bed utilisation would increase capacity by 3,000 hospital beds per day. So not only is this approach a waste of resources, but it adds even more pressure to those nurses and teams attempting to manage the bed estate or requires adding costly NHS bank staff.

Real-time management

It is a real-time automated solution that is required for the Trust executives looking to see a good ROI, and for the Chief Nursing Officer who is looking to improve staff burnout, and for all of those frontline NHS staff wanting to make a real difference to patient outcomes. Many PAS and EPR systems claim to be able to optimise the bed management process, but these are complex clinical systems not designed for the singular purpose of patient flow. Nor are they designed around the specific day-to-day needs of the nursing staff using them. So for those Trusts that may have considered automating the bed management process, unfortunately, without a real-time solution, the desired outcomes just won’t be achieved.

A bespoke bed management solution quite simply takes the contents of those clipboards and whiteboards at the end of each ward and makes it real-time. A small digital change that can have a huge impact – giving nurses more time back to care, reducing stress, and ultimately improving patient outcomes. And, it doesn’t end there, with a simple bespoke and scalable solution, over time, Trusts have the ability to fully transform the entire patient flow journey.

Tracking patients in real-time from A&E through to discharge using, for example, RFID badges, hospitals can transform the way beds are managed. Creating dedicated bed cleaning teams alongside this ensures empty beds are immediately prepared for a new patient while also releasing nurses from the burden of bed cleaning to concentrate on core clinical tasks and caregiving; while porters are automatically informed when patients are ready for transfer, further reducing idle bed time(1). A real-time solution adds small efficiencies to every part of the patient flow process, which in turn adds up to make a huge difference.

During the Coronavirus pandemic, some Trusts have demonstrated best practice using this type of bespoke digital technology to track the numbers and whereabouts of Covid and non-Covid patients and staff caring for them. It has enabled them to predict the numbers of PPE required, which has helped to prevent over-ordering when the equipment was scarce. For example, The Royal Wolverhampton NHS Trust (RWT) was able to use its patient and staff tracking solution in combination with Real-time Location System (RTLS) sensors, for data analysts to audit the number of interactions between staff and possible and confirmed Covid-19 patients. Furthermore, this type of solution supports better overall infection control by enabling Trusts to easily identify the most at-risk patients and communicate with staff so they are prepared to care for them, flagging each Covid infected or potentially infected patient with an isolation precautionary ‘tag’, and tracking staff to minimise risk. 


The NHS journey to achieving full digitalisation of the patient flow and bed management process can begin with small, simple solutions that have the potential to scale up to a fully centralised, RTLS enabled, operational command centre over time and at a pace to suit an individual Trust’s requirements and challenges. A real-time bespoke bed management system positively impacts the entire acute ecosystem; from more time back to nurses to care, better infection control, to reduced medical outliers, reduced length of patient stay, improved operational efficiencies, and importantly, better patient outcomes.

So the question remains if your Trust hasn’t yet considered this type of scalable and bespoke bed management system, why not?

(1)The fundamental measure of bed utilisation – idle bed time – is not tracked, providing the NHS with no insight into the effectiveness, or lack of it, of bed management processes.


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