The EHMA 2022 Abstract Book
‘From people to systems: Leadership for a sustainable future.’
The EHMA 2022 Abstract Book, published by the European Health Management Association (EHMA), is a collection of research papers. This year’s central theme was From people to systems: Leadership for a sustainable future. Users of Alertive Dr Tylan Lucas, Dr Oliver Holman, Dr Jennifer Jebamani, Ms Joanna Eley and Ms Helen Pardoe from The Princess Alexandra Hospital NHS Trust were the authors of; A phased approach to the implementation of a new digital communication tool, Alertive®, to replace the common ‘bleep’ system at a district general hospital in the UK #purgethepager
Introduced in the 1950’s, the pager continues to play a key role in hospital clinical communication. Affectionately known in the UK as ‘bleeps’, they were highlighted by the former UK health secretary as an inefficient and unreliable method of non-urgent communication; sparking a movement to ‘#purgethepager’ via social media. Much academic study has focussed on the challenges of implementing electronic healthcare records (EHR), however clinical communication is as crucial to patient safety; yet literature is sparse. We present our experience of digital transformation to a cloud-based instant messaging solution, offering a mobile alternative to the bleep system (Alertive®).
Our baseline data of alerts with bleeps indicated that the clear majority, 79.1%, were sent via nursing staff; highlighting its importance as a doctor-nurse communication tool. 18.9% of those sent related to a deteriorating patient and 24.4% interrupted a critical clinical task. In addition to this, 11.2% interrupted break/teaching time and 26% of bleeps were sent to the inappropriate bleep holder. Our quantitative data demonstrated the burden of disruption using bleeps is high and the current system carries inherent patient risks with a large scope for improvement.
We present a successful phased approach to retiring the bleep system starting with Junior Doctors and progressing to implementation for nursing staff and allied health professionals. There was a 6-month period of design and testing, followed by a soft go live lasting 11 weeks, before relevant bleep numbers were deactivated. Since launch, we have seen 1,170 users sign up to Alertive®, plus a rapid increase in the usage of the application as it becomes more established in the trust; with over 7,500 messages and alerts sent. Issues and concerns raised prior to go live included the reliability of the local Wi-Fi network, resistance to using personal mobile phones, level of training required, and clinical concerns of risks to patients. Actions required prior to go live included a Wi-Fi Survey and upgrade, development of a ‘Bring Your Own Device’ policy, and availability of the application on multiple devices including smartphones, iPads and desktop. A collaborative approach with the solution provider resolved issues raised by stakeholders including extending the time between entry of passwords, ability for a sender to see “message received” and self-management for temporary and locum staff. For implementation of EHR systems a big bang approach has delivered success reliably, however, for communication technology we found a phased transfer to digital clinical communication safe and successful in an acute hospital.
As digital communication tools are adopted our study considers the balance that must be made in appreciating the barriers to digital health implementation whilst enforcing an alternative to the ingrained unreliable communication tool of ‘the bleep’.
We are incredibly proud to see such positive write-ups about the Alertive app and the benefits it is bringing to our users. To read more entries from the EHMA 2022 Abstract book click here.