Tom Smith

I don't spend much time on X these days. Find me on bluesky here: bsky.app/profile/analys…

With this legend at the @openEHR conference today. So many forward thinking people in one place - @john_farenden @ReadmanLuke @ukpenguin @KTheivendran @AdeByrne @Phil_Koczan -- let's build our future health system on standards! 💙

@nattyhancox I suspected it may help! And really pleased to hear that it is doing. A chart is only as good as its ability to confirm, challenge, or increase confidence in a certain course of action, so without your work it's just a pretty picture (mental note to make charts prettier!)

A huge thanks to @analyst42 for helping use data in a powerful way & making huge changes, without probably realising! I want changes to have happened yesterday, trusting the process and sitting back waiting for the improvements to come fruition is now so easy 🧘‍♀️

@Crlg1Rob @NHSCDAONetwork @marcwfarr @arafintweet Great, thanks

@analyst42 @NHSCDAONetwork @marcwfarr @arafintweet Try this Tom aphanalysts.org/apha-hub/cdao-… should be a list of all news from @NHSCDAONetwork 👍👍👍👍

So many comments I could make on this post, but let’s go with the most important one: I’m so glad they wrote it. Read their wisdom.

@Codie_Sanchez I agree on the general sentiment, but on US life expectancy over the last 40 years the data tells a different story: #Life%20expectancy%20at%20birth,%20in%20years,%201980-2022" target="_blank" rel="nofollow noopener">healthsystemtracker.org/chart-collecti…

Despite all news, you are today living in the best time in history to be alive. In the last decade: - fewer famine deaths than ever - fewer battle deaths than ever - longer lifespans than ever - less poverty than ever Keep building, it will keep getting better.

Uncertainty is the only certainty! Expert forecasts, using an evidence based protocol, reveal wide variation in how hospital activities may evolve over the next 20 years, helping the NHS plan more robustly for the future. See our publication in the BMJ bmjopen.bmj.com/content/14/10/…

We should all watch this video .. youtu.be/dphkf1dTxcU?fe… 😢@PINCNUH @nottmhospitals @andy_callow @A5Chivinge @Onyi33500474.

This is the moment Ratcliffe power station came off the electricity system for the final time, marking the end of 142 years of coal generating electricity in Great Britain!

@nattyhancox Well done Nat! 💥💥💥

Looks like I need to go dress shopping 🙌

@JenkinsonCaz Ah, miss you too Carolyn! ❤️

@analyst42 We are missing Poole like you sorting it all out! Miss you Tom

In acute hospital management, there is a big focus on "flow" of patients though the hospital from admission to discharge. And that is often focussed on beds. After a career in manufacturing I'm trying to recalibrate to this mental model, and I thought I'd write a bit about why...

@kurtstat Thanks, yes I think that matches my model, in the sense that some "friction" comes from handoff points between parts of the process. So the more complex the pathway, the more handoffs, and potentially the more "unusual" the handoffs might be (a to d not a to b)

@analyst42 Excellent thread. One observation I'd make is that I think patient flow is more of a problem for specialties where patients are older, more complex, more multi-morbidity, more dependent on non-NHS services. In general, surgical patients flow more smoothly than medical patients.

To narrow the gender pay gap, give fathers more paternity leave. This is an incredibly good idea, because it links two good things together. theguardian.com/commentisfree/…

@mjrsimmonds 2. Yes, particularly weighted towards where we have direct control (ie. solve our problems while waiting for others to solve theirs). 3. Perhaps it's a bit too late in the day, but this is too cryptic for me! - a good excuse to chat!

@mjrsimmonds Thanks Mark, chat would be great in due course. On the points you mention: 1. Totally agree - a good part of my career has been agreeing what is broken and how to measure it, creating collective agreement that it's actually possible to improve, and then improving it.

@DeborahParr @nickopotamus Absolutely, I'm all for measuring the value-adding processes deeply, and ensuring capacity matches demand (including variation in both through the day, week, month, and seasons). It just doesn't seem very visible (theatres being the possible exception). All else defaults to beds.

@analyst42 @nickopotamus The “flow” through all of those departments is also considered. How LONG it takes to have bloods taken and for results to be available depends on staff availability, lab availability and the range of tests to be carried out. The wait for CT/MRI/x-Ray also - staff/machines.

@Stephen83057086 Although, active stabilisation could also be categorised as the first important procedure, and diagnosis as consuming medical time. But the precise allocation in a given case is splitting hairs - overall I think the general categories hold.

@Stephen83057086 Ah yes, that's fair (can you tell I'm not clinical). For simplicity (and accuracy in the cases you mention) both 5a and 5b value-adding.

@Stephen83057086 Thanks, yes that's a helpful addition to my thinking. I think I'd still categorise it under 5, as "patient-owned", but it's no longer possible to think of it as value-adding. So maybe: 5a, admission stabilisation, necessary non-value add. 5b, post procedure recovery, value-add.

@analyst42 Non elective admissions have other reasons to need a bed rather than solely post intervention recovery / healing. They are often / usually ill on admission and need a bed on that basis at the outset rather than purely post intervention.