PATIENT RESPONSE TECHNOLOGY The Ascom view
Ascom says of the project: “The new Chase Farm Hospital has a range of interoperable technology built in ‘from the ground up’ in its third-floor 50-bedded surgical ward. The new hospital also has eight theatres, day surgery, endoscopy, clinics, and an urgent care centre, across five floors. The global Healthcare Information and Management Systems Society (HIMSS) recently assessed CFH as having achieved stage 6 in the Electronic Medical Record Adoption Model (EMRAM), one of just three hospitals in the UK to reach this level of ‘paperless’ maturity. The model has just eight stages, from 0-7. “Central to the new hospital’s success is a sophisticated nurse call system – based around our Telligence patient response system – co-designed by nurses at the CFH with us at Ascom, and integrated with our Myco smartphones, which connect nurses and clinicians equipped with handsets with patients, colleagues, and other technology, across the hospital. Other staff, such as porters, domestics, housekeeping, and security personnel, carry our I62 handsets.” James Webb at Ascom, one of those that I met at the new hospital, added: “This means that, for example, if a nurse needs a porter to take a patient to theatre, or to bring them back from ‘Recovery’ post-procedure, they can call the porter directly, and the nearest available one will then arrive promptly.” Fiona Morcom noted that this was in stark contrast to the more ‘traditional’ scenario of having to locate a free porter while the nurse stays with the patient.
wider Global Digital Exemplar project which The Royal Free London group had been selected for, and a dedicated member of the IT team was able to support the development and delivery of the nurse call system.
Offsite visits to existing hospitals using the system helped, with lessons learned, and potential pitfalls identified. (In fact, Fiona Morcom and a number of project team colleagues visited several Ascom hospital installation sites in the US, including one in Plymouth Harbour, in Florida, and Ascom’s R&D facility in Bradenton near Sarasota, (in the same US state). Their subsequent feedback, and clear identification of the features and workflow functions the clinical team at the new hospital would require, informed the design of the patient response system.
The process
Working as part of the redevelopment team to build and equip the UK’s first paperless hospital meant that every day was a challenge. Change was the order of the day for us, but for clinical teams it was still ‘business as usual’. Delivering a ‘solution’ without understanding the problem can miss the mark, so we went back to basics. ‘Selling the concept’ to busy clinical teams of a call system in their pocket was a first step. We started by process mapping while observing clinical
86 Health Estate Journal October 2019 Enthusiastic response
Ascom says nurses and doctors more accustomed to using ‘traditional’ nurse call equipment at the original, Victorian- built Chase Farm Hospital – located a short distance from its modern replacement – have welcomed the time and labour- saving, and the enhanced efficiency benefits, of the Ascom patient response system. Alongside the many other practical benefits cited by Fiona Morcom and Andy Dargue, the nurses say one of the biggest benefits is that patients are more ‘visible’ – thanks to the system’s speech software, and the ability to monitor integrated medical devices (such as the GE and Philips patient monitors located by the bedside, which display elements such as heart rate and oxygen saturations) from anywhere in the hospital. For example, should a nurse have a concern over, say, the rising blood pressure of a particular patient, they can either text or call a relevant clinician via their Myco device – who may be anywhere in the hospital at the time. The clinician can then not only talk to them direct, but can also, if they wish, view the patient’s latest ‘observations’ via their own Myco, and decide what – if any – action needs taking.
Ascom UK worked hard to ensure that its nurse call system was fully interoperable with technology from other suppliers at CFH, including GE Healthcare, Philips Healthcare, Cerner, and various app providers. Ascom UK managing director, Paul Lawrence, said: “We are very proud to have worked closely with clinical staff at Chase Farm Hospital on this project, which is an exemplar for the rest of the NHS. It has proved that the greatest success in IT comes from asking clinicians what they need to do their job better, and then ensuring that you do whatever it takes to fully integrate it across the workplace.”
teams in their day-to-day work; this enabled us to demonstrate time wasted in daily workflows. Freeing up this time allows more time to be spent on direct clinical care, and improves efficiency; it also reduces the frustration which can mount through a working day when time is wasted.
Crucially, spending time across different working environments helped us to understand the different functionality needed, and how we could adapt the way in which the system works. While traditional nurse call systems have a ‘one-size-fits-all’ approach, we were able to carefully tailor our solution to the requirements of each area and its specific needs and challenges.
The new £200 m Chase Farm Hospital near Enfield is believed by the Royal Free London NHS Foundation Trust to be the NHS’s ‘most advanced digital hospital’.
Multidisciplinary involvement Close working with the clinical teams, multidisciplinary involvement from the Trust’s IT Department and Estates team (the latter was led on the project by the Trust’s then Programme manager, Mark Bateman, who is now head of Estates and Facilities), the main contractor on the ProCure21 hospital build project, IHP, and external building services and electrical teams, made for some complex meetings. Inevitably, there were times when some part of the discussion around the table was not universally understood, but staying engaged and respectful about the challenges posed by areas outside of our normal scope of experience was essential to keep things running smoothly. There were also some technical challenges to enable a system originally developed for US use, and designed to work across a ‘flat’ network, to communicate across the multi- sub- netted network environment at the new
©The Royal Free London NHS Foundation Trust
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144 |
Page 145 |
Page 146 |
Page 147 |
Page 148 |
Page 149 |
Page 150 |
Page 151 |
Page 152 |
Page 153 |
Page 154 |
Page 155 |
Page 156 |
Page 157 |
Page 158 |
Page 159 |
Page 160
