From Red to Green – Turning Inpatient Delay into Capacity at Western Health

Making inpatient delay visible so teams can action proactively

Challenge 

When hospitals are under pressure, the natural instinct is to look at what’s coming through the door – ambulance arrivals, emergency demand and the resultant inpatient bed shortages. These constraints are early indicators of capacity issues likely to impact progression of care and patient outcomes.  

Traditional reporting focusses on outcomes (eg. length of stay, readmission rates, hospital-acquired complications) – rather than where the delay occurs. For many hospitals, there’s a hidden blocker already inside, invisibly using up valuable beds and care resources.  

Patients who are clinically progressing but waiting unnecessarily (for diagnostic results, a consultation, a discharge summary or an aged care placement) consume capacity that could otherwise be released. These delays or avoidable bed days accumulate quietly, extending length of stay, backing up emergency departments and creating access block that ripples across the system. 

This is where Western Health found an opportunity to increase their capacity, improve access to hospital and better manage patient flow through their facilities. By applying the Red to Green methodology originally developed in the NHS in their Miya Precision platform, Western Health set out to tackle this hidden constraint.

The Visibility Gap

“Our constraint wasn’t demand – it was avoidable delay inside the hospital,” says Fran Brockhus, Director of Access and Patient Flow at Western Health. “Patients have days where nothing moves them closer to discharge. Those days drive length of stay, ED congestion and ambulance offload pressure.” 

A key part of the problem was visibility. Delays were accumulating quietly – patients waiting for medications to be dispensed, for test results or doctor sign off on discharge. Existing reporting showed outcomes but did not provide clear, timely data on where delays occured inside the hospital.  

How Western Health is applying R2G with Miya Precision 

Western Health started small, building a test of concept on one ward and proving its success before expanding. The key was to make delay visible, using tools staff already use, to reduce the burden of additional administrative work.  

Western Health uses Alcidion’s Miya Precision platform to manage patient flow across its four hospitals. Miya Flow provides electronic journey boards that provide ward staff with a real-time view of every patient’s status, while Miya Command delivers operational dashboards with hospital-wide visibility of capacity and demand. Working closely with the Alcidion team, Western Health configured Red to Green directly into these tools, enabling teams to identify delays in progression of care and act on them daily. 

Configuring R2G into existing Miya Precision workflows involved adding custom journey board columns to capture R2G status and refining Western Health’s Miya Precision “waiting for what” categories so that reasons for delay are coded consistently and patterns can emerge at ward and system level.  

Clinical and operational teams collaborated to define the criteria for a ‘red’ or ‘green’ day, as well as determine escalation pathways in relation to different kinds of delay. Using the mandatory Estimated Date of Discharge, the teams were able to put in a collaborative and realistic date of discharge which helped to identify where care was not progressing as expected. 

Using the data available in Miya Precision, Western Health have configured dashboards to help them manage the Red to Green performance across their sites. These dashboards draw on the patient and ward-level data to provide hospital-wide visibility of where delay is clustering and where capacity is becoming available, enabling earlier escalation and more proactive bed management. This insight has been a game-changer for health service-wide capacity.

What R2G has surfaced 

The discipline of daily review has surfaced insights that were previously invisible – and created the conditions for targeted improvement. 

Deep dives into red days for respiratory patients revealed delays in pathology processes for cytology results – an operational bottleneck that, once identified, was addressed to reduce length of stay for that cohort. The team can now also quantify how long patients are waiting for emergency surgery, providing visibility that simply didn’t exist before. 

Using R2G for the identification of blockers and their impact on progression of care provided a framework for capacity planning ahead of the successful opening of the new Footscray Hospital, part of the Western Health network, in February 2026.  

Beyond these specific outcomes, Fran notes that R2G has improved multidisciplinary team communication, enabled earlier identification of diagnostic, theatre and allied health delays and exposed variation in documentation practices that would otherwise have remained invisible. 

The role of digital infrastructure 

R2G is an operational method, however its success at a system level depends on good digital design. “If Red to Green isn’t embedded in core systems, it won’t scale safely. Good digital design is what turns this from a local tool into a system capability.” 

At Western Health, Miya Flow journey boards and Miya Command dashboards provide the crucial foundation for the new way of working – real-time visibility of patient status, expected discharge dates, waiting-for-what barriers and aggregated data at a ward, hospital and health service level.  

These shared views align clinical and operational teams around the same information, replacing the phone calls, duplicated reports and fragmented updates that slow decision-making. 

“Manual work creates risk and distracts clinicians,” Fran says.  

Western Health and Alcidion worked together to reduce this manual burden, improve data reliability and enable automated aggregation of R2G metrics across the organisation.

An operating discipline, not a project 

For health services looking to improve flow, the lesson from Western Health is clear: making delay visible is the first step. What you do with that visibility – how you act on it, escalate it, and learn from it – is what drives lasting improvement. 

R2G is now being positioned as part of Western Health’s winter demand strategy. It has moved from pilot wards to core business – a discipline that sharpens huddles, clarifies escalation and forces a consistent question across the organisation: does this patient still need an acute bed? 

“This isn’t a project with an end date,” Fran says. “It’s an operating discipline that strengthens over time”. 

To learn more about our partnership with Western Health, or how Miya Precision can enable your health service to flow better, get in touch at info@alcidion.com