The Model-Driven Hospital
By Lord Ara Darzi
Modern hospitals are hugely complex, with thousands of staff delivering sophisticated care, often to extremely sick patients. They employ the most advanced technology and equipment and can cost £1 billion a year to run.
Although the standard of care delivered in the NHS is the equal of any in the world, its productivity has not improved compared with other sectors in the economy, which have made huge advances over the past 30 years on the back of smart logistics and real-time information management.
This is partly because we, who work in the NHS, have focused on delivering life-extending and life-enhancing treatments, rather than running efficient systems. Or perhaps that is how we justify it to ourselves.
What we all want is safe, productive hospitals, where patients are treated with the appropriate level of urgency and receive high-quality care; where staff reach their full potential and hospitals deliver excellent value for money.
How do we achieve this? An essential step is to align knowledge flows and working practices by exploiting available technology. If we fail to do this, we risk losing the benefits of information integration, smart sensors and the Internet of things that have transformed other sectors.
In industry, computer-based reference models track entities and activities. Strategically, this allows facilities to be designed or modified ahead of implementation, while operationally it supports the management of intensely complicated product lines, service delivery, and financial transactions.
In healthcare, the Cumberland Initiative suggests we can adopt this approach with a model hospital that simulates the real thing, and use it to develop better processes and better information services. The aim would be to design patient experiences that are safer and reach better outcomes faster, with improved staff scheduling, smarter supply chains and better utilisation of space and equipment.
Such a model would require a team of clinicians, academics, business people and patients to meet the clinical and operational needs of the hospital. An interactive element would allow adjustments to the service to be tested as the impact of improvements in one area was felt in others.
Critically, such models would provide a complete, up-to-date description of all hospital services, increasing the engagement of stakeholders, helping them understand the need for change and encouraging them to support the introduction of new technology as required.
The Cumberland Initiative expects significant results, including ward services with improved continuity of care, a reduction in the use of bank staff and locums, more efficient and resilient central services, such as theatres and clinical laboratories, smoother ward rounds and better discharge processes, with smarter metrics to measure the improvements.
These would be worthwhile gains.
Lord Darzi is a surgeon and director of the Institute of Global Health Innovation at Imperial College London. He was a Labour health minister from 2007-9.