JOE DONNELLY – NHS TAYSIDE EMPTAYDD

JANUARY DELAYED DISCHARGES IN TAYSIDE RECORDED MANUALLY ACROSS HEALTH BOARD, 2 TRUSTS & 3 LOCAL AUTHORITY AREAS Initial Position

Developed to resolve local issues relating to ISD request to compile a validated, quarterly census of delayed discharges ­ Lack of standardised recording methods ­ Lack of clarity relating to patient status ­ Difficulties in exchanging information securely ­ Difficulties in exchanging information quickly Background

Background (cont.) Developed by NHS Tayside’s ICT department in partnership with Information Services, Medical Records, and Local Authority colleagues in Angus, Dundee, and Perth & Kinross Provides secure access to a patient specific delayed discharge database Enables live data recording and real-time reporting

Background (cont.) Builds upon local Community Health Index (CHI) database, a unique patient identifier used throughout local healthcare systems in Tayside and now a required data item in ISD quarterly census Has not replaced local social work referral protocols Requires an agreed information sharing protocol

Background (cont.) Joint Information Sharing Protocol ● First of it’s kind in Scotland ● Agreed between each of the three Health & Social Care Partnerships across Tayside ● Allows sharing of patient data, and information reporting between and across local authorities and NHS ● Not strictly a legal document but a statement of guiding principle with some legal status

 Central patient contact database  Reliable patient index based on CHI  Secure access for Local Authorities and NHS  Contact archiving and searching with flexible query facilities  Comprehensive reporting facilities  Comprehensive user audit logging Key System Features

 Thin client, web based application (MS I.E. 6)  Oracle RDBMS (Version 8i)  Sun Microsystems Server (Solaris version 8)  LDAP (Lightweight Directory Access Protocol) compliant  Operates over NHS Net  Full user and transaction audit logging  Full Back up and Recovery facilities Key Technical Features

Ward Users Input and amend health care data Health Strategy/Delayed Discharge Manager Extract info to inform strategic decisions Reporting at Chief Executive/Board level Liaise with patients, carers, clinical and social care staff Social Care Users Input and amend social care data System Administrator Ensure data quality, report to Directorate level, census validation and submission, and maintenance of system data tables EMPTAYDD Electronic Management of Delayed Discharge Patients IM & T System Development, Implementation, Training and Access Organisational Relationships System User Group

PROCESS Initially - operated centrally by Information Services - Weekly Turnaround Document created by system forwarded to ward, returned, and system updated as necessary Now - ward users input/update live data which is then immediately viewable by Social Care Social Care input/update live data which is then immediately viewable by Health Users Data quality role for system administrator

WARD ROLLOUT Began Summer completed November 2004 (apart from small number of opt-outs e.g. A & E where DDs unlikely) Named ward staff trained and given live access Paper systems withdrawn Registration/reporting is now real time Protocol to deal with occasions when ward staff unavailable to update Regular audits by CHP DD Co-ordinators, Clinical Group Managers, Social Care managers

Jan 2002: Proposal to develop system July 2002: System Q/A by Information Services Aug 2002: Information Services “Live” Dec 2002: Perth Social Work “Live” Sep 2003: Angus Social Work “Live” Nov 2003: Ward pilot by PRI based Community Liaison Team Dec 2003: Dundee Social Work “Live” Apr 2004: Ward Pilot PRI Jun-Nov 2004: Ward User Roll Out Aug 2006: NHS Fife version goes “live” April 2007: Inaugural meeting of System User Group with Tayside & Fife membership Jan 2007: NHS Ayrshire and Arran go “live” January 2008: Agreement for national rollout TIMELINE

Patient Search

Registration Screen

List of Delayed Discharges

Archive

Census Export

Export to EXCEL

Social Work Listing

Social Work Acceptance Form

APRIL 2007 – NHS Tayside achieves nationally set targets - to reduce by 50% those patients delayed in “short-stay” specialties, and those patients waiting more than six weeks ACHIEVED BY COLLABORATIVE WORKING BETWEEN NHS TAYSIDE AND TAYSIDE’S 3 LOCAL AUTHORITY AREAS Current Position

EMPTAYDD IS NOW THE SOURCE OF ALL VALIDATED DELAYED DISCHARGE INFORMATION IN TAYSIDE AND FIFE WORKING TOWARDS ACHIEVING NATIONAL TARGETS OF ZERO PATIENTS DELAYED FOR MORE THAN 42 DAYS OR IN SHORT-STAY SPECIALTIES BY APRIL 2008 Current Position

EMPTAYDD becomes the national recording system for delayed discharges in Scotland Seamless link to inpatient systems (TOPAS) for system users – to support bed management and minimise delay in discharge System users to benefit by availability of standardised, accurate, and timely data for local and national reporting and analysis Extend use of system to include patients with very complex needs – to support future strategic planning The Future Now

Further Information Contact (Technical):- Ian Fenton Head of Information & Communications Technology phone: Contact (Admin.):- Iain Dorricott Information Team Manager (Infrastructure) phone: