Royal Cornwall transforms night handover process


Hospital at Night solution helps clinical teams work more efficiently and effectively

Royal Cornwall Hospitals NHS Trust (RCHT) is now able to manage clinical teams and medical tasks more efficiently and effectively throughout the night following the deployment of a Hospital at Night system.

Introduced as part of RCHT’s service improvement programme (SIP), the system has transformed the trust’s night shift handover process by allowing doctors to create an electronic work list of clinical tasks for patients who require extra attention and/or intervention during the night.

The move from a manual, paper-based system to a more automated electronic process means that senior nurses can analyse the levels and types of tasks being carried out and allocate the correct mix of clinical experience and skills on each night shift, meeting the changing needs of the organisation.

Catherine Cade, service improvement lead at RCHT said: “By using IMS MAXIMS’ Hospital at Night system, not only can we assess the types of clinical tasks that are being requested, but we can also see where the demand is coming from within the individual wards. Further to this, the system allows us to see whether tasks are being carried out within a timeframe. A report can be generated which allows us to see whether these targets are being met, and if not, we can change to improve this.”

The system allows hospital staff to add, update and remove patients from the Hospital at Night work list through a simple data entry screen meaning they can finish their daytime shift with the reassurance that the night team have all the information and instructions they require to complete a safe, efficient night shift.

Subsequently, clinicians are able to easily record clinical information such as Situation, Background, Assessment, Recommendation (SBAR), clinical tasks, clinical responses and notes on the patient throughout the night, enabling doctors to have all the information they require for the following day on the ward.

Cade said: “Part of our aim for SIP was to ensure that if, for example, a second clinician is needed for a medical issue to be dealt with at night, we are able to investigate this and work to get the right person, be it healthcare assistants, nurses or doctors, to the patient the first time round as efficiently as possible, rather than the wrong person quickly.

“Having looked at staffing rotas at night, we wanted to provide a safe, effective and competent multi-professional team with the right sort of skill mix and staff numbers to meet the immediate needs of patients. The IMS MAXIMS software has given us that information which has informed the decisions regarding staffing.”

Having looked at staffing rotas at night, we wanted to provide a safe, effective and competent multi-professional team with the right sort of skill mix and staff numbers to meet the immediate needs of patients

Key to the deployment was IMS MAXIMS’ approach in involving healthcare professionals at every stage of the development process, ensuring their needs and those of patients were given the highest priority.

Cade added: “Clinicians have adopted the system extremely well, which can be attributed to a number of factors. The technology is very simple and easy to use, which was vital for time-sensitive users; a result of involving junior doctors in the development process. It also helped that doctors were already using IMS MAXIMS for other systems at the trust such as order communications and e-Discharge, meaning that they were familiar with the technology.”

The system, which is currently deployed in 35 wards including medicine, ENT and orthopaedics, is an add-on to the existing browser based MAXIMS clinical solution that is widely in use at RCHT, and links to the trust’s Patient Administration System.

Shane Tickell, chief executive of IMS MAXIMS, said: “Royal Cornwall is a very forward-thinking trust which understands the benefits that technology can bring to healthcare, and this deployment demonstrates their ambitions to provide the highest-quality care to patients, 24 hours a day, seven days a week.

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“We recognise that no two healthcare organisations – and no two clinicians – are exactly alike in how they work, and our tailor-led approach means we created a solution which matched Royal Cornwall’s bespoke needs and ensured it was scalable when rolling out across the whole organisation.”