An innovative electronic system which allows staff on the wards at the Royal Lancaster Infirmary to order inpatient meals on the same day has reduced food wastage by an average of 49% since it was introduced in July 2018. This equates to a saving of £26,000 – which is a reflection of the Trust’s commitment to saving money and becoming more eco-friendly and efficient.

Before the new system staff would have had to fill in a paper form and take it to catering staff a day in advance – this could mean that if a patient’s appetite changed meals could be wasted.
The system was rolled out at FGH between August and October 2018.

Since the system swap, a staggering 359,819 meals have been ordered on 20 wards at RLI and nine wards at FGH. The old paper process could take ward staff up to one hour 30 minutes to complete – so staff time has also been saved by using the new system.

Jackie O’ Brien, Catering Manager, University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), said: “The reduction of food wastage has been staggering and something we’re really proud of. The new system has saved time for catering supervisors’ as they no longer have to count meal numbers. The new system does this automatically for them. So they have more time to better provide the services that focus on patient improvements.”

Keith Griffiths, Director of Finance, UHMBT, added: “An astounding 149,267 meals have been ordered, at the Trust since 1 January 2019, using this innovative piece of software, which has reduced the Trust’s carbon footprint and food wastage as well as saving a substantial sum of money – a perfect example of how a sensible change has made a big impact.”

Patient satisfaction has improved thanks to the new system.

Lisa Winn, Ward Manager for the RLI’s Lancaster Suite, UHMBT, added: “Patient care and experience is at the heart of what we do and we’ve had some fantastic feedback from patients on the meals since this system was introduced.

“It’s also provided a fantastic opportunity for staff on the wards to work more closely with other departments, helping provide a highly efficient service, putting the patient at the forefront while creating measurable cost savings.”

A patient on the Lancaster Suite added: “The way you can order your meal is much better now that it’s on an iPad – it felt a bit overwhelming on paper. The quality of the food has always been fantastic at the hospital.”

Staff feedback shaped the design of the app, including having clear deadlines for ordering meals and the ability to order items such as custard separately.

The new ordering system allows meals to ‘follow the patient’ should they be transferred to another ward, as well as providing for swift cancellations if they are discharged.

If a patient is discharged out of hours, a take-home food bag is made available. These bags ensure patients will be able to have food and a hot drink once they arrive home.

The Trust’s Health Informatics team, Foluke Ajayi, Chief Operating Officer, Stuart Hosking-Durn, Head of Resilience and Patient Flow, and Andy Crundell, Matron for the Emergency Department at the RLI were filmed by inEvidence about the benefits of using Qlik software through the Analytic Command Centre.

The final film and case study will be released shortly.

Dr William Lumb, Suzy Foster CEO EMIS Health and Dr Shaun O’Hanlan, Chief medical officer for EMIS Group, visited partners across the bay to view the EMIS system in practice.

The event included a visit to Sedbergh Medical Practice to meet staff and discuss the Bay Health and Care Partners digital strategy, a tour around Westmorland General Hospital to meet services using EMIS Web including Langdales, the Integrated Musculoskeletal Service, district nursing and therapy services.

Our guests also enjoyed a presentation from the Integrated Communities (our Neighbourhoods).

A real-time analytics solution which was created in December 2018 at the Trust’s Royal Lancaster Infirmary site is helping staff to improve patient management, care and experience.

The Analytic Command Centre was designed to work in a similar way to airport air traffic control and displays live information about patients throughout their hospital stay, from incoming patients travelling via ambulance to patients waiting for discharge home.

Improvements so far include:

• The number of patients triaged with the Trust’s Emergency Department within 15 minutes of arrival has risen from 70% in 2018 to 94% for April- June 2019
• The number of nights where a medical patient has been cared for on a non-medical ward due to bed pressure (medical outliers) has decreased by over 1,800 bed-days or 47% between April – June 2018 and April – June 2019.

University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) holds patient flow meetings every two hours in the Analytic Command Centre which helps teams to better analyse the emergency care setting and patient flow in and out of the hospital.

The new screens show live information including:
• Which patients are due for discharge and themes of why there may be delays
• The performance in the Emergency Departments (ED) which allows staff to see the status of ambulances, the number of walk-ins and if there has been a surge in patients
• The number of admissions to hospital through outpatient appointments and departments such as the Ambulatory Care Unit
• The current bed state across the Trust which helps teams to manage the demand for beds across the hospital and ease the number of patients in ED.

Rob O’Neill, Head of Information, UHMBT, added: “Advanced analytics is helping us to deliver the highest standard of patient care as efficiently as possible in this area. By immersing our colleagues in real-time data it gives them the opportunity to pre-empt and react quickly to changing demand.”

