Wexham Park Hospital People Flow Study

Slough, UK

Wexham Park Hospital has been serving the people of Slough and the surrounding area since it opened in 1965. In 2014 management of the hospital was taken on by the Frimley Health NHS Foundation Trust, and a new accident and emergency unit was planned, designed and officially opened in April 2019.

As part of the process of optimising the design for the new A&E department, Buro Happold’s people movement experts were engaged to study the intricacies of the design with a goal of maximising the smooth flow of patients experiencing the hospital’s emergency facilities each day.

To optimise its new A&E department, the hospital trust engaged Buro Happold’s people movement experts to maximise the smooth flow of patients.

We created a dynamic digital model, which simulated the movement of patients around the facilities within a representative 24-hour period.

One of the major bottlenecks identified was having a single triage nurse – simulations revealed the impact on patient flow of having two triage nurses working simultaneously.

Our interventions resulted in an increase in through-put of patients of 23% per day, a reduction in patient total waiting time of 43% in the Minors department.

Challenge

Frimley Health NHS Foundation Trust asked our team to study certain key aspects of the efficient flow and management of patients through the A&E facilities. These particularly focused on the impact on patient flow around different approaches to management of staff members. It asked specific questions, such as what the shortfall in staffing would be to be able to manage 400 patients a day and keep patients moving out of the ground floor within the target time of four hours.

It also sought to examine critical scenarios, such as if there is a sudden unexpected shortage of staff, with modelling examining how that would impact the flow of patients and how the Trust could modify the use of the building to allow for the flow to be maximised within those conditions.

A range of other specific questions were posed around the management of patient flow within the facilities, and the team was also tasked with identifying the best places for wayfinding signage to be sited to avoid bottlenecks with visitors getting lost.

Solution

Buro Happold’s people movement experts gathered and carefully interrogated a wealth of data from the hospital that could be used to illustrate a representative day in the A&E department.

From this we created a dynamic digital model, which simulated the movement of patients around the facilities within a representative 24-hour period. This allowed us to look closely at the space utilisation and the potential for any bottlenecks within the system.

This base model was also used to create specific simulation experiments – such as examining the impact on patient flow if two nurses worked to triage patients at one time instead of one.

By running a series of these sorts of digital simulations we were able to suggest the optimum numbers of staff required to balance all of the processes within the department and maximise patient flow. This resulted in an increase in through-put of patients of 23% per day and a reduction in patient total waiting time of 43% in the Minors department.

Value

Our people movement experts mapped the hospital’s A&E, ambulatory units and associated facilities and interrogated a wealth of data. This informed a detailed spatial analysis and dynamic modelling of scenarios, which were able to provide a range of valuable insights for the hospital trust and helped inform the best approach to its day-to-day staffing and management.