Activeplan has been involved in several NHS initiatives to improve the utilisation of its space and use it as a means of supporting the redesign of service-delivery.
A blocker to that is the number of different NHS and Care providing organisations, each of which “owns” property that includes “Care Settings”.
Because of the way that information has been created, managed and fragmented over the years, individual Trusts do not have reliable information about the properties they own, the spaces within them, what services each space is capable of providing, how intensively it is used and therefore when it is available for providers to use to deliver services. Treatment rooms are block-booked and often used less than 20% of the available time which is both wasteful but also prevents other services using what is, in fact, available space.
For 10 years, Activeplan has been used by Trusts in Nottingham, Norfolk, Leicestershire, Birmingham and Bedfordshire, Luton and Milton Keynes (BLMK) to overcome this. In the first four, we have spatial models of the properties, many of which are healthcare centres where the room booking is used to find suitable rooms for treatment – not in-patient care. However, in Norfolk, we have a couple of Community Hospitals and, through our PFI FM management, we have spatial models for Dudley, QE Birmingham and Barts and Royal London where there is no reason ROOMS could not book a bedroom or a bed.
The novelty of Activeplan is that it starts with the Activity for which a room is suitable and assigns that as an “intelligent” attribute. When someone is looking for a room in a locality that is available to support that activity at a specific time, Activeplan matches the requirement with the available rooms, only showing the ones that are available. The person booking is already registered so when they book the room, the system automatically records which service-provider should be charged (or use simply reported because NHS money tends to be circular, but the reporting can change behaviour.
The “owner” of the space uses professional judgement to determine what activities a space is able to support (although we could also apply the NHS activity database which is more explicit) and all buildings/floors/spaces are made available for any authorised person to book – from multiple service-providers. All space is available unless it is booked. The service-provider of phlebotomy that has historically “owned” the space in a health centre (and perhaps only run clinics three mornings per week) books that room only for the hours they need it.
COVID emergency – the long-established issue of insufficient community-based care settings to support Step-Up and Step-Down care is now much worse
In BLMK, we spent two years working with the regional STP made up of the Health and Care property owners, trying to integrate care. We developed an implementation of Activeplan that would allow Care Homes to put all their rooms on the platform, book the ones that were occupied and those which were not, could be booked by the GP for Step-Up or by the Hospital’s discharge team for Step-Down. A “Care Package” could be assigned against the patient, allowing the relevant service-providers to support them.
This good idea was de-railed by the social care team in the Council who saw their local (private) care homes as a convenient local resource and didn’t want the other care providers in the STP region to use them. This emergency should overcome those political barriers.
Hotel rooms could be added very easily and Activeplan’s spatial model would make it easy to plan for low, medium and high risk patients, the procedure planner manage cleaning regimes, the AIM and Product Library record newly installed assets and a 360 photo can record what the room was like before it was commandeered as a baseline for re-instatement.
Converting CAD plans to spatial models could be done quickly and at low cost by people with CAD from home – and there is also value for other asset/risk management like fire.
How does it work?
ActivePlan is a BIM application that works for portfolios of buildings and how they are used.
The key differentiator that enables ActivePlan to dramatically improve levels of utilisation are “intelligent” floor plans with which clinicians (or their administrators) are presented when they search for a room suitable for an activity or treatment.
Some trusts want to break the “ownership” of space by the service lines. A phlebotomy room can be used for a raft of other treatments.
To make this this possible, each room is assigned a generic function (e.g. consulting or treatment room) but also all the treatments/activities are suitable/safe to deliver.
So we use a CAD plan to create a spatial model of each building that contains intelligent spaces that “know” what activities they can support.
A clinician looking for rooms in a locality that are suitable for a treatment are only presented with rooms that are suitable and available at that date and time.
In this case, they click on Long Stratton and see there are five suitable rooms, three of which are booked, leaving two available for booking.
They drill down into the building and are presented with the rooms they might use in the form of a floorplan. They can see where the rooms are and also which services are being delivered from adjacent rooms at the same time in case of a conflict.
The booking form captures:
- the time of day
- the activity it will be used for
- which service-provider they work for
It can also be set to require a budget code to be entered before the booking is processed
For recurring bookings, they can check the room is available at that same time in coming weeks and forward-book the rooms.
Booking desks or car parking spaces is also managed through Activeplan, recharging costs where appropriate.
Where the management of desk space is key, we can partner with OccupEye to install sensors at each desk that give real-time reporting of the use of each desk and where there is availability.
This combines with ActivePlan’s booking functionality to optimise limited capacity
Reporting the actual use can help change behaviours whereby rooms are block-booked and not used – or clinical spaces used for admin work. ActivePlan also records actual utilisation (not just bookings)
And can report estates cost per patient
The system generates invoices (real or notional) with excellent backup information about who used what, when and for what activity
Cost of common areas can be charged back to space users in various ways – percentage of space in dedicated use, shared space or use of adhoc space.
This is far more effective than a simple apportionment by area which does not address those using space in an adhoc or agile manner. In the example below, the numbers reflect the number of organisations using each space so “1” is dedicated whereas a toilet or corridor is “7” in which case the cost of this space will be divided between the seven building users.
Automated occupancy checking
We have developed a Bluetooth Beacon network that places Bluetooth sensors in rooms or at desks to automatically record and report occupancy.
When combined with ActivePlan’s information about who is using which space and for what, this becomes a very powerful solution.
Step-down and step-up care
ActivePlan can hold information about care homes in the region. The discharge team in hospitals are in daily contact with local care homes to find rooms for transitional care between hospital and the home.
The plan is to add floor plans for all the care homes into the database and for the care home managers to book the rooms they are using, leaving free the ones they are not using.
The discharge managers looking for space can find a suitable room, book it and book the care package, perhaps from the local community services trust or the council, and commission a GP to oversee the transfer and care.