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Back in Manchester a week later for BCS Health 2014 I participated in the stream 'Fit for practice – exploring the nursing experience of the usability of clinical systems' facilitated by the Royal College of Nurses and Chaired by Dr Susan Hamer of The National Institute for Health Research. Here I discussed the implementation of a clinical system and how the success of this project was rooted in the nursing-led implementation.
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Nursing Led Implementation
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Paper is failure.
Audit results from King’s Early Warning Track and Trigger paper charts (POTTS) showed:
●80% POTTS charts completed fully●91% Associated EWS scored●90% EWS calculated correctly●49% Escalated + responded correctly to EWS
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Paper is failure.
Audit results from King's; January – June 2012:
55 separate SUIs● Failure to do obs - 25%● Incorrect EWS calculation - 16% ● Failure to recognise deterioration - 29%● Failure to follow protocol - 31%● Failure to respond appropriately - 49%
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Nursing Leadership
Engagement: Chair of the Trust Patient Deterioration Committee also IT geek!
Evidence: POTTS audit consistently showed inadequate calculation of scores and poor escalation
Engineering: Build it ourselves
Education: Iterate and learn
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Nursing Implementation
● Piloted on two wards● Ward sisters engaged and provided feedback
to improve system● Nurses LOVED IT!!!!● Adopted by Trust IT Dept and team set up for
implementation● Nursing Led Training and Roll-out … Senior PM
was a Nurse
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Trust Wide Deployment
95,000 observations a month
● Failure to do observations - 0%● Incorrect EWS calculation - 0% ● Failure to recognise deterioration - 2%● Failure to follow protocol – 3%● Appropriate escalation response – 98.7%
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Engage nurses from the start!
Nurses know the reality of practice and what is “doable”
Make systems easy, friendly, playful!
Deploy systems that make a tangible and real difference to Patient Safety (not just managers....)
Some learnings...
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
We can do better...
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Meaningful Dialogue
Nurses and Developers working together
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
This is not a process
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
Localised NEWS as Process
Tactix4 at BCS HC2014 19/03/14
Rob Dyke, [email protected]@robdykedotcom @tactix4
@code4health
Come and see Tactix4NHS England Open Source Pavilion