NHSGGC New South TrakCare Presentation · Microbiology (inc. Serology) Full interface Virology Request form Immunology Full interface Neuro-immunology Manual paper request Molecular-pathology

TrakCare in the New South Glasgow

Hospitals

Andrena GordonTrakCare Portfolio Manager, NHSGGC

NHSGGC & TrakCare

The New South Glasgow Hospital Campus

On the Move & Migration Programme

TrakCare changes to support NSGH moves

NHS Greater Glasgow & Clyde

Largest Health Board in the UK

c. 1.2m Population

c. 4,600 Beds

Per annum activityc. 1.3m Outpatient attendances

c. 450k ED attendances

c. 480k Acute IP/DC

c. 16k Births

c.38k Headcount includingc. 3.7k Medical

c. 17.0k Nursing

c. 6.3k Admin

• NHSGGC is in a Consortium of 8 other Health Boards currently using TrakCare across NHS Scotland.

• Across NHS Scotland, TrakCare now has c 60,000 users and covers 70% of the population. Several other NHS Boards are looking at TrakCare and if chosen this would bring coverage up to circa 90% within the next two years.

NHS Greater Glasgow & Clyde - TrakCare

NHSGGC TrakCare Implementation Timetable

•COMPAS (PAS)

•Helix (Waiting Lists)

•SCI Outpatients

• Inverclyde use of Clyde EDIS (ED)

1 -Inverclyde

•COMPAS (PAS)

•Helix

•SCI Outpatients

•Vale use of Clyde EDIS (ED)

2 – Vale of Leven

•COMPAS (PAS)

•Helix (Waiting Lists)

•SCI Outpatients

•Royal Alexandra use of Clyde EDIS (ED)

3 – Royal Alexandra

•South Meditech HISS

•South use of Glasgow eTriage

4 – South Glasgow

• iSoft PAS

• EDIS A&E

• Immediate Discharge Letter System (IDLS)

• Yorkhill Meditech HISS

• Yorkhill Revive Immediate Discharge Letter System

• North and Yorkhill use of eTriage

• Soprano Medical Documents / SMD

• Other supporting systems

5 - North Glasgow &

Yorkhill

September 2011

February 2012

May 2012

December 2012

May 2013

Increasing

functionality

and scale of

users / go-lives

+ 800 users

+ 10,500 users

…Then we upgraded to T2014 in Nov 2014

(in advance of New Hospitals move)

TrakCare use in NHSGGC

• PAS

– Master Patient Index, Admissions, Discharges, Transfers, CasenoteMgmt, Outpatient Acute Clinics, Acute & Community AHP Clinics Roll-out (Physio, Podiatry, MSK, RMC), Outpatient /IP Waiting List, Vetting, Admin/Clinic letters, Coding/Simplecode, 18 Week Referral To Treatment, TTG (Treatment Time Guarantee), Ward Attenders

• Emergency Department (including Minor Injuries)

• Clinical

– Clinical Letters - Outpatient Clinical Letter (OPCL), Immediate Discharge Letter (IDL), Final Discharge Letter (FDL), Emergency Discharge Letter (EDL), Generic Clinical Letters (GCL)

– EPR (incl Alerts, Allergies, Diagnosis, Procedures etc)

• Reports, Extracts and Dashboards (now using MicroStrategy)

• National Statutory Returns (SMRs, Card Classes, New Ways)

• Interfaces from/to TrakCare: – ARIA Radiotherapy, Clinical Portal, Electronic Document Transfer

to GP’s, Local Ensemble, ICNet (Infection Control), Cancer Waits, Telepath (Labs), CRIS (Imaging), SCI Store (Local Data Repository and also accessed by GP’s), SCI Gateway (Referrals) and CHI (National MPI), Badgernet (Neonatal), Weight Management, Quenda (Patient Kiosks), Wardview (Digital Whiteboard), ECS

• Order Comms

– Imaging, Labs, (Requests & Results)

– Requesting only eg Cardiology, Endoscopy, Respiratory, Podiatry, Diabetes, Physio

– Hospital At Night Requests

TrakCare use in NHSGGC

Discipline GGC Wide

Blood transfusion Request form

Biochemistry Full interface

Haematology Full interface

Haemostasis Full interface

Microbiology (inc. Serology) Full interface

Virology Request form

Immunology Full interface

Neuro-immunology Manual paper request

Molecular-pathology Manual paper request

Histo-pathology (inc Paediatric) Full interface

Andrology Full interface

Cytology Full interface

Neuro-pathology Full interface

Haemato-oncology Full interface

Genetics Manual paper request

TrakCare Order Comms Lab Disciplines

All, where defined by service, with specialty-specific adult and child favourites, plus order sets.

