Secondary Care

St Helens makes major patient safety advances with electronic early warning system

Patients and staff at a north-west NHS trust are starting to see the high-impact benefits of technology-enabled care after the introduction of early warning and alerting technology Patientrack.

The system is helping healthcare professionals across 55 wards at St Helens and Knowsley Teaching Hospitals NHS Trust quickly identify the sickest patients, and manage them in the most effective way possible, whilst also enabling more efficient care practices and so releasing staff time to care.

Patientrack is being used by a growing number of NHS hospitals in the UK, where nurses use the software to record vital signs observations. The system then automatically calculates a patient’s early warning score, and shows clinicians when signs of deterioration are present enabling rapid intervention. Such intervention is crucial to help prevent a patient’s condition escalating, and requiring additional care.

Following the introduction of Patientrack, St Helens and Knowsley has recorded a significant drop in the number of patients requiring higher levels of care. ‘High risk admissions’ to its critical care unit fell from over 10% of inpatients in 2015-16, to under 5% in the first half of 2016-17. It has also seen calls to its medical emergency team, which responds to patients in most need, fall by a fifth.

Hospital teams at the trust, who access the system on iPads, have also saved thousands of hours after seeing a two-thirds reduction in time spent performing observations using Patientrack, which is in use in different hospitals across the UK and has been linked to lower rates of cardiac arrests.

Dr Tushar Mahambrey, consultant in intensive care medicine and anaesthetics and Patientrack clinical lead, said: “Nurses have more time to spend actively caring for patients now that we have introduced Patientrack. They can quickly and accurately capture important patient observations at the bedside which is then shared with clinical colleagues across the hospital instantly.”

Patientrack is also helping NHS professionals assess patients to help prevent deadly conditions including sepsis and acute kidney injury, and this flexibility is something that St Helens and Knowsley is also embracing. Financial savings also are expected through the need for fewer bed days in intensive care.

The trust is further developing its use of Patientrack, and is one of the early adopters for using the technology to support clinical decision making in its fast-paced emergency department. It is also looking to consolidate five assessment forms into one to speed the admissions process, which should see more efficient patient flow.

The system is replacing outdated paper-based observations, meaning details on a patient’s status will no longer be confined to individual wards and beds. Instead crucial vital signs information is instantaneously available to healthcare professionals throughout the hospital, regardless of their location, so that they can prioritise patients and act swiftly for those in need. Cost savings through achieving the NHS’s paperless vision are an added benefit.

Christine Walters, the trust’s director of informatics, said: “We certainly see this as a key clinical system. There are great opportunities to help us further improve patient safety and deliver better outcomes for patients, at the same time as addressing local and national objectives for the NHS. Clinical staff have embraced Patientrack fully.”

Clinical engagement has been critical to the success of the project to ensure the system was tailored to real needs. Debbie Warburton, business change nurse, said: “Clinical involvement in the development of software is essential; not only does it ensure that the software will be based around the needs of patients and clinicians, it also means that staff have confidence that the new system will be fit for purpose. Staff have really embraced Patientrack. People like the system for different reasons, some because it saves them time compared to using paper notes, instead accessing information on their iPads. Knowledge of when observations are due is clearer and challenges with handwriting, completeness of observations and audit have now been overcome.”

Donald Kennedy, managing director of Patientrack, said: “This is a compelling example of an NHS trust taking the initiative with innovative technology to make important advances in patient safety. St Helens and Knowsley Teaching Hospitals has chosen to partner with a flexible UK SME to achieve this, where technology is not imposed, but is tailored and adapted to meet local clinical priorities and achieve a rapid impact for the NHS.”