NHS Trust IT: Transforming patient care

Digital Pioneer Fellow, Jenny Muir, shares her experiences of working in NHS Trust IT during the pandemic and the latest update on her project to implement a Capacity Management Tool at St George’s University Hospitals NHS Foundation Trust.

I am the Chief Nursing Informatics Officer at St George’s University Hospitals NHS Foundation Trust. Having worked in several senior clinical, educational and corporate roles within the NHS, I moved into IT in 2014 to help support the NHS National Programme for IT (NPfIT). This was an ambitious programme which attempted to implement a top-down digitisation of healthcare across the NHS.

Very early in the NPfIT programme it became clear that one of the priority agendas for us as a profession and healthcare provider was the need to move our current paper processes to electronic clinical documentation. Many trusts, like us, have been steadily working towards achieving this goal and embedding both the behavioural changes and learning requirements required for our staff to use these new technologies. This has been challenging, but certainly rewarding, as we have seen our working environments and the way we diagnose and treat our patients radically change in recent years. 

Throughout my time in IT, digital innovation has come to the forefront of improving patient care and existing business processes and workforce efficiency. I was pleased to see that in January 2019, the UK government announced its new NHS Long Term Plan to address the healthcare system’s lack of interoperability, and digital transformation was significant part of the plan – from requiring all secondary healthcare providers to transition to digital records by 2023, to ensuring we provide  straightforward digital access to NHS services and that we embrace data to support the development of new treatments to improve the NHS.

We continue to explore these opportunities, however, as we navigate our way through a global Pandemic, digital innovation has been fast tracked to transform the way we communicate and deliver healthcare.

Transformation through a pandemic

The impact of the surge in COVID-19 patients within the acute setting has been phenomenal. Although the pandemic has taken a huge toll on many individuals, staff have embraced the opportunity to work in different ways. Clinical teams have been ready, willing and able to make the changes required to enable digital transformation within healthcare. During 2021 the trust has implemented virtual outpatients across all services, this was part of a five-year strategy but was achieved in several weeks. The team also deployed electronic prescribing and medicines administration (ePMA) within our Emergency Department and provided support for data capture of COVID related requirements along with testing and administration of vaccines as they were developed. As a team we worked with colleagues across all clinical areas to identify lessons learnt from the first surge. This allowed for areas of improvement to be identified including the need for device integration across all of our Intensive Care Units, a refresh of our electronic Patient Status at a Glance Boards and the need to implement an integrated vital signs monitoring solution for our neurological patients.

Implementing a Capacity Management Tool

Part of my role is to provide clinical leadership to the team (IT) and help engage, scope and develop these initiatives and continue to review how technologies can facilitate better patient care. Although some of the changes made are service specific an initiative that is overarching to the trusts requirement is the introduction of a Capacity Management Tool across all inpatient areas.

Managing the capacity of our beds will enable us to bring all services and staff together to achieve one goal; ensuring that our patients are cared for in a timely way whilst providing safe care, in the right location and by staff with the correct skill set. The Capacity Management Tool reaches across all professional groups and includes front-of-house services, including cleaners and portering services. This tool will link directly with our electronic healthcare record.

The toolkit allows us (the trust) to monitor our bed occupancy across the trust, ensuring that patients are being cared for in the right place, at the right time. Colleagues will be able to identify when a bed is becoming available and assign a new patient to it (pending admission). The cleaning staff will be alerted to when a patient is leaving the hospital so that the bed can be cleaned in a timely way. Porters will be assigned jobs in real-time and be tracked throughout the activity. This will allow for better utilisation of resources.

The project currently has executive and divisional support to deploy. Following recent surges and lessons learnt – this project has been identified as a priority for the trust.

Working with our South-West London colleagues we have been able to secure funding for the software required to implement this change. The trust is ready, willing and able to make this transformation.

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