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Case Studies

[ Vasteras Central Hospital ]

By working with Spatial Quotient, the Ophthalmology unit at Vasteras Hospital increased doctor efficiency by 30%, leading to a 26% reduction in the time patients spent in the hospital.

[ Vasteras Central Hospital ]

Vasteras Central Hospital were facing challenges in their Ophthalmology unit. Their pathways were inconsistent, they weren’t using their resources efficiently, they could see that their space wasn’t being used as effectively as possible, and it was clear that patients were often waiting longer than they needed to be. But despite knowing what the problems were, understanding what to do to solve them was proving tough. 

It was then that they called in Spatial Quotient to support them to see what they could do to make things run smoothly.

The data

Whilst Vasteras had been on the right track, the data collected and presented by Spatial Quotient revealed that there was more going on in Ophthalmology than initially met the eye…

  • Pathways were shown to be highly variable
  • Waiting times could spike
  • No two patient experiences were the same
  • Patients were often seen out of order
  • Use of resource, timing of activity and layout of space were inconsistent

On the positive, however, the data revealed that:

  • Ophthalmology had one of the best aggregated patient experiences versus the benchmark
  • Injection sessions compared very well against the benchmark
  • There were clear opportunities to improve the patient workup

A new approach

Following the insight that the data provided, Spatial Quotient worked with Vasteras to identify Blockers and Opportunities for real, measurable, and actionable change. These were:

  1. To develop more consistent high volume pathways that would improve both staff and patient experience by:
    • Standardising all preparations for all patients
    • Standardising specific preparations for Glaucoma & Medical Retina
    • Clearly indicating that steps had been completed
    • Implementing ongoing room standardisation
  2. To improve patient prep and ensuring the clarity of early appointment steps by:
    • Implementing a new Reception protocol for patients
    • Implementing a new configuration of prep rooms close to the Doctor
    • Standardising the rooms
    • Making changes to the patient worksheet
  3. To improve appointment scheduling and the utilisation of space by:
    • Clustering rooms to make it easier to understand the flow of patients and staff
    • Updating cosmic with patient progress

The results

Vasteras implemented the changes we recommended. The results speak for themselves. 

There’s been a:

  • 30% increase in doctor efficiency
  • 25% reduction in the time it takes to complete OCT
  • 26% improvement in patient experience

Looking to the future

Things are looking bright for Vasteras Ophthalmology. Not only can they be proud of the vast improvement to their service, but with the data provided by Spatial Quotient, they also have the insight to improve well into the future with the following opportunities:

  • Potential to reduce the gaps in resource use and allocate support staff to doctors so that they can finish earlier
  • Room to improve better consistency in all OCT sessions rather than just some
  • New processes with the potential to work on protocols for anomalies
  • The possibility of being able to provide a one-stop injection service given the speed of their current service

Spatial Quotient wish Vasteras all the best in the future and look forward to hearing of their continuing success.

[ Guys and St Thomas' NHS Trust ]

We helped Guys and St Thomas’ Assisted Conception Unit increase capacity by 30% within only 6 weeks of the project’s completion.

[ Guys and St Thomas' ]

Spatial Quotient were briefed by Guy’s Assisted Conception Unit to identify inefficiencies in patient flow. Guy’s wanted to ensure more patients could be seen and better care could be delivered to those patients.

It is always difficult to see where the issues are in a complex service delivering many different pathways to many patients. That’s why they called in Spatial Quotient.

The data

We conducted a root-and-branch review of the patient flow experience and highlighted key steps in the care pathway that were under-resourced as well as those that needed redesigning altogether. Our analysis also focused our attention on areas where there was significant variability, which was causing problems for the staff as well as the patients. Spatial Quotient soon helped GSTT see what was going on. Using our non-intrusive data gathering techniques, the following sticking points were plain to see:

  • There were long wait times for patients 
  • Patients were often being seen out of order
  • There were long wait times for specialist consultations
  • Consultation times were registering as above average due to variability in role definitions
  • More generally some roles needed much clearer boundaries and definition
  • New Patient Pathways were too many and varied
  • There was high variation in high volume pathway steps

A new approach

Following the data, Spatial Quotient helped GSTT identify the blockers and uncover opportunities for change that would make a real difference to the Unit. These were:

  1. Addressing variation in high volume activities such as scans:
    • Clear definition of steps
    • Clear allocation of responsibility and handover once completed
    • Managing by exception when things don’t go as planned
  2. Defining a clear specification and reduced variation in New Patient Pathways:
    • Defining the details of requirements and any training needs
    • Ensuring that handover is clearly defined and executed
    • Ensuring next steps on the journey were consistently identified and recorded
  3. Redfining Consultations to ensure consistency with patients and reduce patient wait times:
    • Clear and agreed definition of the role and its boundaries
    • Defining which steps should be passed onto the support team
    • Defining what additional training is
    • Ensuring that handover is clearly defined and executed to deliver a smoother patient pathway