9

TrakCare Order Comms “Others”

TrakCare Order Comms “Others”

26 Services

NHSGGC TrakCare Stats

On average each week within TrakCare:

– 47,000 clinical letters are created, of which 37,000 are electronically delivered to GPs via EDT

– 547,000 prints are generated (including PDFs, physical prints)

– 19,000 staff use the system

– 3,600 Outpatient Clinics

– Order Comms requests raised each week• 195,000 Labs

• 28,000 Imaging

• 4,100 Cardiology requests

• 2,800 Hospital At Night

• Over 3,000 “Others”

• Edition R7 – Testing & Release

• Results Sign off (Labs & Imaging)

• Virology Labs Interface

• Neuro immunology Labs Interface

• More “Others” requesting on TrakCare eg Rheumatology, Vascular,

Nutrition etc

• Clinician to Clinician Referring

• Role Based Access Control Changes & other usability improvements/enhancements

• Clinical Letter Improvements

• ED Questionnaires

• Admin letters via EDT to GP and via Patient eComms

• New T2014 functionality / enhancements

• Clinical & Admin Groups Local & National priority developments

TrakCare Current Projects

NHSGGC & TrakCare

The New South Glasgow Hospitals Campus



New South Glasgow Hospitals

• Scotland's Largest Hospital & one of the biggest critical care complexes in Europe.

• £842 m – delivered under budget and ahead of schedule

• The new campus is built on the site of the old Southern General Hospital

• Maternity, Children and Adult Hospitals all on one site.

• Adult Hospital is bringing together both healthcare & research facilities

• There are 2 major ED Depts – Adults & Children

• 1000 inpatients and 10,000 staff moving to the new facility.

• All of the re-locating service staff – nurses, doctors, admin – are moving into entirely new environment, new working practices, new operational structures, new colleagues

• South Glasgow University Hospital – SGH, VIC, WIG In-Patient, GGH In-Patient (limited), BWOSCC Haem-Onc In-Patient

• The Campus replaces four aging hospitals across NHSGGC - the Royal Hospital for Sick Children at Yorkhill, The Southern General Hospital, Western Infirmary and the Victoria Infirmary and Mansionhouse Unit.


General Facts and Figures

• There are over 7000 rooms between the two hospitals

• Over 10,500 staff will work on the campus

• 1109 Beds over 12 floors (SGUH)

• 244 Beds over 4 floors (RHSC)

• With the exception of critical care, all single rooms all en-suite in SGUH.

– 29 Theatres (20 SGUH/9 RHSC)– 118 bed Acute Receiving Unit (28 bed IAU) – GP Referrals and Referrals

from ED– 79 bed HDU / CCU / ICU

• There will be 3500 car park spaces when the campus is completed in 2016 – 60 buses arriving at peak hours

• The new office block has space for 1200 staff

• Giant roof helipad designed for a sea-king rescue helicopter

Overview of SGUH

There are additional Staff Change and Seminar Rooms throughout the hospital – the floor plan lists the main areas.

Overview of NSG Children’s Hospital (RHSC)

NHSGGC & TrakCare




Programme Summary Overview

• The biggest hospital migration ever undertaken in the UK

• On-the-Move & Migration programme established

• New hospitals handed over 26/01/15

• 12 week commissioning then 8 week migration period– Pre-equipping 350 adult bed spaces and 100 children’s– Pre-stocking wards and departments– Installing IT equipment SGUH – 2300 PC’s, 350 Printers, 190 mobile laptops on

trolleys (Cows). Further 320 pieces of equipment transferred during the migration

– ‘Testing’ the building

• Workforce changes

• Service Transfer Owners determined all IT kit req’s / moving

• A number of Sideways moves & decommissioning work also taking place before, during & after migration to New South eg WIG OPD to Yorkhill site

• Demolition of old SGH buildings Jun’15 to Dec’16

Migration DatesWeek Moves

1 24th – 26th April 2015 Southern General Outpatients, GP Out of Hours,

Therapy Department, Pharmacy,and Renal Dialysis

Outpatients, from the Western and Glasgow Royal

Infirmary

2 1st – 3rd May 2015 Southern General Inpatients, ED, Theatres, ITU/HDU

3 8th May 2015 ENT Inpatients from Southern General and Gartnavel

General

4 9th – 10th May 2015 Vascular and Renal Inpatients from the Western

Infirmary

5 15th – 17th May 2015 &

22nd – 24th May 2015

The Victoria Infirmary ED, Inpatients and Mansion

house Unit over two weekends

6 29th – 31st May 2015 Inpatients and ED at the Western Infirmary

NICU to PRM

VIC Labs to SGH Labs

7 5th – 7th June 2015 Selected Wards at Gartnavel General and the Bone

Marrow Transplant Wards at the Beatson

8 10th – 17th June 2015 The Royal Hospital for Sick Children

Sideways moves

• Further service relocations as a result of moves to New South e.g

Week Moves

Week 2 GGH Wards 6A & 6B to PRMH Wards 69 & 79

Week 4 WIG Level 10 WIG to GGH Ward 4A

Week 5 VIC Ward 2 to GRI

Week 5 VIC Ward 6 to GRI

Week 5 Langlands Ward 57 to Ward 52

Week 5 VIC South 3 to Langlands Ward 53

Week 5 VIC North 3 to Langlands Ward 57

Week 6, 7, 8 YRK NICU to SGH Maternity

Overall Migration Plans

• Pre-equip wards, move patients, move equipment

• At each demitting site the Emergency department closed down at 7.59am and switched over to the new site at 8.00am

• Patients transferred from demitting sites to the SGUH by the Scottish Ambulance Service, supported where necessary by a nurse escort. Transfers between 8.00am – 5.30pm

• Flexible visiting suspended on move days.

