West Suffolk Hospital meeting discharge targets
Since 2007 West Suffolk Hospital (WSH) has worked on a project to develop a discharge summary system which has now been rolled out to all 19 wards with 90% of summaries being created electronically. In phase two, 100% of these are transmitted electronically to GPs via a combination of mechanisms as each practice chooses. Consultants are able to review discharge summaries, editing them or adding comments as they choose, and do so within a workflow system that allows re-transmission to GPs as required. In addition, the drug prescribing error rate is monitored with reports that inform on prescribing habits and are used to feed back into the training of junior doctors and monitors the operational performance of pharmacy and discharge delays.
WSH were well aware that the discharge process was actually complex which touched many different professional groups. At the time it seemed it would not be possible to meet all these considerations with a simple solution and that any solution would need to be considerably adapted to local needs if we were to achieve all the possible benefits. Additionally WSH had a need to bring clinicians back on board by meeting various other needs and delivering some clinical IT in the vacuum after the withdrawal of Accenture.
Working with Bluewire Technologies in Bristol, the company took an innovative approach to the design and development of a discharge summary solution which has replaced the existing paper ones and clinicians have been brought back on board by offering functionality such as the ability to review the electronic documents in lieu of the old follow-up letters.
Pharmacists are now provided electronic information to reduce drug prescribing/transcription errors and all of this had to be done without making excessive demands on users’ time or delaying discharges and meeting the primary target of getting documents to GPs ultimately within 24 hours. The current phase involves transferring the summaries to GPs electronically and integrating with, enhancing or replacing six existing internal systems covering discharge planning, 18 week wait data capture, tracking of pharmacy workload, production / cataloguing of clinic letters and junior doctors handover lists.
One of the most innovative aspects has been the Junior Doctor’s lists. These contain brief summaries of the patient’s current condition and management, together with outstanding tasks and the ability to record patients due for emergency admission who are not yet registered on the PAS system. By implementing this functionality we have moved from an ad-hoc collection of unauditable, unshareable collection of Microsoft Word documents to a central system that supports junior doctors, consultants and others in maintaining patient safety and quality of care.
Strategically, it was important that the system complied with CfH recommendation on the Common User Interface, CUI, and Bluewire worked closely with the Microsoft User Interface Group and have adopted all current CUI standards.
