Dan is a General and Respiratory Physician working in Cardiothoracic Critical Care.
Dan works as part of the team delivering Extra Corporeal Membrane Oxygenation therapy to acutely unwell patients with the most severe Cardiac and Respiratory illness, at Barts Health.
Recently, Dan has been seeking to improve patient outcomes in two ways:
- Early identification of patient deterioration so that clinical teams can respond in a timely manner, thus preventing harm.
- Automation of the collection of audit and performance data in Intensive Care to facilitate rolling Quality Improvement cycles.
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: Dan is responsible for delivering a model system and delivering it on one ward in each of the four Barts Health acute hospitals. 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, 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: The project has a model system working on three wards and will be implemented on a further two wards in the next five weeks. St Bartholomew’s Hospital Board has agreed to support a site wide implementation once this model is delivered.