News & Events-Engineering’ a patient’s Dialysis Day improves renal care


Engineering consultancy Frazer-Nash, working closely with Nottingham University Hospital, has demonstrated how engineering modelling techniques can be used to provide insight into a patient's day in a renal unit - and through a better understanding of an individual's dialysis day, identify tangible ways to improve the overall patient experience.

The project was one of 14 supported by the Department of Health through the Small Business Research Initiative. It was managed by the National Institute for Health Research Devices for Dignity Healthcare Technology Co-operative (NIHR Devices for Dignity HTC) as part of a programme aimed at helping the 5,000 people diagnosed with kidney failure every year.

Frazer-Nash developed a methodology and software tool that demonstrated how, by modifying appointment times and management practices, the renal care process within the study scope, could be improved. As Business Manager, Martin Concannon explains:

"At Frazer-Nash we used our 'Systems Approach' to develop a model of the renal care pathway, enabling us to pinpoint delays in the service and identify ways to improve the patient experience. The techniques we used were similar to those we apply in other safety critical and highly regulated industries − where process and behaviours can have a fundamental effect on an outcome.

"Our model took account of people, processes and infrastructure. A typical patient visits the renal unit up to three times a week, and with several hundred people undergoing treatment, we captured a large amount of data. This helped us understand how the unit and the systems around it functioned.

"We gathered information from interviews and questionnaires with patients and staff; and used anonymous patient data, staff rotas, appointment schedules and travel plans. We also used equipment availability and infrastructure information. Great care was taken to ensure the privacy and dignity of all those involved."

The model tracked the individual patient pathway through their renal treatment, including transportation from and to their home. It provided clinical management with a clearer insight into how the unit operates under normal day to day conditions and showed a number of potential benefits could be achieved, including:

  • Increased patient contact time: improving the experience for both patient and staff 
  • Increased time for staff to complete necessary paperwork
  • Improved schheduling of transport: providing a more effective and efficient transport service
  • Enables a more person centred, integrated approach
  • Optimised changeover time of equipment: improving operational resilience and ensuring equipment is ready for the next patient
  • Improved patient scheduling: using a built in allowance for disruption such as longer than planned treatment or late arrival.

The work demonstrates the potential of applying engineering principles to the problem and that further work is now required to assess the applicability of the model across other renal units before any generalised model can be developed.