The Eastern AHSN started working with Medic Bleep to provide advice and support on adoption of their innovation, including guidance on appropriate evaluation and prioritisation of outcomes from pilots to support broader adoption and spread with Eastern Sustainability & Transformation Partnerships (STPs).
West Suffolk NHS Foundation Trust then commissioned Medic Bleep to pilot the app as a replacement to the non-cardiac pager. The pilot was conducted in its Trauma and Orthopaedic Ward and Maternity Ward in collaboration with Community Midwives. The trust was keen to improve the efficiency of communication within and between teams in the hospital, as well with its primary and community care partners in West Suffolk, with the overall aim to improve patient safety and release time to care for patients.
The Eastern AHSN are now supporting the company with involvement in industry support events, brokering relationships with other organisations within the region and implementing support in the form of quality improvement, project management and evaluation support to West Suffolk Hospital NHS FT as they expand the use of the innovation across other departments.
West Suffolk NHS Foundation Trust is one of the UK’s leading foundation trusts with 430 beds. It has been selected by NHS England as a Global Digital Exemplar for delivering exceptional care, efficiently, through the use of world-class digital technology and information.
The trust relies on a pager system; while ‘bleeps’ have the advantage of not relying on wi-fi or cellular signal, the communication method is one-way, the recipient is unaware who is bleeping, why, or the level of urgency. Work is interrupted, time is wasted, prioritisation is difficult, and the evidence trail is limited. The trust managers were also aware that some NHS colleagues use apps like WhatsApp to share work information, which don’t meet NHS information governance requirements and aren’t safe to be used for patient care.
The trust was keen to explore if there was a different option that can help make working life easier for their staff, and ultimately save time and improve quality for their patients.
“You know what the doctors are going to ask – with Medic Bleep I can give them all the information straight away and say what all the observations are.”
Helen Hettema, Midwife-in-charge, Maternity Ward, West Suffolk NHS Foundation Trust
- 24 interviews across nominated wards and IT team to identify what is working well and how Medic Bleep could be used to improve things.
- Technical preparation and integration of Medic Bleep app to ensure the wifi, and staff access to devices was sufficient.
- Patient preparation – interviews to establish patient perspective with patient flyers developed as a result.
- Staff training.
- User guides and standard operating procedure developed.
- Pre pilot time motion studies (nurse and junior doctor).
- Pre-pilot qualitative questionnaires.
Stage 3: go-live implementation
- Week 1 – adjustment to using Medic Bleep.
- Week 2 – sole use of Medic Bleep, supported by Medic Bleep staff on each ward with regular debrief meetings.
- Pilot time motion studies (nurse and junior doctor).
- Broadcast message sent to all pilot participants’ devices via Medic Bleep or SMS to communicate pilot end.
- Supported transition back to the current communication system.
- Post-pilot qualitative questionnaires.
“Pagers interrupt everything that you’re doing on the wards. With Medic Bleep I took half a minute or a minute to respond rather than spend 15-20 minutes trying to get back through to them. It meant my colleagues could get on with their work and my day wasn’t as interrupted.”
Rachel Belton, Lead Pharmacist for Surgery and Orthopaedics, West Suffolk NHS Foundation Trust
The time motion study showed a statistical significance between Medic Bleep and the pager.
A Welch Two Sample t-test on distributions indicated a statistically significant (p < 0.05) reduction in task mean duration for TTO (‘to take out’ – medicines given to patient on discharge from hospital stay) and patient review categories. At 95% confidence intervals, Medic Bleep saved nurses 10 minutes per TTO and 11 minutes per patient review a saving of 21 minutes per shift and junior doctors 10 minutes per patient review – a saving of 48 minutes per shift.
Staff experienced a significant improvement on response time with Medic Bleep Question from qualitative questionnaire: ‘On average how long do you wait for a response in your base ward before you can complete your patient’s management discharge plan?’
Key Medic Bleep features which released time to care for patients:
- Ability for the sender to write a text message with all the required information and see when it has been delivered and read
- Reduction in workflow disruption as staff no longer had to wait by a phone
- Ability for receiver to quickly refer to a new message and prioritise their work
- Key Medic Bleep features which improved patient safety
- Reduced medical errors through clear written instructions and clarifications
- Staff can communicate in real-time for quicker and informed collaboration
- Better recall with audit trail
- Staff demonstrated the appetite to replace the non-cardiac bleep When asked ‘How likely are you to recommend Medic
- Bleep to a colleague or friend?’ Scale: 1 (not likely) – 10 (extremely likely), the average score was 8.7.
- More efficient communication improved service for patients with earlier escalation of care,
- TTOs completed more quickly and earlier discharge.
- Patients were keen advocates of the new technology
- Potential savings of £4.5 million per annum for West Suffolk were demonstrated and include but are not limited to: freeing up clinical capacity by the equivalent of 18 full time nurses and 18 full time junior doctors per annum and reducing litigation by up to 21% due to poor inter-team communications per annum.
“The effort and time required for communication with the pager means only important information is shared. The easiness of Medic Bleep allows you to inform colleagues more easily of updates and patient progress.”
Christopher Rivett, Orthopaedics Junior Doctor, West Suffolk NHS Foundation Trust
Eastern AHSN will support the company with involvement in industry support events, including access to our readiness series and our Innovation exchanges and showcases, including a planned outpatient event in early summer. The AHSN is also brokering relationships with other organisations in the region, exploring opportunities for a pan STP adoption in North East Essex and Suffolk and use of the solution within the ambulance service.
Eastern AHSN will provide implementation support in the form of quality improvement, project management and evaluation support to West Suffolk Hospital NHS FT as they expend the use of the innovation across other departments.
June to September 2017
Sarah Nolasco, Programme Manager, Eastern AHSN