‘Foluke Ajayi, Chief Operating Officer, UHMBT, said: “We have seen some fantastic results since the Analytic Command Centre was implemented which is helping our teams to plan ahead with the resources they have to give the very best care to our patients.”

The Trust’s contract with Microsoft Office 2010 is due for renewal by January 2020, so we have decided to opt for a better software package which will improve the security of our systems and boasts more up-to-date features and tools – which will benefit our War on Waste.

We are working hard to ensure all computers and laptops across the Trust are upgraded to Office 365 software and that staff are trained on the new system by 18 November 2019.

As part of the roll-out, we are looking for 613 members of staff to sign up as 365 Champions by Sunday 25 August 2019. That means for every team of 10 people, one person would nominate themselves as a Champion to raise awareness of the benefits of 365 and help and advise their colleagues on the system.

Training will commence for Champions on 30 September 2019 and will run over four weeks. Each session will take approximately two hours and each Champion will be required to attend one session.

We would encourage every care group to come on board with the roll-out and identify Champions in their teams and departments.

Staff can sign up to be a 365 Champion by creating a Microsoft account using your Trust email account. To access the signup form please see the article on the staff intranet Trust news pages.

Features of the new system:

Even though we are switching over to an online system legacy features which you may work closely with such as Word, Excel, OneNote and PowerPoint systems will still be available.

Office 365 boasts exciting programmes such as Microsoft Teams (an online chat forum) which can help to reduce emails, improve communication, team planning, team meetings and much more.

As part of the roll-out, we will have an exciting new intranet through SharePoint and our current g-drive system will also move across.

What staff need to do over the next few months:

As part of the move we would encourage all staff to clean up their email boxes by reducing any unnecessary emails and spam, deleted items and clear deleted folders.

OneDrive is going to replace all users My Documents so it is important users take some time to reduce the size of their OneDrives (My Documents as OneDrive will be completely online).

In the meantime, if you have any concerns or queries please email office365@mbhci.nhs.uk

Tony Stewart
Health Informatics Team

Cathy Rawlings, Midwife at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), has joined a private ‘Facemums’ group as a moderator ‘Facewife’, where she shares up-to-date evidence-based information, answers queries and signposts women to appropriate local services.

The Facemums service, which is funded by Health Education England (HEE) and coordinated by the University of Salford, is aimed at pregnant women and women up to six weeks postnatal. It gives women a platform to seek information they need and support each other.

The Morecambe Bay group currently has a small group of registered (followers) mothers and mums-to-be, aged between 16 and 28-years-old, between 12-30 weeks gestation.

Cathy, who is based at the South Lakes Birth Centre at Furness General Hospital, said: “I’m really enjoying being part of the group. The group is going well at the moment. The women seem to be enjoying it although they have only just started really chatting in the group this week.

“I think it is definitely something that could coincide with case loading midwifery which is a new model of care supported nationally and sees midwives take on their own group of women and following them all the way through their pregnancy, seeing them in the community for antenatal and postnatal periods, as well as caring for them in labour to ensure continuity of care in the future. I’m excited to see where the Facemums group goes.”

Feedback from users has included:
“I am enjoying it more than ever. Feel it’s a great help, learning lots from the Facewives and other mums and trying to support where I can.”

HEE is supporting the rollout of Facemums following the success of the research project ‘The Impact of Midwife-Moderated Social Media-based Communities on Pregnant Women and New Mothers’, which demonstrated clear benefits to women in three specific areas:
• Support from other women who have experienced what the other is going through which helps to reduce pregnancy-related anxieties
• Midwives providing information and knowledge based on experience and research
• Continuity of care which relates to a patient’s needs.

Sue Smith, OBE, Deputy Chief Executive and Executive Chief Nurse, UHMBT, said: “It is fantastic that pregnant mums and mums who are six weeks postnatal have a place where they can ask any questions they have to professional midwives

“It’s a great way of encouraging peer support, reducing anxiety and isolation felt by many new mums and mums-to-be.”

Women must be over 16 to join. You can find out more about the Facemums group by contacting Amanda Plackett on amanda.plackett@mbht.nhs.uk

Two prestigious visitors from an international benchmarking company visited the Royal Lancaster Infirmary (RLI) on Wednesday 1 May to help improve the user experience of staff on the electronic patient record.

KLAS is a worldwide electronic patient record (EPR) benchmarking company, who are supporting University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) to improve the EPR experience for its doctors, nurses and Allied Health Professionals.

Jeremy Goff, Senior Researcher, and Professor Rachel Dunscombe, UK KLAS Ambassador, met with Dr Paul Smith and the Health Informatics team to learn about how they were working with clinician users to improve clinical care through better use of digital technology and the EPR.

They then took a tour of the site’s clinical areas, including the Emergency Department and Acute Medical Unit where they spoke to clinicians, nurses and junior doctors about their experience of the system, before meeting up with the team and David Wilkinson, Director of People and Organisational Development, to share highlights from their research.

