Tom Smith

Code-first data analyst @nottmhospitals. Fellow @NHSrCommunity. Personal account, views my own.

[Tom Smith @analyst42]

I don't spend much time on X these days. Find me on bluesky here: https://t.co/t1CXZ4oL7b

[Gary McAllister @GaryMcAllister]

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! 💙

[Tom Smith @analyst42]

@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!)

[Tom Smith @analyst42]

@Crlg1Rob @NHSCDAONetwork @marcwfarr @arafintweet Great, thanks

[Hadley Beeman @hadleybeeman]

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.

[Tom Smith @analyst42]

@Codie_Sanchez I agree on the general sentiment, but on US life expectancy over the last 40 years the data tells a different story: https://t.co/EdcLAZC3rJ

[Strategy Unit @Strategy_Unit]

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 https://t.co/65QEh51TGb

[REACH Network NUH @REACHNUH]

We should all watch this video .. https://t.co/9FcccqChzb 😢@PINCNUH @nottmhospitals @andy_callow @A5Chivinge @Onyi33500474.

[National Energy System Operator @neso_energy]

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!

[Tom Smith @analyst42]

@nattyhancox Well done Nat! 💥💥💥

[Tom Smith @analyst42]

@JenkinsonCaz Ah, miss you too Carolyn! ❤️

[Tom Smith @analyst42]

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...

[Tom Smith @analyst42]

@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)

[Ben Goldacre @bengoldacre]

To narrow the gender pay gap, give fathers more paternity leave. This is an incredibly good idea, because it links two good things together. https://t.co/AxvY9wE9LL

[Tom Smith @analyst42]

@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!

[Tom Smith @analyst42]

@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.

[Tom Smith @analyst42]

@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.

[Tom Smith @analyst42]

@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.

[Tom Smith @analyst42]

@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.

[Tom Smith @analyst42]

@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.