EPR – A work in progress

Advances in medical science have revolutionised how we treat illness. Today we can cure illnesses that previously would have killed us! Our vision EPR will empower us to work more effectively, so patients benefit from improved quality and experience We will be the safest, most efficient and patient-centred organisation in the NHS EPR will take us there

Why are we doing this ? How are we doing this ?

Integrated care Provides us with an electronic record – Ability to share information – What & how ???? – Seamless view of primary care record Other opportunities – E consults – Tele health – Virtual wards

What are we implementing ? Across all hospital sites – 3 major acute sites – 5 Community sites Clinical documentation Order comms E-prescribing New PAS ED functionality Paediatrics

Its more than just EPR Data quality Business intelligence Bed management

How are we doing it ? Each significant area has a work stream Combination of Implementation professionals & frontline Trust staff seconded to posts.

Example workstream Work stream lead – FT post SMEs – variable number – each 1.5 days a week Clinical analyst posts – band 5. Additional posts dependant on subject Large volumes of ad-hoc members from divisions Fixed work days

Engagement & signoff from divisions Clearly critical Operational involvement at workstream / design level Review at divisional EPR boards SME posts spread throughout divisions

Project Governance Clearly critical Project viewed as the biggest project either Trust has undertaken Transformation board chaired by both Chief execs in rotation

Further governance Govenor Involvement with the project Patient representation External assurance assessments – Three during the lifetime of the project – Provided by GE – Assessing key stakeholders

Engagement

Consultants Consultant body as a whole Specialist groups – Clinical governance – Specialist meetings One to one meetings with opinion leaders Demo sessions Medical leaders

Other medical staff Any given opportunity – Flu jab sessions – Training sessions – Formal meetings Juniors forum Leadership fellow

Who have we spoken to ? CCG’s & GPs Patients & public Universities Staff groups Unions Vendors Anyone who will listen (or stands still for >10s)

Senior Nursing staff Nursing Midwifery Development Forum Leadership events Care and Communication workshops Matrons meetings One to one meetings

Ward level nursing staff Ward Sisters/Charge Nurse meetings Visiting the ward areas Demo sessions Setting up a network of informatics link nurses /AHP’s with representation across the staff groups

Nurse engagement Benefits Less time writing Clear guidance/instruction Not chasing paper notes Continuity of care More time to care NO AUDITS! Improved patient care and safety

Primary care CCG level and leadership Formal involvement – Co-opt on to each workstream – Involved at architecture board

How will life be different in our new world ??

Improved clinical decision making Safer patient care Familiar access to primary care records

Ordersets – specifying key care Reducing duplication / unnecessary requests

ED to ward – single source of truth Avoid duplication / repetition

Reduced Adverse Drug Events Reduced missed doses

Improved nursing time management

So ….. How does that lead us to achieve integrated care ?

We have something to share ! Previously written records ……. What do we share ? How and to whom do we share it ? Information Governance ?

Facilitating existing work Virtual ward – Step up and step down philosophy – Many patients – need to track them / review results / consider treatment pathways – Need rapid response and access to information

Newer ways of working Ambulatory care – Preventing admissions – Facilitating early discharge – Bridging the gap from hospital and home

Integrated Care ?????