Colin Brown, Chief Clinical Officer, UHMBT, said: “We were delighted to welcome Jeremy and Professor Dunscombe to the Trust, to showcase what we have done so far.

“It is important to us to improve user experience of the EPR and we are working with the feedback we have had from staff and also the experience and learnings and advice from KLAS, to make user experience even better for them.”

To finish the visit, the pair shared their most recent insights of user experience measurements from some on the 200 trusts and organisations they work with around the world.

The Trust’s Health Informatics Team sent out a KLAS survey in October 2018 to ask users what they thought of the current Lorenzo EPR experience. The Trust’s junior doctors have also collated some useful feedback in recent months. These two sources of feedback have prompted setting up of an EPR User Experience Working Group and an active project, to improve user experience of the EPR.

The Health Informatics team will work fairly rapidly across the sites over the following months, to fix any broken computer kits and upgrade machines to ensure the EPR system runs as smoothly as possible.

They will also look at coaching and upskilling the workforce to be able to use the EPR system better – this will include flexible workplace-based training. They will also work with the partner supplier DXC, to prioritise further key software improvements, to meet the needs of users.

David Wilkinson, Director of People and Organisational Development, UHMBT, said: “Working with KLAS is really useful – the insights from their research will help us to improve how colleagues use digital technology across UHMBT, which has been identified as a high priority area for our colleague experience strategy.”

The Information Sharing Gateway (ISG) led by University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), was first developed in 2014 in partnership with 10 other public sector organisations in Cumbria and Lancashire.

The system has many benefits including:

  • Reducing the paper processes that organisations used previously
  • Greater security in line with General Protection Data Regulation (GPDR), privacy and data protection laws
  • The ability to manage risks around data sharing
  • Templates and common standards of working.

Nicola Briggs, ISG Programme Manager at UHMBT, said: “We aspire to deliver the benefits derived from using the system to as many people across the UK in a bid to support a joined up and more effective data sharing community.

“The ISG is a digitally collaborative way of working which organisations can contribute to the drawing up of agreements, risk assess and agree and sign them electronically.

“The ISG provides a simple answer to a big challenge for organisations trying to overcome information governance requirements when sharing information.”

Phillipa Nazari, Data Protection Officer and Head of Information Governance for Greater Manchester Combined Authority, said: “Greater Manchester (GM) is reforming public services and this reform needs to be insight led. Increased sharing of data and information to benefit citizens is integral to achieving this.

“The Information Sharing Gateway has been a key part of this important strategic agenda by not only enabling organisations in GM to work consistently and transparently in capturing the required information governance arrangements in relation to information sharing but also in the providing the opportunity for analysis of management information about where data flows across GM.”

Aaron Cummins, Chief Executive, UHMBT, said: “The ISG system now means that data is able to flow between organisations where there is a justified purpose.  This allows a much more seamless delivery of care and provides clinicians with complete and up-to-date information.”

You can find out more about the ISG at https://www.informationsharinggateway.org.uk/

A new Analytical Command Centre has been created at the Trust’s Royal Lancaster Infirmary site that is helping staff to improve patient management, care and experience.

The command centre has been designed to work in a similar way to airport Air Traffic Control and displays live information about patients throughout their hospital stay, from incoming patients travelling via ambulance to patients waiting for discharge home.

University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) holds patient flow meetings every two hours and the new Analytic Command Centre will help teams to better analyse the emergency care setting and patient flow in and out of the hospital.

The new screens show live information including:

Which patients are due for discharge and themes of why there may be delays
The performance in the Emergency Departments (ED) which allows staff to see the status of ambulances, the number of walk-ins and if there has been a surge in patients
The amount of admissions to hospital through outpatient appointments and departments such as the Ambulatory Care Unit
The current bed state across the Trust which helps teams to manage the demand for beds across the hospital and ease the amount of patients in ED.
Stuart Hosking-Durn, Head of Resilience and Patient Flow for UHMBT, said: “Our great colleagues from the Informatics Team have given us the ability to have live information fed into the control room which will greatly improve our ability to manage patient flow, patient safety and the overall effectiveness of the services we offer to our patients.”

Rob O’Neill, Head of Information, UHMBT, added: “We’ve co-designed the solution with our clinical and operational colleagues and feedback tells us we’ve got a solution that’s making a positive impact to patient care. We’re attracting national and international interest and are looking forward to collaborating with other care systems to continue to innovate and support more efficient and safer care.”

Foluke Ajayi, Chief Operating Officer, UHMBT, said: “We are delighted to be able to invest in the new Analytic Command Centre and we welcome this new way of working at the Trust which will improve patients’ experience of our hospitals.”

