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Using artificial intelligence to save money and improve patient care in an NHS Trust

A powerful artificial intelligence (AI) tool has helped redesign 'the rules' for booking operations within one NHS Trust, saving money and improving patient care.

Hull and East Yorkshire Hospitals NHS Trust, one of the largest healthcare providers in the country, serves a diverse local population of 600,000 including some of the most deprived areas in England.

Operating from two main sites, it had a problem meeting increasing patient demand. People were waiting longer than they needed to for operations, theatres were full and, as well as impacting on the Trust’s finances, added pressure was put on staff to meet unrealistic targets.

In 2017, the Trust turned to our Advanced Theatre Optimisation Method (ATOM) team. Designed in conjunction with clinicians, the tool uses algorithms to estimate specific patient procedure times and had already successfully reviewed operating theatre schedules in 17 other hospitals.

Tools of the trade

“Using technology for ATOM provides us with a powerful tool,” said Adam Thwaites, a senior manager in Consulting.

“The technology uses natural language processing when surgeons plan their operating list and do a pre-operative review – reading their notes and recognising words like ‘frail’, ‘elderly’ and ‘obese'. It then predicts operating times for patients based on their notes, the surgeon and the procedure.

“ATOM even accounts for spelling mistakes and typos, and AI ensures it becomes more accurate every time it is run.”

Using sophisticated algorithms, together with details of the procedure and timings based on the surgeons’ previous work, the tool can more accurately predict operating times than even the surgeons themselves.

Operating theatres cost thousands of pounds an hour to run, so the more accurately the tool can predict timings, the better.

Adam added: “Hospitals who don’t use this often have highly-paid staff waiting around and starting late because of delays and this can be expensive.

“Importantly, it doesn’t try to get clinicians to work faster, it just eliminates unnecessary gaps and provides a less stressful working environment.”

Clean bill of health

This optimisation method has been used across the NHS for seven years but is continually being developed. It’s been helping Hull and East Yorkshire NHS Trust since summer 2018 and the results speak for themselves.

The number of people being treated has increased by eight percent and theatre activity income has risen by £4.5 million a year (4.6 per cent). Theatre running costs have fallen by £600,000 a year.

Adam added: “Typically the return on investment is upwards of 10:1 and this is really impactful, especially in Hull and East Yorkshire, where they’ve seen a return of 20:1.”

Currently running at more than 98 per cent accurate, the technology improves as it learns and is creating a culture change.

“Patients experience less frustration and stress, and the Trust has improved recruitment and retention,” said Adam. “It has happier staff.”

Frontline feedback

“The timetable has made it much easier to track kit; it has stopped theatres borrowing kit from one another and has helped to decrease turnaround times. We are no longer asked for more kit than is available, as patients are booked in a much more planned and structured way.” Sterile Services Manager

“It’s so much better, now we know that almost 99 percent of the time we will finish on time.” Scrub Nurse

“Staffing rotas are easier to manage, things just seem to run smoother, and we’re more likely to finish on time. Staff are more likely to say yes to an overrun, if we need it, because they are not being forced to stay every night.” Theatre Matron

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