The impact of hospital command centre on patient flow and data quality: findings from the UK National Health Service
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Le résumé fourni par la source
In the last 6 years, hospitals in developed countries have been trialling the use of command centres for improving organizational efficiency and patient care. However, the impact of these command centres has not been systematically studied in the past. It is a retrospective population-based study. Participants were patients who visited the Bradford Royal Infirmary hospital, Accident and Emergency (A&E) Department, between 1 January 2018 and 31 August 2021. Outcomes were patient flow (measured as A&E waiting time, length of stay, and clinician seen time) and data quality (measured by the proportion of missing treatment and assessment dates and valid transition between A&E care stages). Interrupted time-series segmented regression and process mining were used for analysis. A&E transition time from patient arrival to assessment by a clinician marginally improved during the intervention period; there was a decrease of 0.9 min [95% confidence interval (CI): 0.35-1.4], 3 min (95% CI: 2.4-3.5), 9.7 min (95% CI: 8.4-11.0), and 3.1 min (95% CI: 2.7-3.5) during 'patient flow program', 'command centre display roll-in', 'command centre activation', and 'hospital wide training program', respectively. However, the transition time from patient treatment until the conclusion of consultation showed an increase of 11.5 min (95% CI: 9.2-13.9), 12.3 min (95% CI: 8.7-15.9), 53.4 min (95% CI: 48.1-58.7), and 50.2 min (95% CI: 47.5-52.9) for the respective four post-intervention periods. Furthermore, the length of stay was not significantly impacted; the change was -8.8 h (95% CI: -17.6 to 0.08), -8.9 h (95% CI: -18.6 to 0.65), -1.67 h (95% CI: -10.3 to 6.9), and -0.54 h (95% CI: -13.9 to 12.8) during the four respective post-intervention periods. It was a similar pattern for the waiting and clinician seen times. Data quality as measured by the proportion of missing dates of records was generally poor (treatment date = 42.7% and clinician seen date = 23.4%) and did not significantly improve during the intervention periods. The findings of the study suggest that a command centre package that includes process change and software technology does not appear to have a consistent positive impact on patient safety and data quality based on the indicators and data we used. Therefore, hospitals considering introducing a command centre should not assume there will be benefits in patient flow and data quality.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- The impact of hospital command centre on patient flow and data quality: findings from the UK National Health Service
- Date Crossref
- 26/09/2023
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Leeds pays non établi dans la noticeUniversité ou école supérieure
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Bradford Royal Infirmary pays non établi dans la noticeÉtablissement de santé
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Bradford Teaching Hospitals NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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Bradford Institute for Health Research pays non établi dans la noticeOrganisation à but non lucratif
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University of York Department of Computer Science pays non établi dans la noticeUniversité ou école supérieure
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University of Bradford pays non établi dans la noticeUniversité ou école supérieure
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School of Computing pays non établi dans la noticeUniversité ou école supérieure
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Yorkshire and Humber Patient Safety Translational Research Centre pays non établi dans la noticeStructure de recherche
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School of Psychology pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Health Studies pays non établi dans la noticeUniversité ou école supérieure
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Wolfson Centre for Applied Health Research pays non établi dans la noticeInstitution
University of Leeds, Bradford Royal Infirmary et Bradford Teaching Hospitals NHS Foundation Trust, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.