In a health system an hour or so from Whitehall, a group of clinicians have been making serious progress on all fronts as it relates to patient outcomes. Earlier this year, I wrote a piece on the power of clinical and software teams working together to deliver these outcomes. Many readers have since written in asking me to unveil some outcome metrics in order to demonstrate the value of such a combination, something I am excited to be able to share with you here.
Recently, we have heard news of some truly horrific issues in a number of hospitals across the country, where unavoidable deaths have spiralled out of control and brought harm to countless patients, as well as impacting thousands of families. For most patients, hospitals are a safe haven when they are feeling unwell. I can of course appreciate the sentiment, as access to all of the medication, medical equipment and doctors you could need are indeed housed within these institutions. However, statistically speaking, hospitals can be dangerous places to be, a sentiment reflected in the title of a 2008 paper by Adrian Barnett et al. examining the odds of being discharged alive from an NHS hospital depending on the particular day of the week. Your chances of picking up a bug, MRSA, Norovirus and more skyrocket, with 5.5% of acute hospital patients having fallen victim to healthcare-associated infections in 2017, and in some poorly run organisations, misdiagnosis and death are very real issues.
Over the past 15 months, we have been working with a number of clinicians and data teams with the goal of delivering a great clinical outcomes review solution. This solution sees the teams review each and every death to really learn from them, and subsequently redesign processes and pathways around patients and their ultimate wellbeing. As a platform designed alongside clinicians and with utilisation by clinicians in mind, we have already seen some significant and truly promising real-world results from the integration of our Clinical Outcomes Reporting System (CORS) module into hospital practices. Arising from a common issue within trusts in terms of collecting and processing clinical data, this in turn introducing substantial time delays and poor data quality issues, as well as leaving scope for only very limited clinical analytics and learning potential, the platform was deployed to address these problems through a highly structured and user-friendly methodology.
By implementing this process, one NHS team we work very closely with have delivered some real value in terms of their clinical output and outcomes. Already they have managed to successfully improve several factors in the efficiency of their clinical outcome review practices, with both their Qualified Attending Physician (QAP) and Medical Examiner (ME) review turnaround times now showing a 72% and 76% completion rate within 72 hours of death, respectively. And this is not the only way in which efficiency has now been improved at the organisation. More time is being freed for consultants to be able to direct their focus to where it matters most, the patients, through a reduction in consultant reviews needed from 35% to 13% – equivalent to approximately 27 fewer reviews per month. Efficiency savings for both the informatics and clinical governance teams have been achieved at multiple levels, including the introduction of a more effective process for managing mortality reviews, 83% now being identified within 72 hours of death, as well as real-time and automated mortality outcome reporting providing greater efficiency to the mortality review and learning from deaths processes. There is a clear upward trajectory in system functionality that I strongly believe will continue at the trust, and it holds the powerful potential for translation of these same benefits to other organisations.
So how does this all work? The critical component to making best use of the vast amounts of often wasted data generated within hospitals is the effective incorporation and streamlining of this information, alongside reporting from MEs and SJRs, into a single workflow and platform. Relevant Electronic Patient Record (EPR) data is automatically pulled into the workflow to support this, integrating together with Quality Assurance Process and Coding reviews, and providing access to a wealth of up-to-date reports and data that can be easily accessed and digested by the clinical team. Members of the team are now able dedicate their attention to patient care and outcomes, as well as to learning from deaths to ensure the same steps or mistakes are not made again, as opposed to wasting unreasonable amounts of time merely capturing and reporting data they will ultimately not be afforded the time to truly make the most of.
The fundamental goal of any healthcare technology or digital advancement is to improve the quality of a patient’s care and journey. We have seen first-hand now how such improvements can be afforded in a real-world setting, through the focused and well thought out development and application of technology by those most suited to lending their expertise to the process – clinicians. I am confident that there is huge potential in further applying this knowledge to the design and creation of platforms that benefit hospital productivity and patient outcomes, and one of the first steps will be more widespread acceptance and integration of new technologies into our healthcare centres. Through this, I believe we will unlock vast opportunities for future innovations and the patient experience.