The soaring coronavirus death toll in elder care facilities is an urgent reminder that nursing homes are among the places put most at risk by the pandemic.
One-third of all U.S. coronavirus deaths occur in nursing homes.In Europe, the pandemic accounts for up to half of care home fatalities.
But with the help of low-code automation, Bexley Health Neighborhood Care, UK (BHNC) is ensuring that its facilities are providing quality care by complying with regulations, optimizing resource and staffing levels, and isolating COVID-19 positive residents.
"The digital side of things has moved forward enormously," says Darren Blake, Chief Operating Officer of London-based BHNC. "I think that this is a new normal for us," said Blake.
Blake said that testing regimes in BHNC's care homes will continue to help more and more patients get through their care journey. He also said Bexley is planning a two-year cycle to move through the pandemic.
"We'll get hit with more waves of COVID until we get immunization and a vaccine," said Blake."We're fully remote now. We've got digital technology in all of our general practice surgeries. Patient contact is primarily through video consultation. And this entire digital revolution happened faster than we imagined."
In our last episode, Blake gave us the lowdown on how BHNC rebooted with low-code, allowing them to bring together digital and human labor on a single platform in less than a week. The finale of our two-part series kicks off with Blake zooming in on the challenges of managing staff and resources amid a pandemic. (You can read the first installment here.)
Enjoy the conversation:
Appian: Let's talk about resource management and how you do that in a pandemic. Let's start with the new resource management application you built at Bexley and how you're using it in the fight against COVID.
Blake: We built and deployed what we call a staff-checker application which gave us the capability to do daily check-ins with our staff and primary care sites. The application allowed us to track staff who were ill and needed to isolate themselves. Which meant they couldn't be part of the workforce.
This tracking capability enabled us to see who was ill and unable to work, who needed mental health or wellbeing support, and who was able to work and could access the resources they needed to work remotely.
Appian: So, it's not just about managing supplies but caring for staff impacted by the pandemic?
Blake: Yes, from a practice management point of view, our managers were able to check on their staff and the status of their workforce. They could evaluate their operational setup, see protective equipment and workforce levels and check that against what they would normally have. This helps answer questions like: Can you treat your patients based on what you've got? Do you need more resources? How much pressure are you under?
Appian: And how is this information being used?
So, we created a COVID scoring system that showed us if we had the resources we needed to operate. The system could also show us the level of pressure we were operating under at a specific location.
Appian: How is that different from what you did prior to COVID? How did you manage resource and workforce levels back then?
Blake: You couldn't see levels of sickness in your practice. For example, you could have 10 medics, and you could lose five in one go and you could be 50% down in your workforce. The same was true for back office staff. So, we were stress testing operations. Some practices literally got down to 50% of their clinical team because they had to work from home due to the family isolation rules in England. But some staff were not able to work. So, we needed a way to know whether staff could function and work or not.
Appian: And your staff checker application allowed you to do that?
Blake: Yes, it gave you visibility into which staff you could include in your workforce for the day. Before COVID, there wasn't much remote working that went on. And now it's flipped entirely. There's far more remote care happening now than people physically coming in to see a doctor. I think you're seeing the same trend in America.
Appian: So, you're now in phase one of your resource management application. What can you tell us about phase two?
Blake: So, we'll potentially have phase two, phase three, phase four and so on until an immunization vaccination is available and we can get that out to people. In the UK we hit a peak a couple of weeks ago, especially in London. It's tapering off a little now.
But the stress is shifting from the hospitals which now have enough capacity into our care homes.
And one of the roles of general practice is to look after residency and care homes. That's where the pressure is at the moment. So, the big question about staffing assessment is can we provide the right level of care in terms of shifting demand?
When you're looking after care home residents, you want to make sure you're doing the best you can with infection control to stop coronavirus from spreading in a nursing home.
Appian: So, you're now in phase one of your resource management application. Looking ahead, what can you tell us about phase two?
Blake: COVID has phases, so we'll potentially have phase two, phase three, phase four and so on until an immunization vaccination is available and we can get that out to people. In the UK we hit a peak a couple of weeks ago, especially in London.
It's tapering off a little now. But that's a very, very difficult environment. On top of that, you've got people who have not presented and need other medical care. But because of the stay-at-home message, they have not come forward in the way that they would have before COVID.
Appian: So, how has that impacted your operations?
Blake: Emergency departments are 50% down. There's 75% reduction in presentations for suspected cancers. There's 50% less presentations for chest pain. So there's a group of people who are sitting at home and they're actually scared to come out, and they're scared to present in a health center, even though they've got (existing) conditions.
So, there's a backlog of care where people haven't presented and haven't been getting the level of care that they normally would to sustain them.
And that's where phase two of the resource management application comes in.
Appian: So what new functionality have you added to phase two of the application?
Blake: We've got a patient tracker to help us with the work we're doing in care homes now. We're piloting the tracker to look after patients in care homes, so we can manage care assessments as well as care delivered.
As I said, 22 of our practices work in different ways. So, we're looking at using low-code to automate the processes as much as possible, and link into the clinical systems the practices use. Our application works with legacy systems, so we can pull and push (data) between the application and the clinical systems within the practices.
Having that capability is critical when you need to react really fast, but theorganizations you're dealing with have systems that don't talk to each other.
So, our low-code platform sits over the top of these systems. This allowed us to track the patient through their assessment and pull data from different agencies into a single application and have it all in one place.Which allowed us to actually see what's happening to the patient in terms of health and social care.
Appian: That's an excellent note to end on. Before we shut it down, though, is there anything else you want to add that we didn't talk about?
Blake: I just want to add that some patients who present have a health need, but they may also have social needs. They may have a housing problem or maybe they're depressed because they're lonely. So, we're using our resource management tool to help meet the social needs of our patients. One of the things we're looking at is using our low-code application to track the social needs of patients and map them to volunteer resources.
COVID is the new normal and it isn't going away. It's forcing us to seriously look at all of our processes, map them and look at how we can make them far more efficient.You can't go back to what we had before.
(For a deeper dive into why automation is essential to jumpstarting operations impacted by COVID-19, check out this must-read Forrestersurvey.)
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