A rich mix of 60 staff - including nurses, student nurses, doctors, consultants, healthcare assistants and support staff - have been involved in LiA Conversations at East Sussex Healthcare NHS Trust to connect across boundaries around care of the deteriorating patient.
A lead Sponsor for this work, Dr Kate Murray, said: “It was great to be able to discuss all the issues surrounding the deteriorating patient with the wide range of staff who attended. Great ideas came out which we are now going to act on together”.
Dr Nick McNeillis added: “Recognition of the deteriorating patient through LiA was an opportunity to hear from all staff groups involved in ward based-care, and this has led to a greater understanding of the limitations of the current systems and surfaced ideas about how we can all improve the care we deliver”.
Valuable ideas were generated from the LiA Conversations, including the need for improved communication around the National Early Warning Score (NEWS), and the need to ensure both nurses and junior doctors have relevant training. But the top priority identified was the need for technology to support staff to spot and take action more promptly and effectively.
Plans are now in place to act on the ideas that came up, and a new clinical monitoring system using hand-held mobile technology has already been introduced at the Trust. This new system was introduced first on De Cham Ward at Conquest Hospital, and will be rolled-out across acute hospitals at Conquest and Eastbourne, becoming fully embedded by October 2014.
The new system called VitalPAC, monitors and analyses patients’ vital signs and enables staff to automatically summon timely and appropriate help if a patient deteriorates. This removes the need for paper-based monitoring charts.
Sister Victoria Gordon from De Cham Ward said: “Staff have been using the new system and the advantages are already apparent”.
Alice Webster, Director of Nursing said: “Implementing this new system will improve patient safety and patient outcomes as it will identify deteriorating patients earlier and allow for quicker clinical intervention. This is particularly true in enabling specialist teams such as critical care outreach, infection control and pain services, who are using this as a surveillance system to identify and intervene proactively. Staff are excited about using this new technology. We will be able to observe patients’ vitals 40% quicker than before. This means we can manage our patients more efficiently, with fewer people going into intensive care and fewer cardiac arrests. More importantly we will be able to make reductions in mortality rates and improve our patient outcomes.”
VitalPAC enables nurses to record seven routine observations, such as temperature, pulse and blood pressure, and removes the requirement for a paper chart. The system’s software analyses the patient’s readings using a set of algorithms, and doctors and other senior staff receive an urgent alert if they dip below a safe level. It is hoped that the system will also reduce length of stay by avoiding the complications that can arise in patients at risk of deterioration.
The new paperless monitoring system has been funded through £821,000 from the Safer Hospitals, Safer Wards Technology Fund and £186,000 from the Nursing Technology Fund.