Patient experience - a building block for digital healthcare
“Clearly NHS staff and decision-makers are all working incredibly hard through an unfathomable situation but... resources need to be directed to equip staff with the appropriate tools.”
- Dr Jo Garland
Clinical Director, Infinity Health
As the worst public health crisis to hit the world for generations, the onset of the COVID-19 pandemic has reinforced the role of the NHS as a cornerstone of our society. Not least has the pandemic had a “catastrophic” impact on every element of our public health infrastructure - with a surgical backlog of over five million people - but we are now facing a burnout crisis amongst NHS staff.
Recently, one of my friends, Sue, shared her unfortunate experience of navigating the NHS with a fractured ankle. Her story reinforced my view that there has never been a more urgent time to review the ways that staff are working, and take action to upgrade and supply them with the tools they need to make their jobs less complicated and stressful, and more efficient.
In April, almost a year to the day since the UK Government had postponed non-urgent operations in England in a bid to free up 30,000 beds during the first wave, my friend fell, resulting in a fracture and was admitted to hospital in the middle of the night. Whilst in hospital, she had a difficult and disjointed experience of care.
Clearly NHS staff and decision-makers are all working incredibly hard through an unfathomable situation but this is my observation on where resources need to be directed to equip staff with the appropriate tools.
During her admission - from being transferred from A&E on Friday night onto a ward, to having an operation on Monday, to discharge a couple of days later - Sue identified a range of areas where there was scope for better communication with patients and information governance. The overarching theme she noted was a major dearth of information sharing, which I can see clearly could be easily solved by one or more digital solutions.
Pharmacy and medication
One of the first significant issues arose after Sue was admitted and informed the doctor about the regular medication that she needed. This did not seem to be translated into action and she was not given these drugs, nor did a pharmacist come and see her for a further three days. This was clearly not ideal and could have had serious health consequences.
When notes are taken and not shared with other members of staff or the pharmacy, these situations can easily occur. Moving to a system that allows staff from across multidisciplinary teams, including pharmacy, to see patient updates and notes in real-time means they can act quickly and situations like this can be avoided. Not having all the information available is one of the leading causes of the NHS’s £1 billion communication problem, and a significant contributor to adverse events in hospitals. Funds could be well spent improving communication systems and the quality and accuracy of information sharing.
Handover
The problems didn’t end with medication. Sue was nil-by-mouth in preparation for surgery but offered breakfast despite this. The nurse had no idea that she was booked for surgery later that day because the information-sharing between ward staff wasn’t sufficient. Had a task management platform, like Infinity, been implemented, staff would have visibility of the upcoming operation and not made this error. Additionally, the operation was cancelled on two consecutive days but no one informed her until 6pm, after she had refrained from eating all day.
The communication issues continued throughout the stay and as various healthcare staff came to measure her blood pressure and temperature, Sue noticed that they were being recorded on scraps of paper, and seemingly never collated or communicated with relevant staff. The risk of losing, damaging, or being unable to read hastily taken notes was obvious.
The NHS works in shifts and information can be lost if not shared at handover meetings, further highlighting the communications problems the organisation experiences. Recording patient data on pieces of paper is time-consuming, only accessible to those who have it in their hand (or pocket), and at times is non-compliant with data-security standards.
“A digital solution would not only remove the need to take information down on paper, but would also create a virtual team with all members having access to up to date information - removing the need for constant chasing of busy staff for details.”
- Dr Jo Garland
Clinical Director, Infinity Health
Discharge and aftercare
Discharge from hospital is fraught with complications as relevant data needs to be shared across organisations in a safe and timely manner. Sue was told by the occupational therapist in the hospital that a community physiotherapist and occupational therapy team would visit her at home the following day. This was essential to adapt her home whilst she was immobile and to discuss how to navigate daily living tasks.
Unfortunately, this didn't happen and on calling the ward once she was at home, she was told they did not deal with arranging community care. Her GP had no visibility of referrals to the community teams and it was impossible to discover who was responsible and why the correct healthcare staff were not informed of the vital visit. This was a clear error in patient flow and one that could have been avoided with the use of digital tools that spanned across teams and followed the patient after discharge.
Common problems have a common solution
The problems Sue experienced during her hospital stay are common, and stem from a lack of appropriate tools to coordinate, track, and document patient tasks in real-time. Introducing these tools will be critical to not only tackling the surgical backlog and recovering from the pandemic, but also in making the NHS more efficient, effective, and improving patient experience and likely outcomes, all whilst giving a much-needed boost to staff welfare and team working.
I have seen firsthand the huge impact of using Infinity in clinical teams across the NHS for task management and care coordination. Staff retention is a very real problem and providing a user friendly operational tool like ours to manage their daily workload easily is essential for their wellbeing. The resulting efficiency and safety benefits are measurable - please contact us, we would love to work with you.
About the Author
Dr Jo Garland worked as a General Practitioner in North West London for several years, and prior to joining Infinity, was the Clinical Lead at a healthcare startup, leading health coaching programmes for patients with long-term conditions and reducing inappropriate A&E admissions. She is passionate about joining-up care between primary, secondary, and community care within the NHS.