The results

Since our recommendations have been implemented, we have seen a paradigm shift in the ACU team’s positivity as well as productivity. The site has seen a 30% increase in capacity within only 6 weeks of the project’s completion:
  • A 30% improvement in the capacity of the clinic
  • A reduction in patient waiting times, with patients being seen at or even before their appointment times
  • A better overall patient and staff experience
  • Much higher staff morale now that the clinics are running more smoothly
Not only that, but the Lead Clinician has commented on the success of the project personally: “We have increased throughput across the service, which enhanced our productivity. The desire for the team to take on more work has been obvious and the results from the programme with Spatial Quotient deserve our support and recommendation to others who would like to use them” – Yacoub Khalaf.

Looking to the future

The service review carried out by Spatial Quotient has uncovered a number of key learnings that GSTT can continue to implement alongside the great work that they already do. These are:

  • Too many complex pathways leads to more confusion in delivery, more variation and more delay
  • Consultations should focus Consultants are specifically trained to do
  • High volume activities must run like clockwork and be standardised as far as possible.
  • Team morale, productivity and capacity can often seem as though they are hard to attain but small improvements in communication and clarity can make all the difference.

We wish the The Assisted Conception Unit at GSTT the very best for the future and look forward to hearing how they continue to offer great care to patients.

[ Royal Victoria Hospital, Belfast ]

We helped Royal Victoria Hospital reduce the amount of time patients spend in the unit by 43%, reducing waiting times and increasing capacity to serve more patients.

[ Royal Victoria Hospital ]

Royal Victoria Hospital in Belfast were looking at their Ophthalmology unit. Despite all the hard work at the unit they still felt like there was room for improvement. Waiting times were longer than they should have been, there were inconsistencies in the flow of patients through the unit and they could see that resources weren’t being used to their full potential. As a result of all this, patient satisfaction was low and staff were suffering from low morale.

Royal Victoria Hospital were keen to redesign their service, optimise the flow of patients and make the service in Ophthalmology run like clockwork. But inefficiencies and bottlenecks were hard to pinpoint. That’s when they called in Spatial Quotient.

The data

Spatial Quotient soon helped RVH see what was going on. Using their non-intrusive data gathering techniques, the following sticking points were plain to see:

  • There were long wait times for patients 
  • Patients were regularly arriving late to their appointments
  • Patients were often being seen out of order
  • There were inconsistent times and frequency for appointments with staff
  • There were long wait times before patients moved on to be seen by a doctor or consultant
  • Consultation times were registering as above average
  • Pathways were showing up as inconsistent
  • There were often repeated steps in the pathways
  • 35% of the pathways had unplanned activity
  • Rooms weren’t being used to their full potential and had poor layout

A new approach

Following the data, Spatial Quotient helped RVH identify the blockers and uncover opportunities for change that would make a real difference to the Unit. These were:

  1. Defining a clear specification in the Patient Workup, ensuring that their initial engagement was consistent across the sub-speciality by:
    • Defining the details of requirements and any training needs
    • Configuring all the spaces in exactly the same way and with all the same equipment
    • Ensuring that handover is clearly defined and executed
  2. Providing Consultation Support at the beginning and at the end of the time spent with the patient by:
    • Supporting staff in their roles and giving detailed definitions of tasks to undertake
    • Defining which steps should be passed onto ‘Patient Workup’
    • Defining what additional training is required and consider implementing the role of scribe for high volume clinics
    • Ensuring that handover is clearly defined and executed

The results

RVH were very successful in implementing the changes. And as a result there has been:

  • A 43% improvement in the time taken for the patient journey through the clinic
  • A reduction in patient waiting times, with patients being seen at or even before their appointment times
  • A better overall patient experience
  • A more efficient clinic delivery and capacity to up-skill nursing staff as needed
  • Much higher staff morale now that the clinics are running more smoothly

Not only that, but the Lead Clinician has since been nominated for a Trust Improvement award for all their wonderful hard work. 

Looking to the future

The service review carried out by Spatial Quotient has uncovered a number of key learnings that RVH can continue to implement alongside the great work that they already do. These are:

  • Small inconsistencies in service can lead to much longer wait times overall
  • When services and activities are carefully planned the experience is less stressful for both patients and staff
  • Seemingly small changes in the consistency of a service or clinic structure can make a big difference
  • When all the clinic staff work well together the change is much more consistent

We wish the Royal Victoria Hospital the very best for the future and look forward to hearing of their inevitable continued success.