liverpool women’s nhs foundation trust presents - · pdf fileliverpool women’s nhs...
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Liverpool Women’s NHS Foundation Trust presents...
“Meditech on the move… The Community Midwives
Story”
Catherine O’KeeffeBusiness IT specialist/Acting IT Services Manager
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Liverpool Women’s NHS Foundation Trust (LWFT) IM&T Team - Who we are...
• Situated in Largest Women’s Hospital in Europe
• IT Teams include Information Services (Tech Support), InformationSystems, Clinical coding, IG & Data Quality, Information Team, Patient Services, Business IT Team
• IT team cover Crown Street site, Aintree Centre for Women’s Health,Clinical Genetics in Alder Hey, Remote Clinics in PCT, Children Centres,Local Council premises.
• Deliver 24/7 Helpdesk to all Trust staff
• Work to six sigma methodology – 70 Projects delivered in this years(2009/10) operational plan
• Team approach and ethos to all work we undertake.
• ISO 9001, 27001, 14001 certified.
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Community Midwives at LWFT
• 92 Community Midwives working for LiverpoolWomen’s
• Delivering ante-natal & postnatal care to pregnantwomen throughout Liverpool, Knowsley & Sefton area’s of Merseyside.
• Also responsible for delivery of parent education, aqua-natal and specialist advisory clinics in theseareas.
• Visits to patients homes as well as Primary Healthcare facilities
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Issues Regarding Community Midwives Processes• All appointments for the day given from Community
Midwives office via telephone each morning.
• Any clinical history of patient gained from patientshand held notes, or by telephoning Community Midwivesoffice
• Any advice required regarding policies and procedures gained via telephone to Trust or diverting to Trust site-view intranet or paper records.
• All Activity data captured on paper records, only presented when midwife on site and collated by admin staff
• No access to Trust Clinical systems – Clinical risk4
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Health Care Business Drivers
• Historically – payments for Community Midwiferyservices have been received in a block payment by Primary Care Trusts (PCTs)
• In 2010 – payments for Community Midwifery services from all PCTs will be based on tariff (activity)
• This will require accurate patient level data recording - presently paper records – needing to be collated manually in order to be presented to PCTs
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Health Care Business Drivers cont...• Electronic Evidence required to support Community
Midwifery Activity out in the community in long term
• Capture of data regarding patients not previouslyobtained(patients receiving care by LWFT Midwivesbut delivering baby in another Trust)
• Streamlining of data collection
• Activity data could support the need for staff to be targeted in certain areas within Merseyside or forstaff to be employed in the future.
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Aim of project
• An innovative solution to provide Trustapplications to staff proving care in the communitysetting.
• Using the latest technology, built into a lap topPC
• Immediate connection between the Trust and theCommunity
• All Medical information regarding a patient available at the touch of a button.
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Expected Benefits
• Accurate Information captured in order to completethe Minimum Data Set required by PCT’s for PbR
• Accurate data collection to supply figures to theDepartment of Health
• Modernisation of Community Midwifery data collection practices
• Streamlining of business processes within theCommunity Midwifery team
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Technical Process “v” Business Re- design
• Set up of multidisciplinary team at start of project.included representation from...
Project ManagerIT Services Project SupportIT Systems TeamIT Specialist MidwifeInformation TeamFinance TeamCommunity Midwifery Manager/MatronCommunity Midwives (3 x Team Leaders)
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Tech “v” BPR cont...
• Initial project meetings to assess minimum requirements with regards to PCT, Information Team,Finance Team and Users.
• Scoping of potential vendors and providers byProject Manager and IT Technical Team
• Information Systems Team and IT Specialist Midwifeassess existing screens on Meditech to ascertainif they can be used for data capture
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Tech “v” BPR continued
• Process Mapping of present processes with regardsto paper data capture undertaken in order to baseline present practices.
• IT Services Project Support and Project Manager worked with vendors in order to “mix and match”products in order to find an effective solution.
• Final meetings and demo’s held for MDT Team in order to showcase the final solution.
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Tech “v” BPR cont...
• Pilot project undertaken with 7 Community Midwivesin which the following was assessed...- 3G connectivity- Ease of use- Access to Trust Applications- Convenience (weight, size, time taken to use)- Quality of data captured
• Follow up meetings held in which findingsdiscussed and documented
• Further pilots undertaken until correct solution found
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Final solution giving optimum value
• Dell D430 lap tops
• Vodafone 3G (sim card built into lap top)
• 6Mb SDSL Broadband Internet line
• Ericom Remote Connectivity Solution using Terminal Servers solution - 100 concurrent licences
• Meditech Ward Attenders Screen with CDS’s to capture additional data
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Other Trust applications available...
