Co-ordinated use of on-site physical space

Below are the change ideas that can be made to your system that should improve how physical space is used in acute sites. The change ideas listed here will be updated as more learning is generated as part of the Access Learning System. Select change ideas to implement based on what you have learned whilst understanding your current system.  


Allocation of physical space

Spaghetti diagram/mapping to identify how to streamline required space  

Understanding not only who needs to use clinic space, but also how they plan to use and move around the space is important. Spaghetti diagram/mapping is a tool that can allow services to visually map the optimum layout for a ward/department or clinic. It identifies the wasted movements of a team/clinic staff to allow for redesign. This is particularly useful during COVID-19 when services must consider physical distancing restrictions.


Plan using facilities checklists and centralised room/space booking system

To best plan how to use space, the use of a centralised booking system allows teams to accommodate the use of clinic spaces for more than one service simultaneously. This can also provide the opportunity to identify the optimum use of space and possible wasted space.

The use of a facilities checklist can also aide cross service planning. Based on locally shared examples, two facilities checklists have been developed, one to support when a clinic space is required to be physically moved from one area to another and a further checklist for when a service is required to change its physical environment to remobilise. 


Regular huddles to identify allocation issues and troubleshoot

Regular communication with teams can provide insight and a better understanding of issues they are currently facing. It enables tests of change and rapid improvements.


Outpatient capacity tool to support remobilisation 

NHS Fife designed an outpatient capacity planning tool to provide assurance that services could safely increase the number of clinics being held. This tool allows services to plan for the maximum capacity while ensuring physical distancing and safety precautions are in place throughout the COVID-19 outbreak. 


Appointment scheduling

Scheduling tool to help identify change ideas 

A lack of a standardised approach to the scheduling of appointments can not only cause constraints leading to increased waiting times, but can also create potential risks when delivering a service while adhering to social distancing regulations. Having as few appointment types and times available, simplifies the scheduling process, offering more flexibility and reducing delays. A scheduling diagnostic tool is available to help you understand your approach and identify change ideas.


Your change ideas

If you have developed your own change ideas that could be included in this change package then get in touch through the feedback form or by emailing us at