Improving communication between clinicians, saving lives

Jacqui Harrison, Transformation Lead – Information Management and Technology Programmes, Barking Havering and Redbridge NHS Trust and Digital Pioneer Fellow.

It is a very exciting time at Barking Havering and Redbridge NHS Trust. The Digital Journey is challenging with several new projects being deployed, underpinning the move from paper to electronic documentation and allowing visibility of patient’s current information wherever a clinician is in the hospital or off site.

My project during the Fellowship has been the deployment of Careflow Connect which is a secure and mobile clinical communications and collaboration system designed to facilitate faster and safer care co-ordination. It can be accessed on all our ward-based devices and on clinicians’ personal mobile phones.

My role as Clinical Adoption Specialist requires me to work alongside clinical staff to support them as they transition from paper to electronic systems. This is the perfect role for me as it combines my previous nursing experience, senior management, and project management experience along with my leadership and change management skills into one role. The Digital Fellowship Programme was an opportunity for me to develop my skills further and it was a privilege to be accepted on it.

The journey so far with Careflow Connect

A very successful pioneer ward deployment to the Stroke Unit in October 2020 led to real-time multi-disciplinary clinical handover and Electronic Tissue Viability Referrals, as well as support for out of hours and weekend handover.

The functionality has now been deployed to the Geriatric and Frailty wards and will go live in the Specialist Medicine wards shortly.

Referrals are also being introduced and are being used by the Tissue Viability Team, Medical Photography Team and Pain Team on all wards live with Connect.

Tissue Viability Team championing the use of the system for patient referrals

Right from the start of the Careflow deployment the benefits of the functionality for the Tissue Viability Team were clear.

  1. The application enables them to work more efficiently. The ability for photos of wounds and electronic referral documentation to be made available as soon as the referral is completed has helped the team to utilise their time for patient ward reviews.
  2. The referral numbers are high for this team. Connect enables them to triage and prioritise their workload using the referral information and images. Immediate support can be given via comments on the referral and within the handover functionality. This negates the need to phone the ward and the information can be seen by all staff and is referenced during handover and the board round as required.
  3. Task management functionality is being piloted by the team. The Team use Careflow Connect to manage all their patients even if the ward is not yet live with Connect. The team workload is allocated via Careflow Connects Task Management Functionality and each task set is allocated according to the skillset within the team. This process was previously paper-based bringing with it the associated Information Governance risks.
  4. The team can see immediately all their patients and the work that has been allocated to them. The Lead Tissue Viability Nurse can monitor the teams progress wherever she is  and know that her team are seeing priority patients.
  5. Communication has improved between the team with visibility of the Tasks from anywhere as well as the ability to message within the team.

Connect in action: Life-threatening infection identified

Shortly after the Tissue Viability Team started to use Connect a junior member of staff was concerned about some moisture related skin damage that a patient had. This ward was not live at the time with Connect but the nurse took photos of the wound and completed the referral documentation, sending it for expert follow up advice to the Trusts Lead Tissue Viability Nurse.

The lead nurse was working from home that day, she reviewed the referral and the photo of the wound and was immediately concerned about it. It was confirmed that the patient had ‘necrotising fasciitis’ a rare but serious bacterial infection that affects the tissue beneath the skin and surround muscles and organs. The condition can be life threatening if it is not recognised and treated early on. However, using Connect led to early intervention for the patient. The patient received an urgent surgical review, followed by potentially lifesaving surgical intervention. This demonstrates the immense value of Connect for patient care and outcomes.

How will we know it has been successful?

Moving from paper in the pockets of clinicians to capturing all the information electronically available at the fingertips of a clinician wherever they are. This will resolve the associated Information Governance risks, the fact that the information on the paper is out of date as soon as it is printed and the issue that anything handwritten on it may never make it into the patient’s clinical record.

The Digital Pioneer Fellowship programme and me

It has been a privilege to be part of this course and my learning has been immense. The programme has given me the opportunity to step back from the project and view it with outside eyes, looking into the work I had undertaken to date. Meeting all the individuals on the course and attending all the sessions has been so thought provoking and made me step out of my comfort zone and I soon found I was like a sponge soaking all the information in.

Hearing the work of other Digital Pioneer Fellows was inspiring. The action learning sets were so thought provoking and I gained a lot of confidence and knowledge from these sessions both personally and for my project.

The time spent learning how to pitch your project and the feedback received on each learning day has helped me in my daily work, I use the technique in all meetings where I have an agenda item to keep me focused and to the point. 

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