Case study: Salford Royal NHS Foundation Trust creates paperless environment using SMART

Salford Royal NHS Foundation Trust is an integrated provider of hospital, community and primary care services, including the university teaching hospital.

A team of 6,000 staff provide local services to the City of Salford and specialist services to Greater Manchester and beyond.

The trust aims to be the safest organisation in the NHS through providing safe, clean and personal care to every patient, every time. It is already well on the road to achieving this goal, with a statistically better-than-expected risk-adjusted mortality, a proven track record of reducing harm to patients and an ambitious plan to put its patients at the heart of everything it does.

The trust recently renewed its investment in SMART software to support a major workforce efficiency project. It has stepped up its use of SMART automated workforce management solutions to create a stable-yet-highly-flexible framework that saves time and drives efficiencies. With a steering group and project involvement from areas including nursing, HR, finance and IM&T, the trust has successfully collaborated with all parts of the organisation to introduce standardised shift patterns, effectively manage rosters and accurately capture annual leave for staff working in 41 wards. An internal SMART helpdesk supports staff ensuring that the full potential of the SMART technology is realised.

Lindsay Hellewell, workforce information and systems manager at the trust, said: “SMART has become a catalyst for change and is fundamental to the success of our overall workforce efficiency programme. We now have a good, solid technology platform that tangibly measures our performance and drives continuous improvement. The new systems rollout has been a remarkable journey of education, promoting a more-open, collaborative culture across the whole organisation.”

We now have a good, solid technology platform that tangibly measures our performance and drives continuous improvement. The new systems rollout has been a remarkable journey of education, promoting a more-open, collaborative culture across the whole organisation

Phil Speight, resource planning manager, added: “The latest product innovations from SMART have given us the ability and confidence to take a more joined up approach to managing working hours and staff rotas. By moving to an electronic rostering system has saved huge amounts of time for our ward managers and has provided much more clarity for all our staff. This has been extremely apparent when looking at old copies of handwritten rosters. This consistently accurate data means our nurses work the right number of hours, and enjoy the right amount of time ouside of work, fair for both staff and the trust.”

Salford Royal NHS Foundation Trust originally turned to SMART in 2007, but had never realised the full benefits of using the system. When there was a corporate requirement to review how the trust managed staff annual leave, it took the decision to build and expand on the SMART solution. Up until that time, all annual leave was administered via the organisation’s ESR system, but there were often inaccuracies resulting in valuable clinical time spent on manually putting them right. The time had come to streamline the process with a clear audit trail from beginning to end.

To ensure widespread acceptance of the move towards a totally paperless environment and encourage adoption of the expanded SMART platform, the project management team had to secure buy-in from all parts of the organisation – finance, HR, IM&T as well as clinical leads and senior executives. Knowledge gathered from clinicians and functional heads also guaranteed the implementation would meet the specific requirements of the trust as a whole. This approach continues today with a mix of continual clinical feedback from wards and constant support from IT.

Part of the project involved setting up an internal helpdesk that operates 9am-5pm Monday to Friday - and an indepth training programme that has evolved from traditional classroom training to tailored 1-2-1 sessions.

David Hargreaves, HR director at the trust, said: “It is clear to see that our staff are fully engaged with the SMART rostering system. This has come from the hard work and partnership working between SMART, my team, and the wider trust during the reimplementation of the product and the continued support which they have offered. This system provides me with confidence that our trust is delivering safe staffing levels to our patients.”

Ward managers and nursing directors use SMART to manage shifts and track annual leave entitlement producing Target Hours Reports that demonstrate the number of hours worked against agreed contracts. The trust is planning to use SMART strategically, developing the reporting functionality to identify skills requirements and staffing levels in the future. Staff appreciate the transparency of the system and the freedom to record their hours, view their holidays and even apply to swap shifts themselves.

Today, nursing and ward staff across the trust are using SMART e-Rostering and Timesheet solutions. By realising the full potential of the solution, Royal Salford NHS Foundation Trust has noticed considerable benefits including:

• Rosters are now available online leading to a truly paperless workforce management environment that is easily accessible and where changes can be made quickly and dynamically
• Standardised shift patterns. Before the project, ward managers had to contend with multiple shift patterns including hundreds of different start and finish times. There are now three standard 12-hour shifts in eight-week cycles, each one starting and finishing at the same time. This saves valuable management time during handovers, provides more consistency of care for patients and a better work/life balance for staff. In addition, it helps managers with forward planning, enabling them to scale their staff up or down depending on clinical needs and so improve patient care
• Accurate data means correct pay and benefits. The real-time accuracy of the data held in the SMART system means that staff are paid correctly for hours worked. Fair and transparent to everyone, the system is 100% credible and has received positive feedback from all areas
• Auditing and accountability. At a glance, managers and staff can see how many hours they have worked and whether they are close to the end of their annual leave allocation. Because there is a clear audit trail from beginning to end, managers can quickly investigate any queries from staff and demonstrate to the Executive Board more efficient use of public resources
• Potential cost savings. Ward managers can track nursing hours more effectively so they are better able to reduce their reliance on more expensive NHS Professionals (NHSP) or bank staff. As a result, Salford Royal NHS Foundation Trust expects to make considerable cost savings in the future