TECHNOLOGY
said Patience. “That’s a drop of more than 75% on the ultimate measure we use to assess our management of patient deterioration.”
“Electronic observations have undoubtedly been an important contributing factor to this improvement,” added Neville. “Patientrack is a vital part of a suite of measures that we introduced alongside new medical emergency teams, revised escalation policies and an active education and training programme. “Being able to make emergency calls at the point the patient is deteriorating, means nurses don’t need to wait for the patient to start arresting to call for help. We use observations as our evidence. For scores of 4 or 5 or more on NEWS2, staff can call for help straight away. Visibility that a patient is deteriorating means we can get someone to help before the patient has a cardiac arrest.” This proactive process is helping to reduce pressure on nurses and gives them confidence to trigger interventions, Patience explained. “They know they can activate sooner. Nurses are empowered to act on the information they have. Because that information is more visible, it is easier for anyone to act. Anyone can now access observations wherever they are on PCs and iPads, rather than a nurse relaying over the phone.” Patience added that better and earlier visibility of patient deterioration has led to important clinical decisions being made earlier. Ward level views on an electronic whiteboard tell the nurse in charge where the sickest patients are and their status and trust level views of the same information inform critical care outreach while helping
Dawn Patience, director of nursing.
The Trust has moved a significant range of assessments into the Alcidion Patientrack solution. This includes VTE, nutrition scoring, food charts, fluid charts, stool charts, infection control screening and monitoring, neuro obs, as well as smoking and alcohol screening.
the Trust’s dedicated deteriorating patient nurse to identify who they need to see. “This means we are not doing things to patients that we don’t need to do,” said Patience. “There is a review of a patient’s treatment plan earlier and we are getting the right patients into intensive care sooner, rather than ‘let’s wait and see’.”
Sam Neville, chief nursing informatics officer.
The Basildon pathway The Trust has moved a significant range of assessments into the Alcidion Patientrack solution. This includes VTE, nutrition scoring, food charts, fluid charts, stool charts, infection control screening and monitoring, neuro obs, as well as smoking and alcohol screening. All of this has had a big impact on reducing paper – with expected savings on paper alone of £60,000 per year. But the biggest benefit is expected from the development of the Basildon Deteriorating Patient Pathway – a holistic approach to identifying and responding to serious conditions linked with tens of thousands of deaths in the NHS every year – including sepsis and AKI. “Rather than looking at this as a sepsis problem, or an AKI problem, through our pathway nurses are looking at the patient
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as a whole,” explained Patience. “There are commonalities in the triggers for these conditions and others around bleeding and airways, for example. Our approach in Basildon has been to develop an exclusion approach, where we exclude possibilities rather than starting with a diagnosis. “If you focus only on looking for sepsis you are likely to miss a GI bleed. Some of the symptoms are very, very similar. Our approach doesn’t just put the patient on a single sepsis pathway to determine if they have sepsis but assesses the patient as a whole so we can get them the right response and help ensure something serious isn’t missed.” This project is part of the Trust’s wider commitment to develop its digital agenda and to work in partnership with industry to innovate and advance the use of digitally- enabled care. It is also part of a clinically- led patient safety programme that aims to empower frontline staff with new tools and methods to help measure improvements in patient care. “At the end of the day, this is all about improving the care that we provide for patients, and the more efficient, effective use of technology will enable us to do just that,” concluded Patience.
CSJ AUGUST 2020
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