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In this slideshow, Catherine Beardshaw, Chief Executive, Aintree University Hospital NHS Foundation Trust, outlines the strategy used to create a ‘paperless’ hospital, using new technology to increase efficiency. Catherine Beardshaw presented at How can hospitals do more with less? in October 2012.
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New technologies: driving efficiencies
Catherine Beardshaw Chief Executive 17 October 2012
The path to greater efficiency – the paperless hospital • NHS organisations are drowning in paper
– Incredibly inefficient/expensive – Logistical nightmare – Disorganised – difficult to access information – Barrier to change – archaic processes
• Aintree’s two prong strategy
– Resolve the legacy paper – Stop generating the paper
The path to greater efficiency – support for clinicians
• IT as a clinical tool • Data for clinicians • Safer care for patients • First time, right every time
The Paperless Hospital
The paper trail
• 195 million pages on 10 miles of shelving
• 686,000 patients (381,000 active)
• Finding/transporting/tracking 1200 requests per day
• Missing notes inevitable, especially out of hours
• Six figure sums spent on external storage and retrieval
• Paper is our biggest data loss vector
• Records scanned by Capita – and whole archive completed by end of next month
• All doctors have adapted to EDMS with clinical change support and attitudes moving from universal dislike, to tolerance and now some plaudits
• Some errors (mostly clerical) but less than on paper in past and records available 24/7
• Gains on staffing (mostly redeployed), and on estate amounting to £2M revenue and £20M capital for a £1.5 M outlay
• Gains of 24/7 availability and fewer missing records, external access a bonus
• Revolutionised our approach to clinical records • Opens up the expectation of importing data from any other system • Allows the organisation to be more nimble • Provides a better experience for patients
Resolving the legacy paper issue
1
Find the MEWS Chart
2
3
4
Results Management • Results move with the patient e.g. from AED to MAU to ward
to ITU to ward • On discharge from hospital – checks for outstanding
unacknowledged results and can prevent discharge until they are dealt with
Net effects • No paper results– no filing/scanning needed = COST SAVING • Consultants aware of delays = CLINICAL EFFICIENCY • No patient goes home without someone checking the
results = SAFETY
Stop generating paper
Support for Clinicians
Electronic Patient Records • E-assessments – triggers tests, calculates scores • E-orders/results – no result can be lost or missed • Integration – other systems/organisations • Remote access – Trauma/OOH support • Reporting – true Business Intelligence • Reduced costs – logistics of paper is expensive • Transparency – clear view of what is happening • Flexibility – can treat patients quicker
Ward-based Eboards – real-time bed state
• Safety information - falls, alerts, nutrition • Patient information - EDD, location,
Consultant • Results availability - alerts results are
available
ePMA (electronic prescribing and medicines administration)
• Safer system • Greater transparency • Improves compliance with medication policies • Allows data analysis and improves patient care
These records can be just as available for:
• Clinicians in other hospitals
• Clinicians working from home
• Full access to all systems from home decreases the risk of losing highly confidential data
PAS/Letters/results dictation control PACS (Xrays) EDMS (archived records)
Blood label printer
A modern clinical desk at Aintree
Benefits • Financial • Greater flexibility • Better experience for the patient • More informed care delivery • Real-time reporting/management
Issues • Totally dependent upon the IT systems, outages are major
incidents • Changing the culture • Change management is critical
The paperless office and support for clinicians