Reverse Bed Chain, a New Way to Tackle Hospital Inefficiencies


The current NHS waiting list has hit 7.3 million in the UK, increasing monthly. A recent survey conducted by the NHS revealed only 21.3% of staff reported that there is enough headcount  available for them to do their job properly and 44.8% admitted to witnessing errors, near misses or incidents that could have hurt staff or patients. The same frustrations exist in the US healthcare system and rising backups beginning in the emergency department have been described as the canary in the coal mine. Clearly something must change.

Short of a reversal of the global staffing shortage, hospitals and health systems must find ways to do more with less transforming workflows through efficiency and optimization as other industries have been driven to do. Healthcare has always been reactive by nature, but transforming healthcare processes, in a similar manner to successful manufacturing processes, while preserving quality care and patient relationships will take a big transition from reactive to proactive.

One strategy involves reverse bed chain, a concept created to improve patient flow across a hospital environment and alleviate pressure within emergency departments (ED). According to the NHS, flow within the healthcare setting is defined by the movement of patients, information or equipment between departments, staff groups or organisations as part of a care pathway. With a reverse bed chain in place, this continuous flow ensures that each step in the care process is completed without delay. This is like Just in Time (JIT) manufacturing processes made famous by Toyota.

Two areas to be targeted are patient flow and capacity planning, improving both the experience for staff and patients, and increasing the number of patients being seen.

So, how does reverse bed chain work, and how will this help the NHS?

Improving Patient Flow

The traditional method of patient movement begins in a “pull” process with the patient being discharged from hospital and their movement from a base ward to the discharge lounge. A porter or patient logistics staff would move the patient from the ward out to the lounge then have to transition across the hospital to the assessment ward to collect the second patient and then move them to the base ward, the base ward where the first patient was moved from. Upon completion the porter would then head to ED and collect the 3rd patient before moving them to the Assessment ward (where the porter moved patient 2 from). In principle the discharge of a patient from the hospital initiates a pull through each ward and ultimately from ED.

If, however, we were able to bundle multiple patients and their move related tasks together, into a single group, time can be reduced that would otherwise been lost by patient logistics staff and backlog in ED, as the delivery location of patient 1 will be the collection location of patient 2 and so on.  Although this can be mapped out on paper or in a spreadsheet, to efficiently create a pull process, hospitals will need technology to assist.

New location and tasking technology offered in a “lite tech” format utilizing a simple to use phone based app offers hospitals and health systems the ability to group patient moves into a single task, displaying the order in which the group needs to be carried out.  Assignment of the task group is based upon task handler’s location within the building, ensuring that we issue the task to the right person who can get to the start location the quickest.

Improving capacity

By moving patients in a synchronised manner, the backlog in ED is addressed, and delay related harm is mitigated.  Together this “light tech” solution can improve the patient experience, keep care flowing, and help support staff across hospitals.

This means that long term workforce issues can be resolved, for example, clinical staff can continue to care for patients while other team members are perfectly aligned where they can make the most impact.