System-wide early warning tool for acute pathways based on actionable intelligence Nottingham University Hospitals NHS Trust

Recent winters have shown the huge pressure on health care systems and the challenges there are with managing emergency admissions. This project aimed to demonstrate how expert analysis of large and multiple data sources can be used to support operational decision making in acute care.

Clinical observations recorded in emergency departments, combined with other data, can predict pressure to discharge patients, and much of these data are available in real-time. The project explored how this ‘actionable intelligence’ can be used to allow a more considered and timely response across the health economy, for example being able to deploy staff differently or planning for increased community support.

The project initially reviewed a wide range of data to identify which would be most helpful for predicting discharge pressures. In-depth analysis identified that using a single variable was the most accurate predictor of the values of interest: medically safe supported discharge. This made the tool much simpler to implement and enables it to potentially be used to forecast a range of other data of interest.

An early warning tool was developed and tested, and has now been deployed at the Trust as part of the suite of materials available to operational decision makers.

Operational staff are able to use this prediction, as part of suite of information that is used, to take action in advance that aims to reduce delays and waste; reduce lengths of stay, bed occupancy and readmissions; improve the efficiency of care processes; and improves quality of care.

The project required a combination of data analytics, forecasting and project management experience, working in partnership with clinical and operational expertise. The multidisciplinary nature of the project board was key to the success of the project.

The tool has been shared online and is being explored by other organisations for adoption for other purposes.

Contact information

For more information on this project, contact Glen Howard, Programme Manager, Health Analytics and Informatics, EMAHSN.