You can find out more about our command centre at https://twitter.com/i/status/1073569841544642571

‹ Furness General Hospital welcomes the sound of music to Intensive Care UnitUHMBT to crown its Health Heroes ›
Tagged with: Analytic Command Centre, Featured, Foluke Ajayi, Patient Flow, Rob O’Neill, Stuart Hosking-Durn, UHMBT
Posted in General News

An increasing number of patients are getting treatment more quickly and many do not need to travel to hospital for an outpatient appointment thanks to Advice and Guidance.

The locally-developed system enables GPs to have a secure electronic ‘conversation’ with a hospital specialist. This enables them to obtain advice for individual patients, without the need to refer them to hospital.

From January 2018 – December 2018, nearly 10,000 ‘conversations’ took place between GPs and hospital specialists via the service with 71% of cases resulting in having their treatment changed by their GP.

Dr Marwan Bukhari, Consultant Rheumatologist at University Hospitals of Morecambe Bay NHS Foundation Trust, who uses the Advice and Guidance Service to offer advice to GPs, said: “This has been a service that has enabled the quick communication between primary and secondary care and enabled decisions about patient care to be made in a timely manner with reduction in waiting and travel time. It has also provided an educational resource for the GP’s and potentially reduced the number of referrals into the service in addition to allowing those referred to have had appropriate investigations prior to being seen, speeding up the diagnostic process.”

Dr William Lumb, a GP in Sedbergh and Chief Clinical Information Officer for Bay Health and Care Partners, said: “This progress is wonderful to see and will directly improve patient care which is what we are all about. Having a digitally mature hospital is an essential component of our bay wide approach where we meld electronic record sharing, navigation and patient facing apps into a single integrated solution of which we are justifiably proud. Real patients are benefiting on a daily basis-so digital health does matter in Morecambe Bay.”

The scheme was introduced as a pilot in Garstang in 2014 as part of Better Care Together and is now available across the Morecambe Bay area. It has expanded since its launch to cover 50 specialties areas including Rheumatology, Radiology, Diabetic Medicine and Endocrinology and Trauma and Orthopaedics.

Bay Health and Care Partners continue to introduce and support new models of care across Morecambe Bay to improve the way people receive health and care services within south Cumbria and North Lancashire. These new models of care developed over the last five years are integral in the delivery and implementation of the Better Care Together Strategy.

The innovative and imaginative use of technology to improve patient care by University Hospitals of Morecambe Bay Trust (UHMBT) has been featured by the Chief Medical Officer in her annual report as an example that healthcare providers should aspire to.

UHMBT uses a Lorenzo Electronic Patient Record system from the time that a patient enters the hospital until they are discharged back home.

Colin Brown, Chief Clinical Information Officer, UHMBT, said: “The pace and scale of digital change, led by our clinicians, nurses and IT team in recent years has been staggering.

“The Electronic Patient Record system is a fantastic tool to support the triage of our patients across many areas of our hospitals. It means that patients are treated more quickly and safely and it also reduces the number of patients waiting in our emergency departments.”

Other examples of staff using new IT for patient care include nurses carrying out ward rounds using iPods, and midwives using laptops to remotely access patient records when they are visiting women in the community.

Over 122,333 patient meals have been ordered at the Royal Lancaster Infirmary and Furness General Hospital via tablet computers thanks to an electronic eMeals system. The old paper processes could take ward staff up to an hour and a half to complete. This means that staffs on the wards have more time to spend on patient care and the system has reduced food wastage by 45%.

An innovative online system called STRATA has also helped to ease the movement of patients around the local healthcare system, for example the discharge of patients from UHMBT’s hospitals into community health and care services.

Community staff in South Cumbria and North Lancashire are also now delivering better integrated care thanks to the Emis web electronic record system which gives them the ability to book appointments for patients across different organisations.

The iPlato myGP app allows patients to book appointments with their GP practice and order prescriptions online.

An Advice and Guidance service enables GPs to access specialist advice from colleagues working in hospitals and enables patients to be seen more quickly and not have to travel to hospital for their care.

Staff using the Electronic Patient Record System access 250 GP records every day, and in 2017 100,000 letters and documents were sent electronically to GPs.

Dr William Lumb, a GP in Sedbergh and Chief Clinical Information Officer for Bay Health and Care Partners, said: “This progress is wonderful to see and will directly improve patient care which is what we are all about. Having a digitally mature hospital is an essential component of our bay wide approach where we meld electronic record sharing, navigation and patient facing apps into a single integrated solution of which we are justifiably proud. Real patients are benefiting on a daily basis-so digital health does matter in Morecambe Bay.”

Colin Brown added: “Technology really is revolutionising the way staff are working, strengthening partnerships between health and care organisations and giving patients a better experience of local healthcare.”