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Redesigning district nurses services
Leader: Joanne Webster, Margaret Clarke & Ann Ballerini
Lead organisation: Doncaster Central PCT
SHA: South Yorkshire
Duration: Started in 2003
Corporate partner: Oracle
A GP practice in South Yorkshire has given its doctors and district nurses mobile access to patient records using PDAs.
Project objectives
The project grew out of a review of district nursing services in Doncaster that involved patients, district nurses and GPs. One of the areas identified for improvement was access to patient records. The consensus was that it was taking too much time to track down patient information – which could result in duplicated assessments and records.
How it works
The solution, which is being trialled in a GP practice in South Yorkshire, is to give doctors and district nurses hand-held PDAs (Personal Digital Assistants) to input information about patients and to access information held on the GP system.
“It all sounds like a commonsense use of existing technology,” says NHS Live project leader Joanne Webster, “but, in reality, the pilot is the result of nearly two years’ hard work and much behind the scenes ‘jumping through hoops’. Identifying a need is one thing, but translating it into a specific project focus is another task altogether.”
The team registered the project with NHS Live and was able to find a corporate partner in Oracle – the technology company.
“We have benefited tremendously from their expertise in planning and their thinking about how we can improve communications between our district nurses and other health and social care professionals,” says Joanne.
The connection with Oracle also opened doors to other relationships with Oracle’s partners. The project’s steering committee now benefits from the input of Pervasic, Vodafone, Medify Solutions and its partner Emis – which provides 70 per cent of the clinical systems used in GP practices in the UK. Vodaphone is providing the PDAs free of charge for the duration of the pilot, while Medify and Pervasic have offered medical staff to advise on how to get the best out of the PDAs.
Shared learning and challenges
The project faced a couple of main challenges. As Joanne explains: “We had to ensure the sustainability of the project by designing it to support national policy, especially by making sure the device fits with the national strategy for Connecting for Health. We also had to ensure that our external partners, some of whom are private companies, have security systems that fit our requirements. And I haven’t even begun to talk about the complexities of connecting different information systems together!”
Despite the problems, Joanne is enthusiastic about the project. “The connections with these firms have been fantastic,” she says. “We have captured a wealth of experience from them.”
“What came out very clearly was the need to improve communications – it always is!,” says Joanne. “In a nutshell, better communication was needed between patients, district nurses, practice staff and other health and social care professionals.”
A key moment in the project was when the corporate partners investigated the existing systems in the GP practice and realised they could be used to support mobile technology – which would mean that patient data could be entered and retrieved instantaneously during home assessments.
“The partners showed us a fantastic device that would do the job,” says Joanne, “a simple PDA that could be used by district nurses and GPs to access and input patient information immediately.”
To assist the pilot, Doncaster PCT put in a number of support mechanisms, including a helpline to deal with any software-related problems.
Outcomes and future plans
Healthcare staff no longer need to return to their office or waste hours trying to track down patient information. This means greater productivity and a much better patient experience.
Duplicate assessments and records have also been cut.
The project team expects the pilot to give a good sense of how mobile technology can enable GPs and district nurses to give better care during home visits and out-of-hours services. “We’ll also be looking at how we need to invest in the training and development of our staff,” says Joanne. She points out that many district nurses and other community-based professionals, like health visitors, are not used to using IT and may need help to become confident using the new system.
At the moment, the focus is on enabling community staff and GPs to deliver better care to patients. Ultimately, though, the project hopes to use the PDA device to enable professionals from different sectors to exchange information and work together more closely.
The next phase of the project will be to explore how the PDAs can support the care of patients with long-term conditions. The project team plans to identify patients with chronic diseases who would benefit from more integrated care, and then the professionals who would work across such a pathway.
“Our real ambition is to find ways to connect healthcare professionals with other professionals, especially in social care, to help ensure integrated care for long-term conditions become a reality,” says Joanne.
Key contacts
Margaret Clarke
Doncaster Central PCT
margaret.clarke@doncastercentralpct.nhs.uk
Oracle Healthcare
www.oracle.com
Download the PDF version of this case study.
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