04.02.14
Time to care: getting patient management right
Source: National Health Executive Jan/Feb 2014
Senior matron for practice and professional development at Chesterfield Royal Hospital NHS FT, Dr Maxine Simmons, speaks to NHE about a new patient information system that has transformed time to care.
While smart technology is taking off in terms of personal use, many hospitals retain old and outdated systems to manage their information. But how can they stay up to date and win the level of engagement needed to make it a success?
In 2010, Chesterfield Royal Hospital NHS FT implemented a new patient flow management (PFM) system to free up nurses’ time and enable more effective planning of resources.
Now it is completely embedded, NHE spoke to Dr Maxine Simmons, senior matron for practice and professional development, about the benefits the new system had brought, and how staff suspicion of IT could be overcome.
Leaving paper in the past
The trust was looking to move from a whiteboard with magnets to a more efficient, automated system.
She explained: “We wanted technology that would support releasing information about discharge for patients that would not only be more practical to use on the ward, but would be accessible to other staff in other areas of the hospital at the same time.”
Another major driver was managing bed use. The trust had been using a paper-based, “very resource intensive” system, which required nurses to walk around the wards, counting up empty beds.
Cayder developed a system taking information from each ward so matrons can see from a single board where any empty beds are. It also provides information about the reason beds are closed, allowing longer-term planning to be made regarding capacity levels.
Dr Simmons called this “absolutely critical”, and said it means patient demand can be more effectively managed.
Proof of the pudding
Cost savings have not been generated by the scheme, as it was set up with the aim of improving quality of care rather than efficiency, she said. Saving matrons’ time, for example, would have been difficult to quantify as they were “absorbed into doing some other, hopefully patient-facing, work instead”.
The measure she uses for success is that the nurses are still using the system three years on – testament to its effectiveness.
“Typically, nurses are not always great advocates of IT systems. That’s not because they’re all luddites – far from it – it’s because the nurses want to spend the time delivering care to patients, and anything that takes them away from that is seen as being additional
work that doesn’t necessarily add to that.”
Dr Simmons added: “Many IT systems have hit the dust because nurses haven’t engaged with them. So the measure I use of success is that three years down the line, nurses continue to use this system on a daily basis.
“The nurses are obviously realising a benefit because they do put information into the system. For me the proof of the pudding is in the eating; the fact that they do use it.”
Direct benefit
So how did this system make it through while so many others failed to get that vital engagement?
Dr Simmons suggested it was because the technology was directly benefiting the nurses on the ward, “rather than them putting information into a system that someone somewhere else needs”.
The system has also drastically improved the handling of bed cleaning. Previously this involved a phone call followed by an indeterminate wait before assistants would turn up to clean the bed.
Now nurses make a request on the board, which changes colour when it has been accepted. They are also able to view that request in a queue of cleaning tasks, providing more information about when that bed will be ready for use again.
Viewing and inputting information was also made as simple as possible through a ‘two-click’ process.
“They didn’t have to log in and go through a range of processes to be able to input the data, it’s very quick.” But she added: “The nurses would always say it’s never quick enough.”
A smarter future
That’s down to the rise of smartphones, Dr Simmons said, where information is always readily available, whenever and wherever you need it.
“People have become used to having technology in their hand and being able to access things instantaneously. And obviously when you’ve got a system of 500 patients in it and all of their data, you’ve got a couple of seconds lag. [The nurses] want no lag at all. When they’re stood there… two seconds when somebody’s very busy just feels like a lifetime, even though it’s not. It’s all about perception.”
A move towards more smartphone-based IT systems could be on the cards, she explained, with a number of options where staff could already use their personal devices to access and manage patient information.
This includes viewing electronic patient records, information about the hospital made available for new recruits and texting patients about their appointments.
Dr Simmons said: “There’s a real momentum. You can see how people understand that technology, they use it [already]. If the technology develops so that you can use it on a smartphone people would love it.”