New app will aid staff in early intervention of at risk patients

Chelsea and Westminster Hospital has gone live with a mobile web application that will enable staff to respond even quicker to patients at risk of reaching critical conditions in hospital.

The hospital has started rolling out 100 mobile devices to staff so they can use the ThinkVitals electronic observations tool to monitor patient vital signs. It is being used in the detection of patients at risk of being infected with sepsis, or at risk of deterioration and unexpected cardiac arrest.

Using the application on these devices, a nurse will enter a patient’s vital signs, such as heart rate and blood pressure. Clinicians are automatically alerted if these indicators pass a certain threshold, identifying those patients most at risk, which can help greatly reduce morbidity and patient care costs.

The devices will be used the hospital’s acute assessment unit (AAU) after completing a successful six-month trial within the department. During this pilot, the ThinkVitals team has worked in collaboration with staff at Chelsea and Westminster to develop an IT solution that works where it matters most – at the frontline of clinical care.

Dr Gary Davies, consultant in respiratory and acute medicine at the hospital, said: “By listening to clinicians and adapting an intuitive, user-friendly system to meet their needs, we now have a tool that can deliver significant improvements to patient care, and reduce mortality rates associated with sepsis.

“The complex nature of healthcare means there are challenges in implementing new technologies in hospitals, but by talking to the nurses and doctors using the technology, this has allowed clinical engagement to happen quickly and effectively.”

Chelsea and Westminster Hospital has a lower-than-expected mortality rate for the acuity of patients it sees, but continually strives to improve care. The hospital will use the system to support the treatment of sepsis, a potentially life-threatening condition which can affect the elderly, those recovering from surgery, and others in hospital. If not treated quickly, sepsis can lead to multiple organ failure and death. Each year in the UK around 37,000 people will die as a result of sepsis.

Prompt identification from known warning signs can support clinicians treat the condition in good time, which can help reduce the risk of death or long stays in hospital. ThinkVitals combines nursing observation and patient data to trigger an alert to clinicians when such criteria are met, enabling a rapid response from care teams.

“With severe sepsis, mortality goes up 7% for every hour that you delay treatment beyond an hour. The mobile application will allow people to intervene earlier,” said Dr Davies.

Sepsis identification and treatment is a new national performance indicator for the 2015/16 NHS Standard Contract for providers.

The system also sends an alert for deteriorating patients – who may be at risk of cardiac arrest – when their vital signs breach the National Early Warning Score (NEWS). NEWS is a standardised approach used by hospitals to identify people with acute illness, and is calculated from a defined set of vital signs measurements. The software features a countdown timer and alert system to support staff with recording timely and co-ordinated clinical observations.

“Doctors and nurses can now deliver responsive, patient-centred care by knowing who most needs their help, and where they are on the ward. Staff can be assigned to the right place at the right time,” said Tim Taylor, director of ThinkVitals.

“And by capturing data electronically, the hospital can help reduce errors and achieve its paperless ambitions.”

Health Secretary, Jeremy Hunt, has challenged the NHS to go paperless by 2018. The hospital is now saving administration time by removing the time-consuming process of recording clinical observations on paper.

ThinkVitals has been working with clinical staff at Chelsea and Westminster to tailor the product to meet their precise needs since September 2014. Staff have been using mobile devices and large e-whiteboards to see a ward view of patients, and their conditions, allowing easier and quicker identification of those at risk of deterioration, and targeting hospital resources more effectively.

The flexible software is able to draw real-time data from multiple sources, meaning staff can easily access a patient’s clinical observations of temperature; heart rate; respirations; blood pressure, standing or lying; SATS; last NEWS; blood glucose; weight; pain score; urine output; fluid balance; bi-level positive airway pressure (BiPAP); any supplemental oxygen, and lab results in user-friendly charts and reports.

After rolling out the system across the AAU, the hospital will look to extend use of the system into areas such as paediatrics and maternity over the coming months.