Bed Management at Østfold Hospital Trust

Bridging the gap between bed availability and patient occupancy, recent reports have shown an impressive productivity increase of 15-20%. By using real-time data and streamlined processes, hospitals can handle patient transfers and discharges more smoothly.

With the help of integrated digital collaboration solutions, Østfold Hospital Trust has achieved a better overall overview of occupancy in real-time and can more easily foresee what the next 24 hours will be like. This enables more efficient patient flow and use of resources.

Bed Management at Østfold Hospital

Østfold Hospital Trust, located southeast of Oslo, Norway, opened in 2015 a new hospital. The hospital has 5,000 employees, 630 beds and 21 operation rooms. In 2017 they received HIMSS level 6 certification as the first hospital in the Nordics. DNV Imatis is a key supplier of information technology to the hospital and has been integral to the hospital achieving HIMSS level 6. Almost all hospital employees use the solutions daily to support their work processes through around 180 large displays, more than 1800 smart phones and several desktop computers and self-check-in kiosks.

Despite being newly built in 2015, Østfold Hospital Trust faced a common challenge: a discrepancy between the number of available beds and the number of patients requiring them.

Previously, the hospital relied on manual routines involving various forms, which took time during patient visits. Interdepartmental communication was also time-consuming, often requiring manual calls to multiple locations to reach the right person. Vital information was sometimes written on whiteboards, paper, or sticky notes, leading to outdated or forgotten details. The lack of real-time information between bed units created bottlenecks, preventing optimal utilisation of already strained resources.

Nowadays, most processes are digital, with many registrations performed directly on mobil devices.

Digital whiteboards and interaction across wards

The use of digital whiteboards and collaboration with other wards has given the hospital a better overall overview, all in real time.

Digital whiteboards combine logistics with resource and patient management, which helps reduce bottlenecks. One example is when the doctor performs a check-up in the emergency department. Previously, the registering process was time-consuming. Now the doctor scans the patient’s QR wristband, click visited and the check-up is registered in the whiteboard. The time from when the patient arrives until the check-up is completed has been drastically reduced.

Interaction across wards is crucial to make the best possible use of the hospital’s capacity. Overcrowding and pressure on wards is common, but with interaction between departments through real-time updated digital boards, ward managers can have a dialogue and allocate patients. If a patient is in another ward due to overcrowding but has not been visited by a doctor during rounds, the responsible nursing staff can now go into the whiteboard, find the responsible doctor and call him/her directly or send him/her a message to ask when he/she plans the round, so that the ward can plan discharge.
This provides a better overall view of the situation, but also ensures better patient safety.

Another good example is the handling of patients being transferred between hospitals. In the past, it could take several hours to move a patient. Now the emergency department can tell the ambulance which ward and room the patient should be delivered to because they can easily see an overview of the wards’ capacity in real time.

Because all inpatient wards have the same real-time information, patient flow has improved, work processes have been simplified and communication between wards is easier. In addition, the digital whiteboards have helped to focus on logistics and highlighted bottlenecks.

Digital whiteboard display configured with internal ICT resources

One of the key successes of implementing digital whiteboards at Østfold Hospital Trust is that internal ICT resources can configure some of the functionality in the digital whiteboards themselves. This means that when a need is reported, internal ICT resources can respond quickly to create a solution.

For instance, during the pandemic, the hospital frequently created new digital whiteboard views. New rows were organised on the same day or within a few days. The hospital quickly gained an overview of the infection situation at the hospital because it was easy to change the boards and add a new row with tailored content and rules.

Compatible and integrated

Digital boards are compatible with mobile apps and messaging systems. Boards at Østfold Hospital Trust are fully integrated with more than 50 areas, including clinical and administrative systems such as EHR, lab systems, orderly services, cleaners, patient alerts, telemetry, wireless duress alerts and positioning solutions.

Integrations play a crucial role in streamlining the hospital’s bed management by collecting information from other systems. Everything is automatically entered into the digital whiteboards, reducing the need for double registration.

Patient acuity provides a better overview of the care load

The use of patient acuity, which is registered in the digital whiteboards, provides an overview of the care load for the various wards. This in turn makes it easier for managers to allocate staff resources within an inpatient area.

Patient acuity is carried out by nursing staff, who estimate treatment time based on the patient’s treatment plan. For instance, a patient may have a higher score in the morning due to scheduled treatments. Patient acuity is therefore measured per shift.

Outcome - easier to allocate resources correctly

Østfold Hospital Trust has achieved a better overall view of occupancy and can more easily predict the next 24 hours.

For instance, it didn’t take long for cleaning staff to change their entire rotation after the hospital started using Bed Management. Statistics revealed less pressure on cleaning services in the mornings. Resources were therefore moved to when the demand was higher. The system is now used on an ongoing basis to see if there is a need to summon extra staff in the evening.

Another example is how easy it has become for the emergency department to interact with wards and admit a new patient. The patient is updated on the board and the ward is notified. The bed and staff are prepared, a porter is ordered, and the patient is moved. Simple and efficient.

It is a valuable planning tool both for the distribution of resources, and for patient flow and logistics.

Achievements with Bed Management:

Visualisation of information across departments

Overview of patients reported to the emergency department

An overview for professionals outside the hospital, like physiotherapists, providing insight into the locations of patients.

Overview of the number of discharges

Visualised bottlenecks

Easier to allocate resources

The Future

Østfold Hospital Trust needs to expand its capacity. The hospital has become too small and lacks space. Therefore, a new building is planned to be ready in 2030.
It is natural for the hospital to expand some of the digital solutions it uses today. Simultaneously, they aim to continue evolving and collaborate with suppliers to achieve even greater digitalisation and improve workflow processes. This proactive approach will help them meet the future demands of increased patient volume and deliver even better healthcare services.