Clinical communications approaches in the NHS don’t go far enough
Last week, NHS England announced that it is suspending the requirement for COVID-19 patients in ICU to be nursed at a 1:1 ratio. This is a symptom of the extraordinary times we’re living in; as the crest of the COVID-19 wave rises again, the fallout is threatening to overwhelm our health system. The dual pressures of increasing patient hospitalisation and increasing staff absence due to the virus are taking their toll.
But this trend towards being overwhelmed was in motion long before the pandemic; COVID-19 should not detract from the very real and persistent NHS funding and staffing crisis.
Just this week, the Royal College of Midwives reported that more than 80% of NHS midwives think staffing levels are unsafe. Almost half of all healthcare professionals have reported that there are not always enough staff to ensure patients are treated safely, and vacancy levels are increasing. With reports of understaffing and underresourcing on the frontline having a significant impact on staff wellbeing, the situation is unlikely to slow without serious change.
As a result, NHS organisations are having to “do more with less” across their services, not just in ICU. They are seeing more patients, looking after patients with increasingly complex needs, having fewer staff on each shift, providing services with less money, and covering wider geographical areas. Doing more with less sounds like an impossible task, but with the huge number of digital solutions now on the market, perhaps there is a future where the NHS can make sustainable changes.
Digital tools can bring about significant improvements in efficiency and productivity that reduce the reliance on outdated systems that use paper, bleeps, and emails. Instant messaging has been touted as one of the key ways NHS hospitals can improve workflows and save time, and is an important subset of clinical communication tools - alongside phonecalls, emails, bleeps, and in-person - but we don’t think this type of solution goes far enough.
“More communication tools make communication easier, yes, but staff more often than not are communicating to find out information they really ought to have easy access to.”
Frontline staff need to be able to coordinate, track and document care. Healthcare managers need to track and monitor resourcing and performance in real time. These needs go far beyond what existing communications tools can provide, and a solution that properly meets these needs will lead to significant improvements in patient safety, operational efficiency, and staff satisfaction.
Now is the time to transition to a system that puts the right information into the hands of clinicians, when they need it. We think it’s time to roll out digital task management tools across the NHS.
What is task management?
Have you ever gone around the supermarket with a paper shopping list and begun at fruit and veg, gone to pasta, onto laundry powder and tin foil, and then when you think you’re done, found that toilet paper is right at the bottom of the list? Or you get a text asking you to get something from an aisle you’ve already been to? You have to go back on yourself, past each section you’ve already visited, and back to the start. It’s annoying.
If your shopping list had been organised differently, you could have saved effort and time in the supermarket. There are actually a few apps for this. Most automatically organise your shopping list according to the item’s location or “theme”(e.g. fresh, grocery, household), regardless of what order you add it to the list, making for a much more efficient shopping trip. You typically have to walk less far and can finish your shopping more quickly. Maybe you have time to get a coffee on the way home, or spend the extra time doing something else.
Now imagine a shopping list app applied to healthcare. Here, inefficiency isn’t just annoying, it’s potentially life-threatening. Right now, paper is still the primary way NHS staff manage tasks for patients. Clinicians move around a hospital or ward and back again because they can’t easily re-organise their tasks according to priority or location. They are often bombarded with bleeps, phone calls and instant messages from colleagues trying to find out what has been done, what hasn’t, and if they can add more urgent items to their list. Not to push the analogy too far, but urgent loo roll is getting written underneath routine kidney beans, and it isn’t always easy to see and prioritise it.
Amongst this communications chaos, staff might arrive to a patient to find a task has been done by someone else. We’ve also heard stories of nurses waking up at home in the middle of the night after a day shift and realising they had forgotten to write a task down for handover. Both could have terrible consequences for patients, and both result in wasted time and effort.
“We’ve heard stories of nurses waking up at home in the middle of the night after a day shift and realising they had forgotten to write a task down for handover.”
It doesn’t have to be this way. Digital task management tools specific to the needs and demands of healthcare exist, and are in use right now. We believe they hold at least part of the solution to the problem of an overstretched and under-resourced NHS.
Life-saving solutions in action
With effective digital task management, hours of time each day are given back to staff to spend with patients, bring ICU ratios back down, and take much-needed breaks. This is vital for patient safety, and staff satisfaction.
At London North West University Healthcare NHS Trust for example, staff in the early supported discharge and rapid response community team are using Infinity’s digital task management platform to add new tasks to their patient list, check off the tasks they have completed for their colleagues to see, and more easily and safely organise their days.
It’s saving more than eight person-hours per day - in travelling to and from patients, in calling, in emailing, in texting, in instant messaging. It’s helping some clinicians to see 1-2 more patients each every day - a capacity increase of up to 55% - and it’s making sure staff can easily see tasks that they may have missed.
“As COVID-19 took hold, digital task management has meant the service has been able to maintain capacity, even as staff went off sick.”
Staff report feeling that they have more knowledge about their patients’ care, better access to the information they need, and are having more meaningful discussions with patients and their families. Doing more with less is not theoretical here, it’s reality.
Doing more with less is not theoretical, it’s reality.
We must now spread this reality beyond the small number of NHS organisations leading the charge with digital task management. Central bodies like NHSX need go further in their thinking and leadership on solutions that could help ease the load. Current frameworks around communications for example provide a solid start, but only scratch the surface of what technology can do to support frontline staff.
There is scope for a far more ambitious, but achievable, goal. Access to up-to-date, accurate information about patients and what needs to be done for them, in real-time, from anywhere, will lead to less time spent coordinating care, and more time spent with patients.
The challenges faced by the NHS are very real, and there is no magic solution, but there are simple steps NHS organisations can make right now that could make an almost immediate difference. In our view, it is this, wider approach to communication and collaboration that will lead to the biggest time-savings for NHS staff, and where effort should now be focused.
If you’d like to bring the benefits of digital task management to your organisation and release time back to your staff, improve patient safety, and increase staff satisfaction, get in touch with us - we’d love to help.
