February 10, 2022
Is the weekend the weak-end?
Find the weakness to target improvement
4 min read
Is the weekend the weak-end?
In the various roles I have had over the last decade, my focus has been on highlighting variation in performance and outcomes in the healthcare setting. Some of the areas are easy “targets” as such, focus on variation in outcomes at the weekend is easy to show but often more difficult to remedy dependent on the setting.
The UK has long since focussed on ensuring equity of service across the working week within the hospital setting Seven Day Service, resulting in a reduction in variation across the whole period. However, some influencers of variation are outside of the control of the acute setting.
One of the reviews we carried out to assess a patient pathway highlighted the fact that patients accessing hospital services at the weekend appeared to be more acutely ill, potentially having waited to see a GP, unable to see a GP, then eventually requiring hospitalisation by which time more intense treatment could be required. Ultimately the outcome is beyond the control of the hospital now responsible for treating the patient.
Community service provision is a real missing piece of the jigsaw when assessing what is influencing variation in outcomes across the week. Availability of services in the community will impact all the major measures of performance.
Length of Stay
- Can patients be discharged over the weekend, are the services available?
- Are services available for the patient to be supported at home to prevent return to the acute setting?
- Is there provision for the patient to be cared for at home?
In the UK there has been ongoing work to develop integrated care for some years now. In 2016, NHS England asked all parts of the country to begin planning together in new partnerships formed of all NHS organisations, local government and others. In April 2021, Sir Simon Stevens announced that all 42 parts of England had been declared integrated care systems. Naturally, what this means to each patient in every part of England will be very different as this is a huge commitment and undertaking. Nonetheless, bringing together the NHS, local government, community, voluntary, social enterprise sectors, and beyond, presents yet more opportunity to review how we maximise value from our two greatest assets People and Data.
The workforce challenge cannot be underestimated. The volume of existing vacancies, plus the ongoing physical and emotional demands make this a very difficult time to retain existing workers, let alone attract new entrants. Likewise, whilst a plethora of new data potentially offering insights into the wider determinants of health is welcome, the challenge posed by a lack of common identifiers, poor system integration and governance concerns is no small hurdle.
Looking further afield, as the UAE has now changed its working week, it will be interesting to see the impact or potential shift in its variation to match with the shift of services to fit the western traditional weekend of Saturday/Sunday. With a lower provision of community care, the reliance on hospital services is far greater in this region, and variation in outcomes wider across the week. It is ever more important to make that variation visible to the clinicians and those in operational positions, to enable a true focus on making care and outcomes equitable across the week.
Working with our clients in the UAE and Australia, we have collaborated to create analytics which have enabled a joint view of performance across all their organisations, giving them the ability to visualise and explore the variation internally and externally, but moreover compare and collaborate in platform to bring speed and visibility on focussed action to improve performance and outcomes.
In taking learnings from finance and banking, we have leveraged Computer Vision, a tool that combines advanced optical character recognition with artificial intelligence and machine learning. These tools can be deployed to automate all or a part of a processes, allowing employees to do less of the repetitive work and focus on the critical tasks that matter most, essential in a complex environment like healthcare.
Exploiting these, we can start to bring manual process, paper records and analytics into a central, cross organisational portal. Providing insight, signposting and releasing human effort, you can invest more time on shaping affirmative action based on a shared, common understanding of the problem.
The Symphony platform, along with its combined analytical modules, brings the people closer to the data and therefore aids global performance improvement.
Without visibility of where the weakness lies, it’s difficult to target improvement. Now more than ever is the time to work together to share best practice across the geographies and industries to improve global healthcare outcomes. Why re-invent the wheel, let’s work together to help strengthen the weak-end.
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