Spotlight Session 4
Paper Rags to Data Riches: How the Move to Paper Free Working is Supporting Service Improvements and Planning in Children’s Services
Scott Wilson – Senior Information Analyst, NHS Greater Glasgow and Clyde
NHS Greater Glasgow and Clyde has implemented an electronic Clinical Information System, EMIS Web. This supports all clinical and administrative activity within community children’s services, replacing paper processes with digital pathways.
The programme of change has delivered the following benefits:
- A single shared electronic record for children and young people, replacing multiple, single service paper records which inhibited the ability to share information across services. Safer decisions are now being made as clinicians are able to view information obtained by other services and share assessments and care plans.
- Paper records have now been entirely replaced removing costs associated with purchase, storage and archiving. Electronic records are now accessible immediately.
- Seamless transitions have been facilitated between services for example health visitor to school nurse, Child and Adolescent Mental Health Services (CAMHS) community case manager to psychiatric inpatient case manager. A wide range of information is now shareable with partner agencies without the need to ‘rewrite’.
- Communication and co-ordination between disciplines has improved through a single view of planned activity for the child.
- A single chronology of significant events for the child, contributed to by all clinicians using the shared record, is supporting keeping children safe and providing a more holistic picture.
- The use of EMIS to manage clinical and administrative information i.e. referrals and appointments has led to a significant improvement in efficiency of data collection and access to service improvement information.
Electronic data analysis is supporting data quality as a vital bi-product of moving to a paper free system, which has led to numerous development and quality improvement work.
The session will demonstrate the value of data through highlighting some of this work including:
- Improved access to services such as reducing waiting times for children and young people. This ensures CAMHS support is well evidenced by the data including improvements in outcome measurement analysis.
- More accurate reporting on demand for services supporting capacity planning to meet the demand will be shown.
- An overview of embedding a culture of using data to drive improvements so that every team within children’s services utilises their performance data.
Driving Improvements in Laboratory Test Requesting
Claire Lawrie – Programme Manager, Information Management Service, NSD
Dr Liz Furrie – Consultant Clinical Scientist and Clinical Lead, NHS Tayside
Niove Jordanides – Programme Manager, National Network Management Service NSD
Liz Blackman – Senior Programme Manager, National Networking Management Service, NSD
National Services Division (NSD) has developed a prototype Atlas of Variation for Diagnostic Laboratory testing which analyses data and displays useful comparators to identify unwarranted variation. In collaboration with national diagnostic networks, it has identified tests most likely to show variation in requesting and collected data across lab disciplines. Data has been analysed and presented in user friendly dashboards that can be viewed at individual GP practice level, clusters, regions and also a national view.
NSD has also worked closely with labs to identify quality improvement workstreams in a number of areas. It has utilised a range of quality improvement methodologies including several plan, do, study, act (PDSA) cycles. This has been commissioned by the Healthcare Scientist Officer in the Scottish Government with Scottish lab teams providing expertise, and NHS National Services Scotland (NSS) providing the resource and methodology to ensure improvements can be replicated and sustained. This has included supporting the alignment of aims across diagnostic disciplines and primary care.
The work presented has drawn together the national diagnostic networks, the local improvement support teams and has the support of the Realistic Medicine team. This strong collaboration across primary care and diagnostics will result in real improvement for the people of Scotland.
The SAS Hypo Fife Project: Reducing the Harm from Severe Episodes of Low Blood Sugar
Mrs Sharon Robertson – Lead Inpatient Diabetes Specialist Nurse, Diabetes Centre, NHS Fife
NHS Fife Diabetes Service is working with the Scottish Ambulance Service (SAS) with the support of SCI-Diabetes and MSD (Merck Sharp and Dohme, pharmaceutical company) to better manage hypoglycaemia in their patients with diabetes.
The aim of the project is to improve patient care, increase capacity in terms of SAS, A&E and secondary care as well as upskilling attending paramedics. A project team with wide representation from the different groups involved met regularly prior to the project going live. It was important to have support from the SAS Medical Director and the Data Analysts within SAS and NHS National Services Scotland (NSS).
The project includes:
- Creating a daily data flow between paramedics attending hypoglycaemic incidents and the Fife Diabetes Centre via SCI-Diabetes so that patients can be followed up and managed appropriately. Education is given to patients who experience a hypoglycaemic event that results in an ambulance callout.
- Identify Station Leaders at each paramedic base who will receive additional training in diabetes and leadership, ultimately becoming responsible for upskilling local paramedics.
- Develop an online training programme for SAS paramedics across Scotland hosted on the NHS Scotland LearnPro platform.
- Analyse data from the project in areas such as ambulance call outs rates, A&E attendances, ambulance scene time, and conveyed versus non conveyed patients.
- Produce an evaluation of the project that will help shape the roll out of the project across other NHS Board areas in Scotland.