The NHS must drive up productivity and quality in order to meet the challenges it now faces. Helen Mooney reports on a tool that is helping two trusts do just that

Improving productivity and performance and improving patient care is central to the future of the NHS. As NHS trusts face increasingly austere cost efficiency measures over the coming years, anything that helps them reduce long term cost, increase the efficiency and productivity of clinical staff and improve the quality of patient care can only be welcomed.

At Walsall Hospitals Trust in the Midlands and at London’s Kings College Hospital Foundation Trust, a new display system that gives staff access to real time data showing patient, bed and ward information is having such an effect.

McKesson’s ‘Horizon Enterprise Visibility’ (HEV) tool has been set up in both trusts in a bid to increase productivity and reduce inpatient bed days.

Essentially, the tool gives clinical staff on wards access to a visual whiteboard display that converges and assimilates data from across the hospital. It allows them to see a visual display and diagram of a ward via an electronic whiteboard.

The display shows the beds on the ward and a series of icons are displayed above each bed that show information including detailed patient information, the anticipated date of discharge of each patient from the bed, interventions in the patient’s care pathway and laboratory reports that have been ordered or are due back.

McKesson’s care management director Matthew Hunt explains that the tool enables clinicians to locate patients and access patient information without having to go to the ward on which they are situated. He says that it is also allows ward managers to quickly plan bed capacity at a glance.

“It removes the need for numerous telephone calls between wards and bed managers, it puts nursing staff in greater control of the ward and is a lot better use of clinicians’ time,” he explains.

Walsall Hospitals Trust rolled out the visibility tool in April last year. Operational efficiencies at the trust between May 2009 and August 2009 include a 21 per cent reduction in average length of stay in adult acute wards, a 40 per cent reduction in breaches of the four-hour emergency wait limit and a 78 per cent reduction in the number of surgeries cancelled due to lack of available beds which the organisation attributes in part to its use.

Brigid Stacey, the trust’s deputy chief executive and nurse director, admits that before implementing the tool a lot of people were working hard to keep patients flowing through the hospital and there were good divisional bed management systems but that these were being operated in silos. “We wanted to help staff to visualise what was happening in real-time across the organisation, and to synchronise the various teams - from scheduling and bed managers to the nurses who were trying to discharge patients.”

Ms Stacey says the biggest achievement since using the system has been the engagement of frontline clinical staff. “The project was not about implementing a new IT system; it is about helping staff and making their working lives easier, and releasing time to care. We got rapid buy-in from staff, and HEV has become an important part of their everyday working lives, enabling them to concentrate on the most important aspects of their job. If you took the system away, there would be a huge uproar!”


  • Tells nurses exactly what is going on with their patients at all times - at-a-glance - so they can intuitively prioritise their day
  • Saves up to one hour per nurse per shift by saving seven to 10 phone calls and three to four wasted logons per day
  • Helps place patients in the right bed more quickly, manage observation beds and reduce discharge delays
  • Uncovers between five and 10 hidden beds per day
  • Eliminates phone calls and pages, creating a quieter, safer and more efficient patient care environment
  • Speeds clinical decisions and ensures real-time compliance with core measures and other time-sensitive protocols, which improves care delivery