Digitising Clinical Workflows in Bedded Services

In this case study, South-West London Integrated Care System (SWL ICS) Digital Pioneer Fellow Alan Rio, Senior Project Manager at the Improvement and Transformation Office Department in Central London Community Healthcare NHS Trust shares how he is working on digitising clinical workflows in Bedded Services.

Project Summary

The vision is for clinical workflows in Bedded Services to be digitised. Staff will also be provided digital resources to access the information they need to make better-informed clinical decisions.  

Project Objectives

National funding became available for front-line digitisation due to the shift in moving paper Electronic Patient Records (EPR) to digital platforms. While there have been some delays, the Central London Community Healthcare NHS Trust’s (CLCH) EPR transformation is now underway. The project’s scope is the main challenge, as it covers 240 beds, 12 wards, 8 hospitals and 600 staff, who all require digital skills training.

The project plan takes a three-phased delivery approach and is managed by a CLCH project team that will commission Capita, via detailed Change Control Notices (CCNs). This discrete work will comprise core business process analysis of the paper process, reconfiguring clinical systems into clinical workflows and onsite training to support staff. The training and support will be delivered through current mechanisms which include CLCH resources. Statutory reporting requirements are being reviewed, which will be delivered in parallel.

Key Challenges

• Project team resource requirements: delivery of the project will require an experienced project team skilled in managing complex change in the clinical environment and communicating the project progress effectively to a wide audience.
• Capita delivery planning and clinical applications team engagement: delivery on time within the project’s scope may be challenging for the Trust partner.
• Digital assets including mobile devices and fixed assets: there is limited knowledge of the digital assets within the trust and how these can be integrated into workflows.
• Reconfiguration of the CLCH estate to secure, store and charge the new digital assets: the clinical environment has a limited capacity and physical space to secure, store and charge the new digital assets.
• Digital skill development of end users of the clinical system: digital exclusion remains a serious problem within society and among working adults. 

Impact/Outcomes

In 2023, we conducted a staff survey, with the data showing positive views and support for the transition to new ways of working using digital technologies.

Once fully integrated, NHS staff will be able to work more efficiently via the use of digital devices as compared to paper methods (e.g., they won’t have to wait on importation). This also benefits patients who will see improved quality in their care due to being better informed about clinical decisions since information will be kept up to date in real time. Patients have also been included in the project’s development, allowing us to account for their opinions and feedback.

Clinical, administration and community staff will also have simultaneous access to view and input information into the clinical record regardless of location, fostering enhanced collaboration and communication among teams and benefiting patients. As part of this transition, these staff will develop new digital skills, improving patient care and positively impacting broader society as these skills permeate into communities. Each unit service will strive to minimise paper usage, particularly in printing, contributing to environmental sustainability efforts.

In a nutshell, I’m very satisfied that the needs and welfare of patients seems to be very high on the list of priorities, and that one of the targets for the whole digitisation strategy is to give staff more time to attend those patients’ needs. As I’m sure you appreciate by now, I will speak up if I feel that there is something amiss that need addressing. I am part of the meetings that take place and being an active member of the project allows me to have visibility on many parts of the project such as purchasing. I very much enjoy being part of the CLCH project as it adds transparency, and I can have an input when necessary.

CLCH Project Staff Member

Implementing the Electronic Prescribing and Medication Administration (EPMA) module within clinical systems could enhance medication safety significantly by preventing omitted or delayed doses, errors in documentation, and incorrect administrations. Real-time recording of admission, discharge, and transfer (ADT) data will facilitate efficient bed management and patient flow within the healthcare system.

Digitising processes like the National Early Warning Score 2 (NEWS2) could also boost efficiency for Healthcare Assistants (HCAs). Additionally, reducing paper consumption mitigates environmental impact by lowering CO2 emissions associated with production, but also mitigates the risk of inaccessible or irretrievable paper records, aligning with Data Protection legislation and NHS records management guidelines, with a target set for accomplishment by 2025.

Next Steps

The next steps will be moving towards EPR implementation, and the future working processes will be primarily digital and paper light.

Alan Rio is a Fellow from Cohort One of the SWL ICS Digital Pioneer Fellowship programme.

The SWL ICS Digital Pioneer Fellowship programme supports change makers employed by NHS, Local Authority and Voluntary Sector organisations in South-West London to design and lead health and care transformation projects underpinned by digital innovation. Funded by the South-West London Integrated Care System, the programme builds on DigitalHealth.London’s Digital Pioneer Fellowship programme but is specifically for staff employed by NHS, Local Authority and Voluntary Sector organisations in South West London.

To find out more about the other Fellows in Cohort One of the SWL ICS Digital Pioneer Fellowship programme, please refer to our innovation directory.