New technologies:
 driving efficiencies


Catherine Beardshaw
Chief Executive
17 October 2012
The path to greater efficiency –
the paperless hospital
• NHS organisations are drowning in paper
  – Incredibly inefficient/expensive
  – Logistical nightmare
  – Disorganised – difficult to access information
  – Barrier to change – archaic processes

• Aintree’s two prong strategy
  – Resolve the legacy paper
  – Stop generating the paper
The path to greater efficiency –
support for clinicians
•   IT as a clinical tool
•   Data for clinicians
•   Safer care for patients
•   First time, right every time
The Paperless Hospital
Catherine Beardshaw: Driving efficiency with new technology
The paper trail
• 195 million pages on 10 miles of shelving
• 686,000 patients (381,000 active)
• Finding/transporting/tracking 1200 requests per day
• Missing notes inevitable, especially out of hours
• Six figure sums spent on external storage and
  retrieval
• Paper is our biggest data loss vector
Resolving the legacy paper issue
• Records scanned by Capita – and whole archive completed by end of next
  month
• All doctors have adapted to EDMS with clinical change support and attitudes
  moving from universal dislike, to tolerance and now some plaudits
• Some errors (mostly clerical) but less than on paper in past and records
  available 24/7
• Gains on staffing (mostly redeployed), and on estate amounting to £2M
  revenue and £20M capital for a £1.5 M outlay
• Gains of 24/7 availability and fewer missing records, external access a
  bonus
• Revolutionised our approach to clinical records
• Opens up the expectation of importing data from any other system
• Allows the organisation to be more nimble
• Provides a better experience for patients
Catherine Beardshaw: Driving efficiency with new technology
Catherine Beardshaw: Driving efficiency with new technology
Find the MEWS Chart
     1




         2

             3


                 4
Stop generating paper
Results Management
• Results move with the patient e.g. from AED to MAU to ward
  to ITU to ward
• On discharge from hospital – checks for outstanding
  unacknowledged results and can prevent discharge until
  they are dealt with

Net effects
• No paper results– no filing/scanning needed = COST SAVING
• Consultants aware of delays = CLINICAL EFFICIENCY
• No patient goes home without someone checking the
  results = SAFETY
Support for Clinicians
Electronic Patient Records
•   E-assessments – triggers tests, calculates scores
•   E-orders/results – no result can be lost or missed
•   Integration – other systems/organisations
•   Remote access – Trauma/OOH support
•   Reporting – true Business Intelligence
•   Reduced costs – logistics of paper is expensive
•   Transparency – clear view of what is happening
•   Flexibility – can treat patients quicker
Ward-based Eboards – real-time bed state

• Safety information - falls, alerts, nutrition
• Patient information - EDD, location,
  Consultant
• Results availability - alerts results are
  available
ePMA
(electronic prescribing and medicines administration)

•   Safer system
•   Greater transparency
•   Improves compliance with medication policies
•   Allows data analysis and improves patient care
These records can be
just as available for:
• Clinicians in other
  hospitals
• Clinicians working from
  home
• Full access to all systems
  from home decreases the
  risk of losing highly
  confidential data
A modern clinical desk at Aintree
  PAS/Letters/results dictation control   PACS (Xrays)   EDMS (archived records)




Blood label
printer
The paperless office and support for clinicians
 Benefits
 •   Financial
 •   Greater flexibility
 •   Better experience for the patient
 •   More informed care delivery
 •   Real-time reporting/management
 Issues
 • Totally dependent upon the IT systems, outages are major
   incidents
 • Changing the culture
 • Change management is critical

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Catherine Beardshaw: Driving efficiency with new technology

  • 1. New technologies: driving efficiencies Catherine Beardshaw Chief Executive 17 October 2012
  • 2. The path to greater efficiency – the paperless hospital • NHS organisations are drowning in paper – Incredibly inefficient/expensive – Logistical nightmare – Disorganised – difficult to access information – Barrier to change – archaic processes • Aintree’s two prong strategy – Resolve the legacy paper – Stop generating the paper
  • 3. The path to greater efficiency – support for clinicians • IT as a clinical tool • Data for clinicians • Safer care for patients • First time, right every time
  • 6. The paper trail • 195 million pages on 10 miles of shelving • 686,000 patients (381,000 active) • Finding/transporting/tracking 1200 requests per day • Missing notes inevitable, especially out of hours • Six figure sums spent on external storage and retrieval • Paper is our biggest data loss vector
  • 7. Resolving the legacy paper issue • Records scanned by Capita – and whole archive completed by end of next month • All doctors have adapted to EDMS with clinical change support and attitudes moving from universal dislike, to tolerance and now some plaudits • Some errors (mostly clerical) but less than on paper in past and records available 24/7 • Gains on staffing (mostly redeployed), and on estate amounting to £2M revenue and £20M capital for a £1.5 M outlay • Gains of 24/7 availability and fewer missing records, external access a bonus • Revolutionised our approach to clinical records • Opens up the expectation of importing data from any other system • Allows the organisation to be more nimble • Provides a better experience for patients
  • 10. Find the MEWS Chart 1 2 3 4
  • 11. Stop generating paper Results Management • Results move with the patient e.g. from AED to MAU to ward to ITU to ward • On discharge from hospital – checks for outstanding unacknowledged results and can prevent discharge until they are dealt with Net effects • No paper results– no filing/scanning needed = COST SAVING • Consultants aware of delays = CLINICAL EFFICIENCY • No patient goes home without someone checking the results = SAFETY
  • 13. Electronic Patient Records • E-assessments – triggers tests, calculates scores • E-orders/results – no result can be lost or missed • Integration – other systems/organisations • Remote access – Trauma/OOH support • Reporting – true Business Intelligence • Reduced costs – logistics of paper is expensive • Transparency – clear view of what is happening • Flexibility – can treat patients quicker
  • 14. Ward-based Eboards – real-time bed state • Safety information - falls, alerts, nutrition • Patient information - EDD, location, Consultant • Results availability - alerts results are available
  • 15. ePMA (electronic prescribing and medicines administration) • Safer system • Greater transparency • Improves compliance with medication policies • Allows data analysis and improves patient care
  • 16. These records can be just as available for: • Clinicians in other hospitals • Clinicians working from home • Full access to all systems from home decreases the risk of losing highly confidential data
  • 17. A modern clinical desk at Aintree PAS/Letters/results dictation control PACS (Xrays) EDMS (archived records) Blood label printer
  • 18. The paperless office and support for clinicians Benefits • Financial • Greater flexibility • Better experience for the patient • More informed care delivery • Real-time reporting/management Issues • Totally dependent upon the IT systems, outages are major incidents • Changing the culture • Change management is critical