Dementia assessment tool deployed at Nottingham trust

Nottingham University Hospitals NHS Trust goes live with Nervecentre solution

Nottingham University Hospitals NHS Trust (NUH) has gone live with a dementia assessment solution from Nervecentre.

The mobile solution, which NUH has adopted as a strategic information and communications tool, has automated the assessment process, ensuring that every person over the age of 75 admitted into one of NUH’s emergency pathways is now evaluated for risk of dementia. In doing so, not only is NUH now able to meet the National Commissioning for Quality and Innovation (CQUIN) targets set by its local commissioning board, but the trust is also better able to ensure individuals are getting the most appropriate care, positively affecting health outcomes.

In April 2012, the National Commissioning Board announced its CQUIN plan aimed at identifying people at risk of dementia, assessing those individuals and referring them for further prognosis if necessary. The plan stipulates that within 72 hours of a patient over 75 being admitted into an emergency pathway, a dementia assessment must be carried out by a junior doctor and a notification sent to the relevant GP. With NUH needing to evaluate approximately 1,000 patients per month, finding a comprehensive and intuitive solution was important.

Increasing awareness around dementia as people are admitted to A&E is incredibly important as a correct assessment and prognosis within the first 72 hours can make a huge difference to the patient’s care pathway and health outcome

Andrew Fearn, director of ICT services and senior information risk owner, said: “Increasing awareness around dementia as people are admitted to A&E is incredibly important as a correct assessment and prognosis within the first 72 hours can make a huge difference to the patient’s care pathway and health outcome. However, as this is a new requirement, getting the process right when faced with the very high volume of patients that we have is a challenge. Automating it and making it so simple that it is a natural adjunct to the clinicians’ existing tasks was key.”

The solution automates the way in which the tasks are allocated to junior doctors, with the four-question dementia assessment then being carried out using a hand-held device at the patient’s bedside – providing both a full audit trail and speed of response.

Nervecentre operates on NUH’s existing wireless infrastructure and takes a live feed of all the new relevant admissions from NUH’s Patient Administration System (PAS), therefore capturing all patients that need assessing. This generates a task for a junior doctor to do, which is sent to the doctor responsible for the patient. The doctor completes the assessment on their mobile phone, which in turn determines whether the patient requires any follow up or not. Based on that, a notification is sent directly to the GP.

Nervecentre means we can be 100% confident about which doctor the task was assigned to, when it was communicated, when the assessment was carried out, that it was carried out appropriately, and what the result was

Fearn said: “The first and main thing for us is that everyone over the age of 75 who comes in on an emergency has a dementia assessment. From a clinical point of view that helps determine how well their care is being managed and it makes sure that they’ve got the appropriate care and that they are put in the right place. Nervecentre means we can be 100% confident about which doctor the task was assigned to, when it was communicated, when the assessment was carried out, that it was carried out appropriately, and what the result was.

“The other benefit is that it can easily be converted to undertake other assessments moving forward. As an organisation, we have many different assessments to do and the number is only likely to increase. The problem with a lot of IT is that people need to sit, learn and understand the product and system before they can get on and do the work. Nervecentre makes communication simple and it puts real-time task management information physically in the hands of the clinician on a device they are comfortable with.”

NUH has adopted Nervecentre as a strategic information and communications tool to facilitate not just dementia assessment, but also other applications that include hospital at night, portering, nurse call and specialist referrals, with further applications in development.

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