Nottingham reduces clinical incidents

Nottingham University Hospitals NHS Trust has reduced night-time clinical incidents by 70% since implementing a new IT system to support its Hospital@Night working, a speaker told EHI Live 2012.

Speaking on improving patient safety and handover using mobile devices, the trust’s lead nurse, Debbie Guy, said the implementation of Nervecentre’s mobile task management system had reduced cardiac arrest calls dramatically.

The trust has seen a 70% reduction in clinical incidents at night and the average length of hospital stays has gone down by 12%.

Guy said that before the implementation of the system the Hospita@Night coordinator was “chained to her desk”, because she was taking more than 100 calls a night from staff looking for junior doctors and specialists to support their patients.

The bleep system that the hospital used had no way of prioritising the calls, so there was no way for the “bleeped” staff to know what was urgent, how long each call might take, or whether other help was available.

The trust recognised that there was a communication problem and that it needed to invest in an intelligent communication system.

It chose Nervecentre because the system provides accountability and a full audit trail from when the task is requested to when it is completed.

A nurse makes a request for a task, which is then sent to the nurse coordinator, who can see what doctors are available and select the most appropriate. A notification is sent to the doctor on a mobile device, which adds it to a task list.

“We had to change something,” Guy told the Best Practice Showcase at EHI Live 2012. “There was no support for junior doctors as the head nurse was chained to the phone.”

Guy added that getting a system the staff wanted was important: “There was a definite focus on what made a difference for the nurses and the ward staff.

“We made sure that every step of the way we engaged with the staff that were going to be using it. We asked what would make it easier for them.”

The Hospital@Night team had a reputation for not delivering when they needed to, Guy said; but that has changed since implementing Nervecentre.

The team has also been able to solve staffing problems that threatened to overwhelm it, because staff did not want to work in such a difficult and stressful environment.

“The coordinator now spends 80% of her time out and about on the wards, because all the referrals come through electronically and it take seconds to allocate.

"She has full awareness of where the team is and what tasks are outstanding,” Guy added. 

The trust is also about to launch electronic handover, another part of the system.

“Everyone realised it was something that would improve their working day. The solution delivered benefits for the people who use it.”

Nervecentre Software was set up in 2010 to provide real-time information on staff productivity and to improve efficiency. The software can be used on Cisco WiFi phones, and BlackBerry, Nokia and Android smartphones.