Case Study

“From a hospital’s point of view, it is hard to imagine how we ever ran without [The TWHS System]…using the same data for all levels of the organization transforms the importance of data and, through this, its quality.”

- Chief Executive
UK County Hospital


  • The Problem
    • A large British hospital had been rated overall among the lowest performers in the country.  In particular, the hospital had been under pressure to reduce waiting times for patients in Accident and Emergency (A & E) services.
    • The National Health Service performance standards against which all hospitals were measured had been published, but reports of hospital data illustrating performance were available two to four weeks after the fact.
    • Process changes to date had yielded negligible performance improvements.
    • Hospital personnel, particularly the front-liners, were demoralized.
    • Existing IT infrastructure did not support national performance initiatives and improvement measures.
    • Extensive negative press focus and Department of Health scrutiny warranted rapid action from the hospital chief executive.
  • Approaches
    • Interdepartmental and enterprise process and systems analysis
    • Chief executive-sponsored joint process improvement sessions
    • Integrated rapid process and application development
    • Data quality improvement
    • Real-time systems integration
    • Spiral methodology
    • Extensive use of prototyping
  • Solutions
    • Redesigned Accident & Emergency services data capture and workflow to support proactive management
    • Developed a departmental real-time visual performance management system, first for Accident & Emergency, then implemented in many other departments
    • Deployed an enterprise business intelligence system available on management and staff desktops to provide immediate visibility into current state and historical trend analysis
    • Eliminated manual analysis of lengthy paper-based reports through the development of systems-supported exception management alerts
    • Implemented a hospital-wide data quality improvement program concurrently encompassing processes, systems, and staff education
    • Created a performance data warehouse to accurately record operational metrics gathered as a result of real-time process monitoring
  • Results
    • Dramatic improvement in the quality and timeliness of patient care
    • Dramatic improvement in the national rankings of the hospital Accident & Emergency service from among the three worst in the country to among the three best
    • Unprecedented improvement in the national rankings of the hospital from the worst to nearly the top in the course of six months
    • Data quality improved in all systems of record
    • Staff developed ownership of the data, as for the first time, they could see the immediate effect of data quality with respect to their ability to perform performance
    • Staff satisfaction increased
    • Staff efficiency increased

Case Study Details

  • Why TWHS?
    • Proven industry experience and familiarity with the UK National Health Service and its hospital operations
    • Proven innovation with visually-driven performance improvement systems design, development and deployment
    • Constant advocacy of pro-active management and operations to solve problems before they become a statistic
    • Substantial experience with systems integration and real-time query optimization with third-party systems
    • Data quality improvement experience
    • Staff motivation and coaching techniques during challenging implementations
    • Rapid business process and application development methodology and technologies
    • Established ability to take paper- and spreadsheet-based processes and integrate them into fully-automated, integrated processes and systems
    • Experience with business-critical timelines where failure is not an option

Products and Services Used

  • Software:
    • TWHS Rapid Prototype Platform
    • TWHS Kaleidoscope Application Development System
    • TWHS XAS Real-Time Business Intelligence System
    • Oracle® database