UHBW improves patient safety with digital innovation from System C

The pioneering use of digital clinical noting from System C has enabled the busy pediatric emergency department (ED) at University Hospitals Bristol and Weston NHS Foundation Trust to reduce their reliance on paper forms at the Bristol Royal Hospital for Children (BRHC).

New electronic processes powered by System C’s CareFlow Clinical Noting have halved the time it takes to triage patients, ensuring that the sickest children are cared for faster.

To further boost patient care and safety, the rollout of a new digital Casualty Card (Cas Card) is transforming documentation and communication around the hospital – with significant efficiency and time savings.

The Bristol Royal Hospital for Children is the only pediatric major trauma center in South West England, providing a wide range of specialist pediatric surgery and consultation services and comprising 10 wards, an intensive care unit and a pediatric emergency department (ED). ) Is.

UHBW’s decision to introduce the new system in the pediatric ED was based on the department’s important role as an entry point to the hospital and the increasing demand in the ED, which is putting more pressure on stretched resources and potentially impacting patient safety. Used to be.

In the winter of 2022, with outbreaks of group A strep (scarlet fever) as well as peaks in covid-19, RSV and influenza, the pediatric ED saw a steady increase in the average number of patients in the waiting room and at times increased by 300%. ,

Without improvements in digital clinical noting and triage processes, patient care would have been compromised.

Mark Little, Consultant and Senior Research Fellow in Children’s Emergency Care at UHBW, said: “Infections and events such as chronic asthma attacks can increase rapidly in children, so it is essential to identify patients and alert the clinician as soon as possible.

“But danger signals may not go smoothly in a busy ED environment, especially when the waiting room is full and the triage process is dependent on time-intensive form filling and slow processing, posing a risk to the most critically ill children.” Does

“Putting digital notes at the heart of the triage process has had a significant impact on how quickly we identify and treat patients who require immediate intervention. This innovation is a vast improvement over previous practices, allowing us to more quickly classify patients and find and treat those most at risk.

Careflow is developed keeping in mind the needs of the hospital

Careflow clinical noting has replaced paper or electronic proforma and the team has developed triage description screens to be specific to their patients, incorporating the Manchester Triage System – a score-based diagnostic system used in the ED. Risk management tools to ensure that patients are seen in order of clinical priority rather than order of attendance.

Nurses now follow signals, enter data and make key observations of the patient’s condition in electronic form that will automatically trigger any potential alerts (such as high temperature or shortness of breath).

This process, along with the introduction of CareFlow Vitals, reduces free text data collection and removes paper movement around the ED. This saves time and improves the quality of data captured during triage.

Using digital systems means that vital information can now be retrieved and displayed in real time, so vital data about a patient’s condition can be viewed and acted upon without delay May go. Screen alerts immediately flag areas of concern, such as sepsis risk, informing the medical team that a particular patient requires emergency attention.

The successful rollout saw triage time more than halve, saving more than 10 minutes per patient. Further improvements are planned to bring triage to less than 4 minutes per patient.

The introduction of CAS cards has increased the noting capability for all ED clinical documentation. Capturing needed information electronically at each key stage of the patient journey means that instead of hand-transferring paper forms, CAS Card electronically ‘follows’ the patient to the ED and observation unit.

Data is updated in real time on the patient’s digital CAS card to create an end-to-end electronic pathway, enable visibility of critical clinical information, and track all interactions across a variety of care settings Tracking and management – eg, ED acute inpatient, theatre, X-ray or ICU.

To date it has been used over 20,000 times and has received many examples of positive feedback.

Max Ward, Head of Clinical Systems at UHBW, said: “In the ED you don’t always see things coming, but this improvement has helped prepare us for the future and enabled us to successfully manage unexpected volume peaks Is.

“Since its launch, it has already provided enormous benefits in terms of patient flow, data reporting, push-pull data streams, decision making and providing trigger warnings.

“We will build on this initiative in the next phase of our digitization plan to create a more holistic view of the entire patient journey and transform the way people access our healthcare services.”

System C is a leading supplier in rapid EPR with over 30 NHS trusts,