CASE STUDIES NORTH STAFFORDSHIRE NHS TRUST

One of the UK’s largest hospitals has implemented “Touch Screen” technology from U-Touch to increase efficiency and improve patient care for a community of over half a million (whilst helping to ensure continued funding for the Trust).

North Staffordshire NHS Trust is one of the biggest and busiest acute hospitals in the country, with a turnover of £200 million. Serving a population of almost 500,000 people in North Staffordshire it also provides a range of speciality services for a wider community of more than 3 million. The Trust employs more than 7,000 staff and has over 1,300 beds. In the last financial year it saw in excess of 77,000 in-patients, almost 36,000 day cases, over 103,500 new outpatient referrals and more than 261,000 outpatient follow-up appointments.

During 2003 the hospital handled almost 130,000 emergency attendances - 14,885 of which were seen via the Walk-in Centre which opened in June 2000, whilst a further 90,518 came through the Accident & Emergency (A&E) Department.

The Trust is committed to providing the best possible care to the community it serves. Last year it asked its ‘Information Management & Technology’ (IM&T) department for help in its drive to improve service to the 90,000+ patients requiring care through A&E each year.

The hospital has a highly skilled team running the department. Like every other Trust the hospital has their own Patient Administration System (named “HISS”) which logs when a patient enters and leaves A&E. HISS tells staff exactly how many patients are being treated at any given time. However, given the variety of potential injuries and illnesses, each patient’s route through the department is unique and A&E Staff had no simple means of detecting areas of potential bottlenecks.

A system was needed that no only logs the time a patient enters and leaves A&E but also captures full details of a patient’s movements during their time at the hospital. A manual whiteboard system had been implemented in an attempt to tackle the issue - but it proved awkward to use, limited in the information it displayed and there was no way to store information for management reporting or analysis (all records were removed as soon as the patient left A&E). Furthermore, the information captured was often lost if a patient or member of staff rubbed up against the board.

The lack of granular visibility of each step in a patients route through A&E (and potentially through other departments within the hospital) also made it difficult to assess how the hospital was performing against the metric set by the government for all Trusts ­ i.e. to register, diagnose and complete treatment (or admit) all patients within 4 hours from point of registration to the point they leave A&E.

The implications of missing the 4 hour target are significant for any Hospital Trust ­ including financial penalties that can have a major impact on the hospital’s funding in future years. Conversely, an ability to quickly identify and fix treatment bottlenecks and consistently meet the 4 hour target, raises the potential for corresponding financial rewards when budgets are assigned for the following year.

The hospital’s A+E Directorate identified the need for a solution which would enable A&E staff to track each patient’s movements from point of registration through diagnosis and treatment to the point they are discharged (or admitted into a ward). The IM&T department were given a high level project brief to develop and implement a new system. IM&T knew that the system had to be very simple to use ­ any solution that required A&E staff to use a keyboard to update records would only add to an already heavy workload. The system also needed to capture sufficient data points to enable workflow analysis and identification of bottlenecks in patient care. Furthermore, it had to provide the department’s Directorate with access to an up-to-the-minute view of how A&E was performing against the 4 hour treatment target along with the potential for Management Reporting on key A&E performance metrics. Ultimately it had to help A&E identify the corrective action needed to resolve bottlenecks before they result in an issue for patients under the hospital’s care.

IM&T quickly identified the scope of the information that needed to be tracked and set about designing and developing a bespoke software application to capture and report details of patient movements. Input was taken from all hospital stakeholders with consultation meetings held to ensure that the final application and ‘Touch Screen’ platform met the hospital’s design brief whilst providing a stable, robust solution requiring minimum support and maintenance. The next challenge was how to make the solution easy to use for staff within the working environment whilst at the same time being robust and resilient enough to withstand the potential for abuse within a hectic A&E department. IM&T came up with the ideal solution - to use a large ‘Touch Screen’ overlay from U-Touch to convert the 40” LCD displays into interactive screens which enable staff to move patients from one cubicle or department, simply by touching the screen to select from a list of available options (e.g. patient location and new treatment status).

The live A&E application not only displays the location and treatment stage for each patient but also provides a selection of simple “action buttons” on the ‘touch’ screen which staff can use to capture and update the status of each patient as they move through A&E and to and from other hospital departments.

The large format U-touch screens have a “high brightness, clear image” with a rapid “touch response” speed ­ critical for doctors and nurses who need to enter information quickly & grasp patient status at a glance, whilst on the move. The surface of the U-Touch screens can withstand constant use ­ being touched with any implement from a sharp finger nail to the point of a pen, providing a highly flexible data entry facility. The U-Touch overlays are also very easy to “wipe clean” and keep free of bacteria and other germs ­ again, particularly critical for hospitals today. In addition, the product’s reliability is ideal for the mission critical environment of a busy hospital where the screens are in use 24 hours a day, 7 days a week.