Streamlining processes to improve patient care
Delivering patient care is a complex process requiring participation and input from many stakeholders within a hospital from various specialities and departments. Effective communication between all involved in this process is essential for providing the highest standard of care. An ineffective communication system can increase pressures within hospitals, affecting the efficiency of resource utilisation, the effectiveness of core operations, the quality of work and service ¹, and can negatively impact staff mental wellbeing and patient outcomes ².
Previously the Princess Alexandra Hospital NHS Trust used a combination of bleeps and social media messaging to communicate with colleagues. This communication creates a heightened level of urgency but makes it more difficult for staff to establish priorities and work efficiently. During an audit of existing communication practices, they found that:
- 24.4% of bleeps interrupted critical clinical tasks
- 26% of bleeps were sent to the wrong person
- 70% of incidents in their Datix reporting system cited communication as a contributing factor
The first challenge encountered by staff when using the old communication processes was not knowing the appropriate person to contact – this often required asking or calling around to find out who was on call and how they could be reached. Furthermore, once the message had been sent out via bleep, the sender had no way of knowing whether the message had been received, if they would be receiving a call back from the recipient and when that would be. Pre-Alertive, the recipient of a bleep would have to stop whatever task they were performing and call back the sender to find out the task details. This call was unsuccessful in 14.5% of cases, meaning the call had to be made multiple times until the recipient finally picked up. These inefficiencies caused delays and frustration among hospital staff, leading to a real need for a more effective communication solution. This made staff adoption of the application high, which helped the implementation process progress smoothly.
“The adoption was quick, and we managed to get people invested in using it. With the Head of Digital Nursing as part of our project team, she encouraged the nurses and got everybody interested. We also did ward walking to get the user adoption up and running.”
Joanne Groarke, ICT Project Manager
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The Alertive team worked closely with the Princess Alexandra Hospital team throughout the implementation process. At the beginning of the roll-out, a bring your own device policy was created, and staff were encouraged to download Alertive onto their devices. The number of Trust devices was also increased, with additional iPads on wards and Alertive installed on the Trust’s desktop devices. A project user group was established with key stakeholders from different departments, including the Trust’s CCIO, IT Managers, Junior Doctors, Nurses, and Service and Site managers in attendance. This team performed ward walks and face-to-face training sessions. A Tech Trolley was used to reach frontline clinical staff, engaging hard-to-reach stakeholders such as ward nurses and porters by bringing training materials and devices into their clinical areas and instructing them on how to use Alertive.
Within a short period of time, a large number of staff members were actively using Alertive, and its benefits in resolving the Trust’s communication issues became apparent: the issue of not knowing who to contact about a specific task was addressed by contacting colleagues based on their roles. Read and delivered receipts enabled the sender of the task to have a better overview of its progress, and the need for the recipient to call back the sender to gain information about the task was eliminated. This streamlined communication process allows clinicians to manage their time more efficiently and gives more visibility regarding the progression of patient care.
“One of the main problems Alertive has helped solve that we didn’t imagine was how it’s helped our flow and site management. We’d be able to create a number of roles, for example. Our silver on-call and gold on-call are now part of an Alertive group. It helps from an escalation perspective; we’ve been able to contact our on-call and managerial teams outside of hours. We didn’t consider that when we started on the project, but as we understood its usage and its opportunity, we’ve really been able to use that very effectively.”
Phil Holland, Chief Information Officer
▶ Click here to watch the full video interview
By addressing the drawbacks of inefficient communication systems, the implementation of Alertive enabled The Princess Alexandra Hospital NHS Trust to achieve significant time savings. Average response times were reduced from 4:09 minutes to 2:07 minutes, with 59% of Alertive responses received in less than one minute. Additionally, 38% of surveyed Alertive users reported savings of over an hour, and 8.7% reported savings of more than 3 hours per shift. By circumventing the commonly experienced issues of not knowing who to contact, having to wait for switchboard operators to connect to the correct colleague and waiting for a call back from another staff member, the process of relaying information was simplified and accelerated, allowing clinicians to provide patient care more efficiently.
The details of the communication process pre and post-Alertive are detailed below. Please read our full case study for a more detailed breakdown of all figures and benefits.
¹ Agarwal, R., Sands, D. Z., & Schneider, J. D. (2010). Quantifying the economic impact of communication inefficiencies in U.S. hospitals. Journal of Healthcare Management / American College of Healthcare Executives, 55(4), 265–281; discussion 281-282.
² Lederman, R., & Morrison, I. (2002). Examining quality of care-how poor information flow can impact on hospital workflow and affect patient outcomes. Proceedings of the 35th Annual Hawaii International Conference on System Sciences, 1889–1897. https://doi.org/10.1109/HICSS.2002.994107