experience of, and future plans for wardware….. The King’s experience - Moira O’Toole

experience of, and future plans for wardware….. The King’s experience
Moira O’Toole, Senior ICT Project Manager
Zebina Ratansi, Head of Nursing Critical Care, Theatres and Diagnostics, Senior ICT Project Manager
Zebina Ratansi, Head of Nursing Critical Care, Theatres and Diagnostics

Transcript

1. experience of, and future plans for wardware….. The King’s experience Moira O’Toole, Senior ICT Project Manager Zebina Ratansi, Head of Nursing Critical Care, Theatres and Diagnostics
2. Audit results from King’s adapted Early Warning Track and Trigger paper charts (POTTS) showed: • 80 % POTTS charts completed fully • 91% associated EWS • 90% EWS calculated correctly • 49% escalated + responded correctly to triggered scores The development of wardware A short history ………. Page 2
3. Why is response to EWS important Our patients are at risk because we fail to detect their deterioration at an early stage & to act appropriately
4. NCEPOD 2005 27% Hospitals – no EWS 21% ICU admissions - avoidable NPSA 2007 11% of deaths -deterioration not identified/acted upon NCEPOD 2012 75% cardiac arrest cases warning signs present Evidence Page 4
5. Public Inquiry – Mid Staffordshire 2013 Francis Report Recommendation 243 Observations recorded automatically where possible as taken Results being immediately accessible to all staff electronically
6. So how did we get to wardware? • Chair of the Trust patient deterioration committee also IT geek! • POTTS audit consistently showed inadequate calculation of scores and poor escalation • All problems are fixable with a bit of imagination • Chair and IT geeks put heads together and come up with wardware with a little help from HoN Page 6
7. Start small • Wardware functionality for EWS tested on two wards • Ward sisters engaged and provided feedback to improve system • Nurses LIKED IT!!!! particularly when they gave feedback, changes were made! • Trust support and agreement sought • Wardware became a Trust IT project and team set up for implementation Page 7
8. How does it work?
9. From this …..
10. this …..
11. To this….. Page 11
12. this ….. Page 12
13. this ….  Page 13
14. and this ….  Page 14
15. No observations recorded for long periods No recognition of deterioration/no action EWS calculated incorrectly Limited access of paper based system Delay in receiving prompt medical attention Observations due are flagged  Prompts - abnormalities flagged, escalation protocol flagged  System automatically calculates EWS Observations immediately accessible electronically  Data readily available for audit  Page 15 Key themes Benefits
16. So what next? Page 16
17. Fluid balance chart (screen shot) Drips & Drains Page 17
18. Fluid Balance Chart Page 18
19. Stool chart + infection control (screen shot) Stool Chart Page 19
20. Waterlow Assessment Skin Integrity Page 20
21. Waterlow Page 21
22. Waterlow trigger Page 22
23. • Plethora of nursing paper work • Duplication of paper work • Need to streamline documents and systems to talk to each other • Engage nurses from the start! They know the reality of clinical practice and what is “doable” • Make systems easy • Make them user friendly • Make them accessible to all • The system needs to make tangible and real difference to Patient Safety What have we learnt? Page 23
24. Any questions? Page 24