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Dan is a General and Respiratory Physician working in Cardiothoracic Critical Care at Barts Health NHS Trust. Whilst on the Fellowship programme he has been appointed to the role of Deputy Chief Clinical Information Officer for Barts Health.
Dan has been seeking to improve patient outcomes in two ways:
1. Early identification of patient deterioration so that clinical teams can respond in a timely manner, thus preventing harm.
2. Automation of the collection of audit and performance data in Intensive Care to facilitate rolling Quality Improvement cycles.
Digital Pioneer Fellowship project: Implementing a system of biomedical device integration
Problem: Data produced by bedside vital-signs monitors and other medical devices at Barts Health is transcribed by clinical staff into the paper record. This happens on wards, in intensive care units (ICU), operating theatres and catheter laboratories. The process is often incomplete, risks transcription error and is extremely time consuming. For example, each ICU nurse spends ten minutes every hour transcribing data. Across the 110 ICU beds in the Trust this is equivalent to 36 whole time nurses every day and more if ward nurses are included. Worse, data essential for national and local audits must then be transcribed back into electronic systems by a team of full-time audit nurses. None of this data is visible to clinicians at distant locations in real-time.
Solution: We are implementing a system of biomedical device integration which will allow devices to transfer data directly into the electronic patient record.
Scale of the project: The project has grown, in the past year, from a model system on one ward in each of the four Barts Health acute hospitals to over 40 wards Trust wide. Dan is planning to integrate all devices on one site, St Bartholomew’s Hospital, which admits 25,000 patients yearly. Finally, the project is seeking funding for a whole Trust implementation to include the emergency and outpatient departments. This would encompass over two million patient episodes each year.
Desired impact: The system will allow clinical teams to remove paper from the bedside and automatically alert relevant teams to patient deterioration thus reducing harm. Moreover, it will provide dashboard and audit data automatically, in the service of quality improvement.
Progress to date: Since inception to date the system has grown from a small pilot to becoming a Trust standard. We now have funding to ensure that all in patient beds in 4 hospitals are covered in the next 12 months.