DIGI TAL HEALTH
Digital transformation for Dudley Trust
The Dudley Group NHS Foundation Trust’s digital transformation has facilitated earlier detection of patient deterioration, supported care for patients during the COVID pandemic, and is now on its way to enabling better integration of care patients.
The Dudley Group NHS Foundation Trust, based in the heart of the Black Country in the West Midlands, provides hospital and adult community services for a population of nearly 450,000. The Trust’s acute care facility, Russells Hall Hospital, was first planned in the 1960s as a general hospital for Dudley but was redeveloped in the 2000s as the main acute and elective treatment centre for the area. The revamped Russells Hall Hospital was opened in 2005 and cited as “among the most technologically advanced in the country.” At the heart of the Trust’s £32 million digital healthcare strategy is the Allscripts patient administration system (PAS) which helps to support all aspects of patient registration and appointment scheduling, patient administration, and bed management within the hospital. In 2016, the Trust wanted to retain its
PAS, first implemented in 2006, and add clinical functionality. Following an open tender, it announced that it would develop an EPR by deploying Sunrise Acute Care as an integrated solution. Recognising that new models of integrated care rely on information sharing between clinical settings, teams and patients, the Dudley Group announced that it would use the Allscripts population health platform, dbMotion, to support integrated care in the borough and more widely as part of an integrated care system. The Trust went live with the first elements in May 2018, when it started its deployment with electronic observations and Sunrise Mobile. It also implemented a proof of concept project to share information with local GPs, using dbMotion. As an early implementer, the Trust worked with a handful of local practices to demonstrate the platform’s capacity to share information across the healthcare economy and to provide a foundation for further integration between the acute, primary care
JANUARY 2022
and other systems in the area. The Trust continued to extend its use of Sunrise in 2018, adding enhancements for NEWS2 scores and sepsis documentation. It then went live with the system in the emergency department (A&E) and rolled out order communications across the entire Trust in 2019. In 2020, it rolled out medical device integration, electronic prescribing and medicines administration, a selection of assessment tools and further dashboards.
An award-winning project to tackle sepsis The Trust decided to deploy the Sunrise EPR to make sure that staff members could record patient observations in a standardised way across all areas. It used the e-observations functionality to help staff automatically calculate the National Early Warning Score 2, known as NEWS2, which was developed by the Royal College of Physicians to identify patients at risk of deterioration.
It also built in a sepsis tool that
prompts staff members to complete sepsis documentation for patients at risk, based on clinical data already entered, and guides them through appropriate assessment, investigations and treatment. In addition, escalation, de-escalation and exceptionality tools have been configured to ensure individualised care needs are appropriately met. In parallel, the Trust created sepsis dashboards to give senior clinicians and the Trust sepsis team an overview of the entire hospital population, to identify deteriorating patients, ensure appropriate care and enable earlier intervention, where required. Bill Dainty, the resuscitation and deteriorating patient lead, explained: “We have seen individual teams ‘own’ their data and look for ways to constantly improve outcomes and shorten the time taken to commence treatment. “By identifying the very sick earlier, we have been able to expedite treatment for many patients who might otherwise have experienced extended stays or poorer outcomes.”
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