Paper-based and basic electronic systems for case management aren’t cutting it, writes Julie Plant, senior matron of children’s services at The Royal Wolverhampton NHS Trust (RWT). Here Julie explains how RWT has overcome this problem and the benefits it has brought.
Case management across the health and social care sector is a challenge, and there are reccurring issues that practitioners and healthcare leaders commonly face throughout the process. These issues are often exacerbated by inefficient systems, generally paper-based or, at best, electronic systems in their most basic forms, such as Word documents or Excel spreadsheets. Organisations very quickly outgrow these approaches to case management, which are clearly not sophisticated enough for the demands placed upon them.
Integrated systems offer a better approach, one that supports health and social care organisations’ drive to digital transformation under the NHS Long Term Plan; and an approach that Royal Wolverhampton NHS Trust has indeed pursued within our 0 – 19 service, with much success.
Our recording system for the 0 – 19 service was 100 per cent paper-based, there were forms, books, and loose paper used for case management and this manifested into a number of challenges for RWT. For instance, as data was not centralised, there were common challenges around the accessibility, quality and timeliness of information, practitioners spent long amounts of time undertaking administration, and creating reports was a lengthy task.
In addition to these day-to-day complications, paper recording generated further implications around storage, security, and consistency of data.
Making case management digital across our 0 – 19 service was essential, and as part of our drive for continual improvement, it was vital that the staff who were going to be usingthe technology were central to its development, to ensure that it was fit for purpose. We included a wide mix of healthcare professionals from health visitors to school nurses, in order to grasp their ideas, opinions and feedback, and use this to shape the development of our case management solution (ECLIPSE from OLM).
Taking this line of action and getting the users of the system involved has ensured that it actually works for us. The electronic case management system does what we need and how we need it to. Involving our staff also encouraged their buy in, and they have been enthusiastic about using it from the start, rather than seeing it as disrupting established ways of working. Embarking on this project was viewed as a welcome step forward.
Today, we have made a clean break from paper-based case management and can confidently report that the results have already exceeded expectations. The difference an innovative case management system has brought isincredible.
The data is accurate and up to date. This is enhanced through multi-agency access, whereby all frontline services that have contact with the individual can add thoughts and observations. Through collaboration and interoperability, we have a complete holistic view of children and young people. Details such as the relationship with family, friends, police and school can be added to the system. This has an impact on the quality of information and reduces the possibilities of data error or duplication. All of which saves time and keeps our team up to date on each service user's circumstances.
Our multi-disciplinary team each have a unique login with a personalised screen based on their tasks and workflows. Data entry is much easier, and it has provided the ability to record in new ways.
Our team is no longer confined to the office when updating notes, or locating information. Instead they now work from anywhere at any time, from any place; writing notes directly into ECLIPSE while with the individual, or from the office, the car, anywhere. This added flexibility has freed up staff time, allowing them to spend more time on the frontline with children and young people.
As the system is also directly integrated with our Patient Administration System (PAS), when a patient is added to the PAS, they are also automatically added to our case management system.
It’s been just nine months since the system went live. The improved service due to access to key information and the efficiency savings are considerable. Changes in process mean we can save 70 hours each day across the 0 – 19 service. This equates to an additional 350 appointments each week which can now be completed, as well as reducing the number of miles travelled each day by up to 480. These are valuable savings and efficiencies thathelp us provide a better 0 – 19 service, and allow us to meet the digital ambitions of the NHS Long Term Plan.
Our next step is to continue to expand, and the project will be opened up to an additional 170 healthcare professionals before the end of 2019. Case management is changing, andtechnology is supporting the advances so desperately needed. For case management to be successful in terms of delivering better patient care and generating efficiencies, health and social care must go paper-less and instead embed digital solutions.
Julie Plant issenior matron of children’s services atThe Royal Wolverhampton NHS Trust. Follow RWT on Twitter@RWT_NHS