Harrogate and District Hospital leaps ahead in safer care with Patientrack

Alerting doctors and nurses to deteriorating patients is allowing early intervention and innovative care.

The Brief

The National Health Service (NHS) in England has a national ambition to become the safest healthcare system in the world. Harrogate and District NHS Foundation Trust embarked on a patient safety initiative, with the aim of reducing adverse events and mortality rates. It needed an early warning and alerting system that would allow staff to respond more quickly and effectively to patients showing signs of deterioration.

The trust was approved for funding by the Safer Hospitals, Safer Wards Technology Fund to help implement a real time patient observation and escalation system. This, combined with support from HSCIC, enabled the hospital to engage with Patientrack, because of its ability to capture digital bedside observations, calculate early warning scores, and automatically alert doctors to patients that require urgent attention. Plus the system could also provide staff with the flexibility to respond to other clinical demands and introduce new innovative ideas.

From signing a contract, deployment needed to begin within weeks to allow for go live required. The technology also had to be tailored to working practices in the hospital and meet the requirements of clinical staff.

The Client

Harrogate and District NHS Foundation Trust cares for the population of North Yorkshire and York and North East Leeds in England by providing essential hospital and wide ranging community health services.

Foundation trust status means that more than 17,000 members of the community are involved in running the organisation. The trust strives for excellent standards, and is constantly working to improve the provision of healthcare for the population that is serves, as well as the achievement of the ambitions of the NHS digital healthcare agenda.

The Situation 

A new digital approach to capturing patient vital signs and recording critical bedside observations was required to allow the hospital staff to respond more quickly to patients who need urgent attention.

As a forward thinking UK hospital, Harrogate and District NHS Foundation Trust successfully secured funding from the UK government’s Safer Hospitals, Safer Wards Technology Fund to embark on a clinically led digitally enabled observations project.

Moving away from a process of using paper based observations was a big step, so the hospital needed to be sure that a new digital system would truly support nurses and doctors in being able to deliver more timely, safer care. Fitting in with the trust’s processes was also critical.

Other essential elements included the ability for observations to be constantly and consistently carried out, to enable the rapid calculation of early warning scores, therefore supporting hospital policies on the escalation of deteriorating patients.

The new system also needed to allow variances to be set for different specialties and departments throughout the hospital. Plus the ability to support an environment where doctors, nurses and critical care outreach teams were kept continually up to date and alerted to patients at risk, was essential.

 

“When a nurse has a deteriorating patient they need a response as quickly as possible. With Patientrack, nurses no longer have to leave a deteriorating patient to go and identify the right doctor to bleep. The nurse knows the system handles that escalation process for them by calculating the NEWS score and automatically bleeping and alerting the doctor. They know that doctor will respond.”

Robin Pitts, Clinical IM&T Project Manager and Paediatric Advanced Nurse Practitioner.

The Solution

Patientrack was chosen as a means to transform the way doctors and nurses attend critically ill patients. In a robust procurement competition, the solution was chosen due to its ability to support both clinical and technical requirements and to help the hospital meet national safety targets and standards.

Going live on the first wards just eight weeks after the contract was signed, the real-time patient vital signs, early warning and alerting system was deployed to help healthcare professionals avoid a wide range of risks and adverse events for patients in their care.

Patientrack has been automatically identifying and escalating patients who may be deteriorating, before sending alerts directly to those clinicians who need to take action.

It has provided hospital staff with greater visibility of the most ill patients and has specifically empowered nurses to spend more time directly at patients’ bedsides, instead of having to manually phone around to call for a doctor when intervention is required.

Paper based observation processes are now being completely removed as the solution continues to be deployed in different parts of the hospital.

Patientrack means that nurses now capture observations in real-time at the patient bedside on handheld tablet devices, with clinicians also able to access that information from anywhere in the hospital.

The software accurately calculates the patient’s National Early Warning Score (NEWS) and uses this information to alert doctors to patients who need urgent attention. It also tells staff when the next set of observations are due to ensure they are not missed.

With the doctor now receiving specific information, such as a patient’s name, ward, bed and NEWS score, they can prioritise which patients need to be attended to first based on this data.

The Result

The impact of Patientrack has been strong, with the technology being very well received by staff who are committed to delivering the best possible care. Patientrack is helping to ensure the right pathways are followed and that the right treatments are given.

Information that was once inaccessible, and new highly useful information, is now provided to all relevant staff across the hospital in real time or at the push of a button.

For nurses the technology saves time and allows them to remain with the ill patient, as they do not have to manually call for doctors to attend. Appropriate doctors are now not only contacted at the correct stage but are continually reminded of the need to attend to the patient.

Hospital escalation policies are now being met, with senior doctors, junior doctors and the critical care outreach teams all being informed when a patient is at risk. This helps to ensure appropriate measures have been taken to mitigate risks for the patient.

For doctors, the ability to view digital information such as the patient’s chart at a glance instantly, whilst on route to the patient, means that they know what course of action needs to be taken when they arrive.

A major difference has also been made for end of life patients through Patientrack. Harrogate has innovated with Patientrack to create a new observation profile that considers a patient’s comfort. This covers pain scores, alertness, agitation, respiratory rates, respiratory noises, mouth condition and other factors that affect a patient’s comfort. This system bleeps the nurse in charge when a patient is suddenly in more pain or more agitated and may need an intervention. Clinical staff have found this has made a real difference to the compassionate care of patients at a highly important point in their life.

As more and more staff across the hospital are exposed to the system or witness its benefits, they are proactively calling for it to be deployed in other hospital environments.

 

“We have made a huge difference for end of life patients with Patientrack. Through an entirely new comfort observation profile, Patientrack now bleeps the nurse in charge to intervene when the patient is suddenly in more pain.”

Robin Pitts, Clinical IM&T Project Manager and Paediatric Advanced Nurse Practitioner.

The Future

With such a positive reception and demand for widespread rollout from staff, Patientrack will soon be in use in 21 environments across the hospital, including all medical and surgical wards, as well as theatres and Accident and Emergency (A&E).

Innovations in improving care for patients on end of life pathways will soon be shared with other hospitals that use Patientrack.

Additional pathways are being built into the system to allow the hospital to better respond to serious, life threatening conditions including acute kidney injury and sepsis, the two national clinical priorities set by NHS England.