Case study: How the right IT can release time to care

12-Dec-2013

How Chesterfield Royal Hospital NHS Foundation Trust is using patient flow management technology to improve care

In this case study, DR MAXINE SIMMONS, senior matron for practice and professional development at Chesterfield Royal Hospital NHS Foundation Trust, describes the plans the organisation had for improving ward processes through the use of IT, and the challenges around changing the attitudes of nurses

Technology is often lauded as the key to transforming the way hospitals operate to improve patient outcomes, but is this really accurate in the eyes of frontline staff? Chesterfield Royal Hospital NHS Foundation Trust is proving that with the right IT in place, nurses can streamline processes, creating more time for patient care.

A first-class mission

In 2010, Chesterfield Royal Hospital NHS Foundation Trust, which serves a catchment area of around 400,000, identified the improvements it needed to make in managing the progress of patients through treatment – from referral to inpatient stay and back into the community – as part of its mission to become a first-class district general hospital.

Nurses have traditionally been suspicious of technology with a fear that IT systems take them away from dealing directly with their patients

Tracking patients through their hospital stay; and managing the subsequent ancillary activities such as bed management and cleaning, was proving problematic. For example, the trust was experiencing issues such as copious phone calls to organise bed cleaning and multiple team meetings to discuss bed allocation for patients. The result was an inefficient use of nurses’ time, and potentially increased length of stay for patients.

Dr Maxine Simmons, senior matron for practice and professional development at the trust, describes the plans the organisation had for improving ward processes: “One objective was to reduce the reliance on a manual bed management process across the organisation; another focused on implementing the Department of Health’s ‘Productive Ward’ principles; and we also wanted to be able to locate patients across the hospital, particularly for improving our night handover procedure.”

The solution

To meet these objectives, the trust selected Cayder’s Patient Flow Management (PFM) solution. Its aim was to support nursing staff in managing their patients\' progression in the hospital by providing them with up-to-date, real-time information that could be viewed at a glance and involved minimal interaction with IT. The system was deployed hospital-wide across all 15 of its wards including surgical, orthopaedic, paediatrics, neo-natal and general medicine, as well as key departments including pharmacy and domestic services.

With just one or two touches on an electronic whiteboard, the PFM solution now provides nursing staff with a quick and highly-intuitive way of realising efficiency benefits immediately. To deliver this solution, a series of 55inch inch, wall-mounted touchscreens, replacing the traditional whiteboard, were situated on each ward and relevant departments, with bi-directional links to the hospital’s patient administration system (PAS) ensuring both systems remain completely in line and up to date.

Today, this solution is helping to reduce administration around the admission, transfer and discharge of patients. In addition, it is making it easier for nurses to schedule and track routine activities and drive discharge planning, including tracking TTOs (medicines to take out).

Adding value

The trust was keen to ensure that the solution added value to their nurses’ daily routines, as well as improving the patient journey. Dr Simmons said: “Nurses have traditionally been suspicious of technology with a fear that IT systems take them away from dealing directly with their patients. So this project has helped them to understand and appreciate the benefits IT can really deliver – and effectively help them to spend more time caring for patients.”

This project has helped them to understand and appreciate the benefits IT can really deliver – and effectively help them to spend more time caring for patients

Prior to implementing the solution, nurses working out of hours, without the support of a ward clerk, were finding it difficult to keep patient records up-to-date. By integrating the PFM system with the trust\'s existing PAS, the result is minimal administration for nurses, by reducing repetitive data entry behind a desk, as this has been replaced with quick ‘on-the-fly’ touchscreen updates. The result provides staff with instant information regarding patient status and an updated PAS.

Dr Simmons says: “Linking the two systems together means that when we discharge a patient via the PFM solution, it automatically updates the PAS. This has made it very easy for the nurses, because they just click on the patient name and click on discharge. When the patient has left, the bed is empty, ready to be cleaned, quickly enabling them to care for the next patient requiring critical emergency care.

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