Kent trust goes live with emergency department digital solution

Medway NHS Foundation Trust has successfully deployed the Sunrise electronic patient record (EPR) system in its emergency department as well as its electronic prescribing and medicines administration (EPMA) functionality across the hospital in phase two of its EPR delivery strategy.

The rapid go-live of Altera Digital Health’s Sunrise EPR within Medway NHS Foundation Trust’s emergency department (ED), and the introduction of EPMA across ED and inpatient wards, marks the successful completion of the second phase of the trust’s EPR strategy.

The trust successfully completed both go lives within four days of each other – on 24 September and 28 September respectively.

This followed the earlier implementation of Sunrise across the trust’s 24 adult inpatient wards, achieved in a record-breaking five months.

Once again, Medway has demonstrated remarkable levels of planning and determination to achieve two significant go-lives within days of each other, proving that digital transformation can be achieved in a matter of months, not years

This latest phase of the wider EPR implementation project will drive better patient care with significant improvement to patient flow throughout the hospital, including faster admission to inpatient wards, greater oversight of patient data and quicker, more-efficient discharge.

As with the phase one deployment, Medway prioritised the formation of a multi-disciplinary team, with clinical, operational, and IT staff collaborating to deliver the project – this time also with the addition of pharmaceutical leads to support the EPMA delivery.

Clinical transformation

Michael Beckett, director of IT at Medway NHS Foundation Trust, said: "We understand the importance of having clinical input into digital transformation projects and have taken steps to ensure that we have the right mix of expertise.

“Having a dedicated pharmacist on this project has been critical in terms of the development of the medication catalogue and order sets.

“This will ensure that our EPR provides improved patient safety, better auditing, and financial benefits in terms of stock control or prescribing management.” 

During the planning phases, the project team looked to Altera Digital Health and other trusts for best-practice approaches, as well as applying lessons learnt from the phase-one project at Medway.

Suzanne O’Neil, EPR director at the trust, said: “The ED is incredibly busy so we had to ensure that the go-live didn’t have a negative impact.

“In order to mitigate this risk, we took steps such as bringing in extra staff and ensuring that digital champions were stationed within the department to provide support.

“We also provided a quiet room where the digital champions could give additional training, away from the busy department.” 

She added: “There was a real desire to be able to use Sunrise in the ED.

“Doctors and nurses didn’t want to start a patient’s notes on paper and then move to digital; it is much more beneficial to have the whole patient pathway documented digitally. This really helped to accelerate the implementation of Sunrise within ED as the staff buy-in was there from the start.”

For the EPMA go-live, the trust employed a transcribing team that included pharmacists from neighbouring trusts.

O’Neill said: “Transcribing teams consisted of junior doctors, pharmacists, and technicians.

Delivering at speed

“We didn’t have enough pharmacists to cover this extra work, so we turned to our neighbouring trusts for support.”

The team systematically transcribed the notes for each inpatient into the EPMA. Once a ward was complete, it was given a date and timestamp that was signed off by the pharmacist and the junior doctor.

O’Neill said: “We started with surgical and frailty wards because, historically, we don't change the medication that often.

“This gave our transcribing teams the opportunity to familiarise themselves with the system before doing the wards with more-complex prescriptions.”

Just four days after rolling out EPMA functionality across the hospital, the trust activated the EPR in its ED.

Doctors and nurses didn’t want to start a patient’s notes on paper and then move to digital; it is much more beneficial to have the whole patient pathway documented digitally. This really helped to accelerate the implementation of Sunrise within ED as the staff buy-in was there from the start

It took several steps to ensure the launch went smoothly, including organising a multi-agency discharge event that brought together regional partners to undertake intensive discharge activity to create capacity, and therefore mitigate any impact on ambulance handovers.

And the trust is already seeing the benefits of the recent go-lives and is planning to undertake formal evaluation studies in order to fully understand the benefits to patients and staff.

Clear benefits

Beckett said: “One of our surgeons has reported the benefits of being able to clearly read what is written on drug charts and the benefits of using a catalogue that clearly states dosage.

“Discharge notices are also automatically populated, so we know that the right information is sent to GPs and patients and our clinical colleagues are not having to duplicate inputting this information.

“We also know that we now meet the requirements of the Professional Record Standards Body, which was a strategic objective for the trust.”

Paula Ridd, general manager for the UK and Ireland, at Altera Digital Health, added: “Once again, Medway has demonstrated remarkable levels of planning and determination to achieve two significant go-lives within days of each other, proving that digital transformation can be achieved in a matter of months, not years.

“We were delighted to support the talented team throughout this project and, with the help of our other NHS clients, provide best-practice guidance and advice based on recent experience.”