University Hospitals Coventry and Warwickshire (UHCW) has added an extra case per daily theatre list, recovered time lost to manual coordination, and exposed a data problem that understated operating theatre utilisation by a fifth. It can also now see theatre activity in real time and act ahead of delays instead of reacting to them.
That’s according to UHCW’s director of operations, Juliet Starkey (pictured, in white), who spoke at this week’s AWS Public Sector AI Symposium in London, where partners Proximie, Amazon Web Services (AWS) and Deloitte detailed what they called the largest surgical artificial intelligence (AI) programme the NHS has ever run – real-time surgical intelligence across 104 theatres, endoscopy suites and cath labs, spanning eight hospitals and more than 20,000 procedures a year.
Starkey is director of operations at the Hospital of St Cross in Rugby, part of UHCW, which has worked with Proximie for just over a year. She describes the moment she first saw her own theatre data properly. For one day, it came back from the trust’s own reporting at 66% utilisation, which she knew was wrong. Proximie’s ambient sensors recorded the same list at 88%, beating the NHS benchmark that dictates at least 85% of a planned operating theatre session must be spent on active patient care.
The problem is widespread, according to Proximie, which says about 59% of data entered into electronic patient records carries errors – what Starkey called “garbage in, garbage out” – and that up to 24% of theatre time is recoverable.
Starkey said the technology part was the easy bit. “Change management was absolutely the hardest part,” she said. “You put any technology that has a sensor in and there is a concern that this is about surveillance. And so we had to really drive that this was really about improvement and not about watching individuals.”
The trust took a “crawl, walk, run” approach that started with the plastic surgery team and pain services before expanding. It set up a “task-and-finish” group and held engagement sessions in theatres rather than in boardrooms, so staff could challenge the product.
“Some members of our teams who were, shall we say, apprehensive about this technology coming into theatres are now our biggest advocates,” said Starkey.
Governance mattered as much as buy-in. The trust completed a data protection impact assessment, while Proximie technology obscures images at source so “you can see that there is something on a table, but you can’t make the individual out”. Raw images are not retained, and the productivity data belongs to the trust.
The payoff, said Starkey, is “having that overview of what is happening in our theatres and being able to use that information, that granular-level information to drive change without having to spend hours physically observing what’s happening in the theatres”.
The partnership rests on three legs: Proximie provides the technology, AWS the cloud infrastructure, and Deloitte the change management. “Digital change is never just about the tech,” said Ella O’Regan, who leads Deloitte’s financial and operational improvement work and previously spent 11 years in the NHS. “It’s mainly also about the people.”
Starkey’s definition of a good partner is simple. “A good partner is one that doesn’t just come in and drop technology on you,” she said.
The next step, added Starkey, is to keep the learning spreading from one speciality to others.