• Control & Command Hub – Director Led during migration moves.

NHSGGC & TrakCare




TrakCare NSGH Changes Keep it Simple – use existing BAU teams

• Hospital Name /Address Changes

• Clinics (~1400), Case Note Tracking Locations

• Letters – location details, phone numbers

• User Login Location Changes / User Preferences

• Wards/Floorplans (~90)

• Order Comms – receiving locations, routing & print rules (~2000)

• New functionality – IAU workflow, Discharge Lounges

• Printer Changes

• Support & retraining – preparing new teams for working together eg Same day Admission unit

• TrakCare interoperability

- Self Service Kiosks & Patient Calling

- Wardview – Digital Whiteboard

- Clinical Portal

TrakCare Key Planning/Dependencies for Build

• Overall Migration Plan – what moving/when.

• Hospital Names – confirmation, testing changes

• Locations Build Approach with all teams – agree naming conventions/build approach/interoperability dependencies

• Bed & Specialty Configuration Model

• Floorplans & Clinic Templates etc collated and signed off

• Letters – Telephone nos for secretaries / wards

• Staff usernames / roles moving/changing

• Any Requirements for change following process review/design

• No downtime on TrakCare – seamless transition

Teams from across Health Records, IT Support, Diagnostics, Service staff, ISC & IT Projects working together, building & testing large volumes of changes.

TrakCare – Wards/Floor plans

• New Wards/Floor plans build in advance with future active dates

• New Wards have different prefixes to distinguish from old hospitals

– SU instead of S and CH instead of Y

• Beds have room references that show the Ward, Estates Department room reference, and the Hospital.

• Day of moves, patients moved across into new Ward Waiting Area, then once arrived is assigned to bed (as normal). Old Ward/Floorplan deactivated when advised.

• Location changes for downstream systems eg Wardview

TrakCare – Order Comms

• Order Comms – a complex schedule of changes as lab and other services reconfigure / moved sites

– Existing SGH and RHSC Receiving location name changes

– 1,000s of Labs OCS catalogue routing rules changes moved to LIVE as receiving departments close (e.g. WIG Biochem). Note, not all going to SGUH, some tests going to GRI

– OCS others based on hospital codes, but receiving service staff need to monitor old sites and transfer any requests routed there (e.g. requested just before moved, or requested against old episode)

– Print rules for OCS “others” & imaging changed

– Labs had internal processes to redirect requests if go to wrong lab

TrakCare & Related New Changes/ Processes

• The Discharge Lounge (IP & OP)- Ward Attenders & floorplan

• IPWL screen changes.

• IAU GP Expects. This is for use by staff who are taking calls for the IAU (Immediate Assessment Unit)

• New role/responsibility (RBAC changes)

• New Workbenches (OCS requests)

• Patient Kiosks (Pre existing) & Patient Calling (New)

• Wardview (Digital whiteboard)

• Single Sign on (SSO) (New)

• Secure Personal Printing (SPP) (New)

TrakCare Printing

• Each physical PC is mapped to a defined printer

– For pre-equip’d done and tested in advance

– For PCs moving new mapping info captured (remove old and upload new mappings)

– For Laptops on Trollies assigned to a fixed ward to the main printer in that ward

• Secure Personal Printing (SPP)

– Health Records, Admin Block and truly mobile devices (e.g. consultants laptops)

– Mapped in TrakCare to SPP queues

Preparing for go-live

• Staff attended local training for the new/changed functions

• Staff used the PLAY system to practice their skills before go-live

• Service Managers:

– Ensured Support Process displayed

in every area

– End User Reference Guide displayed next to

every PC

– local trainer rota for Department / Ward

displayed in every area.

– Staff reminded of the process to follow

when seeking support.

Overall IT Migration

• Pre Commissioning / Commissioning

– On-going programme of work over last 2 years

– Engagement with OTM groups

– Pre-equipping and user engagement for sign off

– UAT with user and representation from other areas of IT

– Application preparedness/readiness – including TrakCare utilising existing teams

Overall IT Migration

• Migration Support

– Continued to maintain support services to the rest of NHSGGC

– Support for additional changes in support of moves

– Heightened monitoring of systems

– Support on-site staff

– Remembering that clinical staff require immediate access to hardware and core systems – hospital business as usual immediately

– Anticipating Challenges eg (directly/indirectly) with TrakCare & preparing for:

• Preferences changing, finding lost letters, new processes (e.g. IAU), printer issues, printer changes, use of correct episodes, floor plan/Clinic issues

Handover Keys 26th January 2015

Commissioning 12 weeks

Pre-equipping April 2015

Migration Started 24th April 2015

Migration completed 14th June 2014

Next set of moves, business as usual and developments

continue.…..

Thanks