Saving 10,000 hours: improving patient flow in the Emergency Department through portering

Infinity Health provides a secure collaboration and task management solution that transforms how healthcare professionals coordinate activity and share critical information. The company recently won a prestigious HTN Award for its work with London North West University Healthcare NHS Trust, where its ePortering solution saved more than 10,000 hours of staff time in just one year. Here, we visit the project case study, and explore just how they saved those hours.

London North West University Healthcare NHS Trust (LNWH) is a large provider with more than 8000 staff, serving a population of over one million people. In 2018, the Chief Information Officer, Sonia Patel, who has a reputation for innovation and “delivering the best digital healthcare,” contacted the DigitalHealth.London Accelerator asking for recommendations as part of Northwick Park Hospital’s “Let’s Get Digital” programme. It put Infinity Health forward, which was subsequently selected to help transform the coordination of patient transfers to improve clinical efficiency and patient experience.

Millions of porter requests are coordinated every year in ED, but delays in transferring patients to investigations or ongoing care impacts patients awaiting admission. The median waiting time for all patients increased from 134 minutes in February 2012 to 165 minutes in February 2019. In major EDs, 18.5% of patients waited longer than four hours in 2018-19. At 70 trusts, more than one in five patients spent over four hours in A&E*.

At LNWH, staff went to a fixed location to handwrite porter requests. Additional information was rarely communicated, so porters didn’t know who made the request, the patient’s name or the equipment required. Porters returned to this location to pick up the next job. This lengthened the process and ultimately increased patient waiting times. Additionally, the portering cancellation rate was 39%, for unknown reasons. On the clinicians’ side, they lacked visibility to track the status of portering tasks, and inconsistent communication between clinical and operational teams resulted in an inefficient and frustrating process.

After the successful introduction from the Accelerator, the Trust decided to go ahead with a small-scale pilot with Infinity, which developed into full implementation at Northwick Park Hospital based on the pilot’s success.

Up to that point, the Accelerator had supported Infinity with access to health economists at Imperial College Health Partners. This helped them build their knowledge around evaluation, and consider and plan the KPIs and metrics they would need to collect to demonstrate their impact and make successful business cases to NHS organisations, like Northwick Park.

Infinity’s ePortering solution replaced the manual, paper-based process for requesting porters at LNWH into a truly digital, “just in time” service. Staff now submit porter requests from anywhere in the hospital, using secure mobile devices, and can easily escalate urgent tasks. Porters accept and share their activity in real-time, similar to popular taxi services like Uber. Notifications alert key staff if issues arise, whilst reporting dashboards reveal business insights, for example how long certain tasks take and how many jobs are completed in a time period. A complete audit trail is recorded for all activity, including reasons for cancellations, which feeds into future planning and improvements.

The solution is now used to by more than 500 staff in the ED, the performance of which has significant consequences on the operational efficiency of the entire hospital. In LNWH, Infinity Health has helped reduce cancellations by over 80%. This has resulted in a sustained reduction of six minutes per porter request, which translates to a saving of more than 10,000 hours each year, equivalent to five FTEs.

Cirtis Lozane, Porter Supervisor, London North West University Healthcare NHS Trust, said: “It has changed our lives, everyone now works as a team. We have more time to do our job, I love it more than anything else. I would recommend it 100%.”

Carrie Johnson, Senior Sister, London North West University Healthcare NHS Trust: “Porters are visibly happier and happy porters make everyone happier! Nurses like knowing the status of their jobs. Escalating a request is so easy now and it’s preventing breaches. The app is brilliant!”

The overarching impact is that the right information is being shared with the right people, at the right time. Porters now know who requested the transfer, the patient’s name and any additional requirements, meaning that patients experience a far more streamlined and coordinated service. Infinity automatically escalates requests for critical patients, expediting diagnosis, treatment and appropriate transfer, which further improves efficiency and patient outcomes.

Sonia Patel, Chief Information Officer, London North West University Healthcare NHS Trust: “The collaboration with Infinity Health demonstrates how working with the right partners genuinely improves the daily working lives of our staff and ultimately, patient care.”

Infinity Health and LNWH are now exploring the innovation’s use in other clinical settings.

More information

• Learn more about Infinity: infinity.health | @infinityhealth
• As its ePortering and other solutions are further developed, Infinity Health is looking to carry out clinical trials of the technology and would welcome involvement of patients in co-production.
• Beyond London, Infinity is looking to scale its ePortering innovation. It is working with other members of the AHSN Network, and is for example in conversation with Health Innovation Manchester, Yorkshire & Humber AHSN, and Wessex AHSN about adoption and spread.
• The DigitalHealth.London Accelerator continues to support adoption by recommending and making connections with Infinity and NHS organisations, where appropriate.
• *Baker, c (2019). NHS Key Statistics: England, May 2019, Briefing paper Number 7281, House of Commons