Caradigm solution helps Milton Keynes A&E department improve clinical workflow
The College of Emergency Medicine claims A&E departments have become “like warzones,” while the Care Quality Commission has admitted that in some parts of England, emergency care is now “out of control.” At Milton Keynes Hospital NHS Foundation Trust, however, innovative technology developed with Caradigm is helping to support the hospital’s A&E department in the daily management of these challenges.
The winter of 2012 was a particularly challenging period for the Milton Keynes A&E team and it became apparent that a new software system was required. Installed in just 90 days, the solution has already resulted in productivity improvements from replacing an ageing system, largely reliant on paper. The use of Caradigm’s intelligence platform has resulted in clinicians spending less than one minute at the computer, compared to about eight minutes in the past - giving them more time to spend with patients.
IT Manager Craig York says the ideal solution was to extend the use of Amalga, the first generation intelligence platform, which the hospital already uses elsewhere to pull together data from multiple source systems in - near real-time - and to provide analytics services and drive workflow. “Its flexible nature and ability to rapidly create workflows made it the perfect solution. It meant we were able to respond quickly to our clinicians’ requirements with different iterations of the solution and call upon them occasionally to suggest improvements. I believe the result is a robust and well-designed solution.”
From a patient’s perspective, the quality of care and their experience of the NHS define the purpose of any healthcare system. According to A&E consultant Dr Vimal Desai: “The imperatives were to develop a system that clinicians could use quickly, simply and that we could develop with practice - and without lots of time consuming IT problems.” The rapid development of the new system inspired the highest level of clinical engagement he has ever seen. “Above all, our clinicians greatly appreciate being able to spend more time with patients and less on mentally exhausting administrative work.
“Local GPs have also been highly complimentary about the quality and promptness with which they now receive information about their patients treated in A&E,” confirms Dr Desai.
Being a busy A&E with limited resources and intense pressure on staff to provide the best medical care, the department needed to replace its outdated workflow system with a more appropriate, modern IT solution says Jacqui Burnett, Emergency Department Matron: “The system allows accurate tracking of patients and we are already using it to capture information at the patient’s bedside. This one part of the system alone has changed the way in which we work and helps to keep patients safe. Staff find the system easy to use, it is a useful tool at hand over and teams from outside the department also use the system to track ‘decision to admit’ times and to predict bed requirements over the next few hours.”
The solution has also led to greater compliance, with entry of clinical notes for discharge summaries up from 30% to 95%. Consequently, over 90% of all discharge letters are sent to patients’ GPs within 24 hours - either via the National Data Transfer Service (DTS) or via email - a process which previously took around 10 days. Indeed, the use of the DTS means discharge letters can be sent directly to GP practice systems.
The improved compliance of locum staff, who now use the new system with appropriate training, has also replaced the need to enter data into the system from the notes the following day as with the old manual system. The new solution has vastly improved clinical quality data capture. This makes coding much more accurate and helps inform audit, training and planning for the future. Moreover, the clinical site team - whose job it is to ensure adequate flow of patients through the hospital on a day-to-day basis – can now see at a glance the complete picture within A&E at any given time.
The solution is a huge leap forward for the trust and for patient care, according to Richard Craven, VP and Managing Director Europe: “The flexibility of the Caradigm solution means we can quickly adapt the solution as demands change,” he says. “In an environment where prompt intervention is vital and often life-saving, it gets the doctor back to the patient, irrespective of the department and specialty.”
Dr Desai concludes: “As well as greatly improving our overall performance in terms of patient care, the solution has enhanced the department’s reputation within the healthcare community. We now have lots of visits from our peers around the UK and overseas who are eager to witness what we’ve achieved.”