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Present Use
• 67 Community Midwives presently live with thesolution.
• 25 to be trained
• Presently over 4000 activity episodes being capturedper month
• Other benefits other than capturing of activity databeing realised.
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Benefits realisation – Financial • Obtaining Activity Data not previously captured....
Time Consuming Activities –Child Case ConferencesParent Education ClassesTelephone Advice
Location Data –GP SurgeryChildren’s CentresPatient’s Home
Care Delivery –Patients delivering in other Trust’s.
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Benefits Realisation – Financial cont...
• Accurate and Real Time data capture – can be collated at any time for use (Data Warehouse)
• Streamlined Business Processes – Admin Assistantsfreed to carry out additional duties
• Improved Trust reputation – Modern working can lead to a increase of patients choice as LWFT for care
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Benefits Realisation – Clinical Excellence• Instant Access in Community to Trust intranet for
Polices, Procedures and Guidelines
• Advice can be delivered within the latest NICE Guidelines
• Access to all of patient’s Trust records at the touchof a button (prev and present pregnancies)
• Access to Home Birth Screens – real time data capture of home deliveries matching info of hospitalbirth delivery
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Benefits Realisation – Clinical Excellence cont...
• Access to Safeguarding Children/Social Service referralforms in Community Setting- Social Services made aware of potential situations
quicker- Action can be taken quickly by Trust to safeguardvulnerable women and children
- Assists the Trust in meeting Government targets in this area
• Potential decrease in litigation – increased staff and patient safety (NHSLA standards)
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Access to patient’s medical history
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Access to vital patient information
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Access to patient issues
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Benefits Realisation – Improved Patient Experience• Staff can deliver the optimum, informed care
• Increase in patient safety
• Care can be delivered at their choice of venue/convenience
• Reduced requirement for patients to repeat their history to staff delivering their care in Trust & Community setting
• Increased time staff can spend with patient
• Modern care delivery – increased trust in staff
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Benefits Realisation – Improved Staff Experience • Improved Care Delivery – all information required is
available quickly
• Improved Staff Safety – access in community to patient alerts and social history
• Access to Trust Internal Email System (GroupWise)- remote users have access to communication and
messages- option to use calendars for diary management
• Less travel time to hospital setting to enter data intoMeditech
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Lessons Learnt
• SIM Card Activation – ensure true activation beforerelease of lap top
• Connectivity 3G provider – check which 3G provider is best coverage for your area
• Terminal Services need little bandwidth to run smoothly (other solutions we piloted required more)
• Battery life of PC (will need extended battery life)
• Biometric log on (time consuming)
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Lessons Learnt cont...• Easy Operating System required (one button shut down)
& minimal user interaction for logging on to system
• Correct Image on PC – tested & tested before release
• Security/Loss – adequate cover for losses
• Ensure have rolling stock for replacement
• Choosing the right hardware – PC & bags
• Adequate training, guides and support
• Change Management planning26
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Use in Private Healthcare and Primary Care
• Solution can be adapted for use in any business incPrivate healthcare
• Able to leverage latest 3G technology
• Clinics can be held in any location with3G access – no longer restricted to Trust Estates (potential to increase revenue)
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Use in Private Healthcare and Primary Care cont...
• Increase potential of Clinic/hospital reputation bytaking care to the patient
• Increase the use of “Virtual Teams” to deliver careover large geographical areas
• Can be applied to lap tops and static pc’s – can supportexpansion of companies to other geographical areas,and still retain centralised access to monitor and control the applications.
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Use of Remote Access by other LWFT Employees
We presently have a number of ways of gaining remote Access to the LWFT network......
• Ericom solution – by 3G and URL
• SSL VPN/Network Connect – used in ACWH toconnect to LWH network
• Log Me in – used by non-clinical staff
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Future Developments..• Move to smaller lap top PC’s to aid midwives moving
about within the community
• Use of URL in locations connected to N3 network– instant access to Trust applications
• Roll out of SSL VPN solution for connectivity in longer term
• Potential of development of Meditech Screens to capture further patient information– furtherstreamlining process
• Potential development of other screens to assist midwives in their remote working
• Further development of 3G technology in UK30
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To conclude...• Innovative solution using latest technology &
Meditech functionality.
• Captures activity data and provides complete Trust functionality out in the community
• Assists Trust in meeting Corporate objectives of - improved patient experience- clinical excellence- financial strengthening
• Positive impact on Service Delivery
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Thank you for listening...........
Any Questions??
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