\n\n\n\n
Five years ago Maidstone and Tunbridge Wells NHS Trust in Kent performed averagely among 137 trusts with major accident & emergency (a&e) departments, when measured by wait times. Recently, even as other trusts have been buckling, it has rarely left the top ten.<\/p>\n\n\n\n
Two things in particular have helped to turn things around, says Miles Scott, the trust\u2019s chief executive. One is its \u201csame-day emergency-care centres,\u201d places where patients who have had things like chest pains or falls can be assessed, diagnosed and treated without being admitted. The other is its \u201cmission control\u201d, the base from which the flow of patients is tracked through the trust\u2019s two hospitals.<\/p>\n\n\n\n Managing this patient flow well is essential. Every day the National Health Service makes over 16,000 emergency admissions to its hospitals. Each patient must be slotted into a limited number of beds in a limited amount of time. That makes a&e, a hospital\u2019s main entry point, \u201ca bit like Tetris,\u201d says Nick Bagley, a consultant and clinical director of operations of the Maidstone Emergency Department. But in this life-and-death arcade game, when the patients start arriving quicker, things can quickly spin out of control.<\/p>\n\n\n\n Until the covid-19 pandemic struck, Maidstone’s managers conducted this operation using \u201cpencils and rubbers\u201d, says Sam Roberts, one of their number. Nurses determined which of the trust\u2019s more than 700 beds were available by running up and down several flights of stairs to check on them for themselves.<\/p>\n\n\n\n Now they use TeleTracking, a tracking system made by an American firm of the same name. Electronic wristbands are fitted as patients enter hospital, providing real-time data on where they are and on how long they have been waiting for admission or discharge. At mission control (actually a back room in the hospital, with jaunty pop music playing in the background) operators then match ailing patients to available beds. Aggregated data flash up on eight giant dashboards, turning red if the metrics do not meet predefined targets. By historical comparisons, at least, they are flying: the wait times for those admitted from a&e onto a ward are almost three times shorter than they were before the pandemic.<\/p>\n\n\n\n![\"\"](\"https:\/\/eadn-wc04-11971913.nxedge.io\/wp-content\/uploads\/2023\/09\/teletracking-mtw-economist-photo.jpg\"){kind=tracking}
<\/figure>\n\n\n\n