PATIENT RESPONSE TECHNOLOGY
and identify, via the colour, whether a scenario is routine or ‘emergency’. Unlike a ‘traditional’ nurse call system, however, alerts within the room are silent, meaning much less disturbance to patients. The Telligence system’s ability to send alerts or texts direct to a staff member’s handset, meanwhile, means a need for just two display consoles within the 50-bed ward. These nurse panels do, however, enable nurses to identify, at glance, and keep an eye on, patients that may need additional monitoring, and also to ‘drill down’, for example if they need specific audit or ‘call trend’ information. Within the background of the Telligence software, the Unite Analyze ‘package’ enables the production of regular scheduled reports around call response times, allowing staff to recognise peak times or bottlenecks and plan staffing accordingly.
Training
Supported by both our Trust lead and suppliers’ training teams, challenges were apparent. A ‘demo’ system cannot give the same effect as a fully operational system in situ, no matter how good the set-up. ‘Training fatigue’ was beginning to show within a staff group who had been on the receiving end of a great deal of training and preparation for the move to the new hospital. We had anticipated this, however, and in the first week after we moved in, in September 2018, and before we had patients, we trained intensively, practising scenarios and ironing out any issues. Once the staff could see the system in their own clinical areas, they could make sense of how it would work.
Delivering efficiencies in practice Key to our investment in the new system was, of course, that it would deliver efficiencies in practice, which it certainly has. Among these have been: n Integration of medical devices means we can ‘monitor’ patients closely who may not be in direct line of sight, but also reduces the stressful noise and alert fatigue associated with multiple alarms. This improves both the patient and the staff experience.
n ‘Safety huddles’ – the handsets improve situational awareness for the whole team by informing them about important changes to an expected plan – alerts about, for example, the condition of a patient recently admitted, can now be delivered instantly via group texting on the Mycos. This saves up to 45 minutes a day, by effectively replacing physical safety huddles – where all staff need to be got together – with ‘virtual’ huddles, which take about 30 seconds. Shared information is recorded for use at any time.
n Audits – nurses are saving up to 30 minutes a day each on audits,
88 Health Estate Journal October 2019
The system of overdoor lights at the new Chase Farm Hospital has proven especially beneficial, given that the 50-bedded inpatient ward is on a long corridor, with 42 individual en-suite rooms.
The workflow buttons can be assigned whatever workflow functions the hospital or other healthcare site wishes.
previously undertaken manually, but now done digitally via the ‘Perfect Ward’ smartphone app. Nurses can view and send audits at the touch of a button.
n Theatre recovery throughput – saving up to 15 minutes per patient (average 30 procedures a day) in moving through recovery and back to the wards, thanks to more efficient and effective communications.
n Bed turnaround time – up to 40 minutes per bed saved using the domestic clinical workflow button, which helps to ensure that domestic staff are quickly available.
n Time previously wasted in routine communications between theatres,
A nurse call console showing that a patient has requested a drink, and the associated ‘wait time’.
‘Recovery’, and the ward, has been dramatically reduced, with ‘Coordinators’ for each area calling directly to each other to facilitate patient flow.
Conclusions
This has been a useful learning experience for us on the Project and Redevelopment team. Our key message would be to have a vision, and decide what outcomes you need, in terms of improved care, safety, and staff utilisation – and to work back from that. Equally, make the system you specify ‘future-proof’ – technology should be scalable and replaceable, without having to ‘rip out’ your interoperable system. Always have a clinician in charge of the project, and be prepared to work across many boundaries, including all the key stakeholders early on. These will include IT, Networks, Estates, Security, ‘Admin’, and Portering personnel. Staff engagement needs to be real, across the multidisciplinary team, not a token effort. Train your staff in using the technology, and check if they need more training after you ‘go live’. Keep the ‘tech’ simple and user-friendly. Our staff use smartphones that are intuitive to use – just like their own mobiles outside work.
Going paperless isn’t about imposing a system on clinicians. It’s about finding out how they want to work, and choosing the best technology to fit. We will continue to review the efficacy of the technology and the organisation of clinical workflows to ensure that we are making the best use of it. Staff and patient feedback continue to be crucial, and we will be looking at what further training people need to use technology in the best way to make their job easier. We will share information from teams in different clinical areas, so that we can find smarter, more advanced ways for everyone to work.
Key Chase Farm project players
n Main contractor – IHP. n Lead architects – IBI. n Architects – AD Architects. n M&E consultants –
Troup Bywaters + Anders.
n Electrical contractors – W Portsmouth. n Mechanical contractors – Norstead. n Structural consultants – Thomasons. n Cost advisors — Turner & Townsend. n Trust supervisors – Currie & Brown.
hej
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