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Alder Hey’s vision to create the best experience and outcomes for children, young people and families
Alder Hey Children’s NHS Foundation Trust is a provider of specialist healthcare to over 330,000 children and young people each year. In addition to the hospital site at West Derby in north Liverpool, Alder Hey has a presence at a number of community outreach sites. The trust also provides inpatient care for children with complex mental health needs. The trust employs a workforce of 3,354 staff and, as a teaching and training hospital, there are around 1,000 medical, nursing and allied health professional students each year.
What were their aims?
The trust’s vision as a participant of the Global Digital Exemplar (GDE) programme was to offer exceptional care and experience to patients and families, supported and enabled by digital technology. They set out to do this by achieving three main goals:
- Improve patient safety and quality of care.
- Improve staff experience.
- Improve the experience of children and young people, and their families.
As a specialist paediatric trust, Alder Hey has unique and specific needs. Patient experience is critical and links directly to outcomes in paediatric care as when children are stressed or frightened, they are less likely to cooperate with treatment, sometimes causing delays and inefficiencies to the delivery of care.
What were the solutions and impact?
The trust delivered a number of varied technology programmes, to achieve each of their goals.
1. Improve patient safety and quality of care
The trust introduced “closed loop technology” to reduce human error when administering medications. The technology scans the barcode on a patient’s wristband and then verifies this against the medication being given to ensure the right person is getting the right drug. This safety measure has seen a 50% reduction in error since it was introduced. It also assists clinicians when taking blood, or giving a mum’s breast milk to babies. So far, the technology has been rolled out to all inpatient wards and nurses and other clinicians have given positive feedback, leaving the trust confident that the system is making medicines administration safer for patients.
Point of care devices have been integrated with the electronic patient record to save time and reduce transcription errors. This technology removes the need for clinicians to note down results or comments, and type them up later. Instead, results automatically feed through to the patient record. This frees up time for nursing staff to spend on direct patient care and reduces human error made when typing up results.
2. Improve staff experience
The trust extended the functionality of their Picture Archiving and Communication System (PACS) to include more images, making it easier and quicker for more clinicians across a range of specialities to find images. The PACS system originally stored images from radiology, but the trust extended this to consolidate images from other specialties including speech and language therapy and Gait Lab (videos and images for posture). Before this functionality was added, clinicians would print and scan images onto records and computer files. Now, images are immediately available on PACS, saving clinicians time and making it easier to find what they need. To date, an extra 2,154 images have been made available.
The trust has worked with 52 of its specialities to digitise their processes, removing most paper, and enabling clinicians to access and review information at their fingertips. This work involved working collaboratively with clinicians to develop bespoke digital packages to suit the needs of the individual specialities. Staff satisfaction is high. Within the gynaecology department, a survey has shown 93% positive responses to this digitisation, and within the emergency department, staff experience has improved by 29%.
Key medical devices have been electronically tagged so they can be easily located, saving staff unnecessary time and frustration searching for equipment they need. Expensive and high end investigative machines, such as cardiology equipment, are regularly moved around the hospital. This electronic remote tracking will mean equipment can easily and quickly be found, so staff do not have to spend time searching for it. This saves them time and means patient care can be delivered more quickly.
Over 700 staff are now trained on Attend Anywhere for virtual consultations. This means staff can work remotely and patients can attend appointments from home. The trust sees 4,500 appointments held remotely via Attend Anywhere every month.
Alder Hey’s Share2Care system has been extended across Lancashire and Cumbria, enabling clinicians to access all the same information in one place. Alder Hey has built and hosted Share2Care on behalf of many partner organisations. Information available on the system includes patient medications, allergies, results, reports. Already there are a huge number of organisations making use of the shared data:
- 21 Clinical Commissioning Groups
- 640 GP Practices
- 27 NHS Providers
- 13 Local Authorities
- 1 Academic Health Science Network
- 8 Universities
- Shared support services
3. Improve the experience of children and young people, and their families
The trust introduced Alder Play, an app that provides entertainment to children and young people. Designed by the children, young people and families of Alder Hey, Alder Play is an app that provides entertainment and distraction on a rewards-based system. It helps to improve a patient’s overall experience when receiving care, and is something they can continue to use at home.
The trust has also made use of virtual reality headsets as distraction therapy for apprehensive patients. One of the common challenges in phlebotomy or dressing clinics is the nervousness felt by young patients. This not only impacts patient experience but also increases the time needed to deliver care. Virtual reality headsets show films tailored to the patient (roller coasters, dinosaurs, games) and help distract them whilst clinicians take blood or change dressings. The success of this technology means it has now been deployed to A&E and ICU where it is expected to continue to improve patient experience and save time, reducing waiting times for these clinics.
Alder Hey’s vision remains the same, to create the best experience and outcomes for children, young people and families. They intend to build on their successes from the GDE programme and continue on their journey to improve patient safety and quality of care, improve staff experience, and improve the experiences of children, young people and their families.
Given the move throughout the pandemic towards remote consultations, the trust will harness this work to bring virtual consultations to the emergency department, and develop portals for patients to use from home.
As a trust that role models the digitisation of services, and the development of its staff, the team are also keen to share learnings and support other trusts and local systems to follow in their footsteps.
“VR headsets have been able to help reduce distress in the changing of burns and trauma dressings.” Simon Minford, Advanced Paediatric Nurse Practitioner
“The Bedside Verification project has been a great innovation to be part of. It was not without its challenges along the way however, working together alongside the Digital team, we were able to overcome these barriers and issues and turn it into the great success it is today, improving the safety of our Children, Young People and Families” Jennifer Holden, Advanced Paediatric Nurse Practitioner