About Hannah Heales
Hannah is the lead pharmacist for Clinical Informatics at the Royal Free London NHS Foundation Trust. She qualified as a pharmacist in 2015 and spent 3 years rotating through various clinical specialties including; Elderly Care, Maternity, Neonatal Medicine, Paediatrics and Surgical Specialties. In January 2018 she joined the Electronic Patient Record (EPR) team to help deploy electronic prescribing across the Trust.
Hannah was commended for the Digital Pioneer Fellowship 2020 Empower Award.
Problem: Different patients with the same diagnosis are not receiving consistent care across sites. EPR is live at Barnet Hospital (BH), Chase Farm Hospital (CFH) and the maternity department at the Royal Free Hospital (RFH). Further roll out is scheduled for the rest of RFH across 2019/2020. The digital transformation project is still in its early stages and there is substantial work to be done in order to standardise pathways across the Trust ready for implementation at RFH. In addition, ensuring continued engagement and adoption from the staff and patients who use EPR is challenging.
Solution: The Trust has identified 40 clinical pathways covering 70% of our total activity. Hannah will be working with clinicians to digitally develop Clinical Practice Groups (CPG) pathways to help drive out unwarranted clinical variation. The project will test and implement 20 of these pathways in 2019 across sites. Complex prescribing plans will continue to be developed with clinicians and medication clinical decision support (mCDS) tools will be developed to aid prescribing decisions and improve user acceptance.
Scale: RFL is one of the largest UK Trusts delivering care to more than 1.6 million patients each year across three main hospitals: BH (440 beds), CFH (159 beds) and RFH (830 beds). The next stage of the project will involve the EPR role out at the largest site, RFH.
Desired impact: The Trust’s aim is to become the most digitally advanced Trust in the UK by 2020. Developing and implementing a single harmonised EPR across all hospital sites will aim to reduce unwarranted clinical variation and ensure patients receive the best standard of care, wherever they are treated.
Progress to date: At the start of the Fellowship programme, Hannah’s project was in the early adoption phase with staff all new to the electronic system. Their aim was to try to get staff on board, which included getting nurses to scan wrist bands and medication. They had zero uptake across the two hospital sites between November and May 2019 so there was a need for a massive push.
During the time Hannah has been on the Fellowship programme, the Chase Farm site has achieved HIMSS level 6 in June. They have seen an increase in medication scanning, wrist band compliance and digital maturity. Furthermore their Gentamicin calculator is demonstrating 100% dose accuracy compared to 60% on paper based systems.
“I joined the Fellowship programme because my manager was leaving and I had been asked to step up, the scope of which included managing the EPMA project and team.
The elements of the programme that created the most value for me were the Action Learning Set groups, which were really helpful. The discussions with my group and mentor helped me to think through and change the way I was working. We introduced a daily stand up for instance. One of the mentors supported me with a 5-year strategy I was developing. I’ve been thinking about Agile ever since we had the session on it. It really struck a chord with me.
Now I have a much stronger leadership role and I sit on the Digital Board (which I instigated and includes the Trust CNO, CMIO, and CIO). I provide regular patient safety metrics updates. The programme has helped me to define what a benefit is and how I use much better metrics.
I am delighted to have been accepted onto the NHS Digital Academy – cohort 3. Being on the Fellowship helped with that, in terms of my confidence and the language that I used in my application.”