An integrated digital solution for scheduling and delivering cardiovascular procedures in real-time

Diagnosing and treating cardiac patients takes place in a unit’s cardiac catheterisation facilities, diagnostic procedure rooms and operating suites.

In most UK hospitals, demand exceeds scheduled time. This is made worse by inefficient working practices and the COVID-19 pandemic.

Facilities are also often under-used. In most units, only 66% of available time is devoted to active patient care.

Situation

Scheduling procedures is complex. A mix of elective, urgent and emergency cases need to be accommodated each working day.

This means that a system needs to, at a glance, reflect and communicate change in real-time to:

• labs
• wards
• co-ordinators
• doctors

Existing systems lacked a real-time response. This:

• caused delays
• created inefficiency
• increased costs
• missed opportunities for patient care

Using a patient safety checklist improves outcomes.

In cardiology, different procedures are best served by specific checklists, but this practice is often not the norm in the UK.

Most centres also have problems with inconsistent approaches to applying the checklist.

Centres do not have a robust way to monitor quality and compliance of the process and its team brief.

Aspiration

The Liverpool Heart and Chest NHS Foundation Trust (LHCH) wanted to simplify and centralise scheduling and tracking patients. The Trust wanted to do this when patients:

• arrive
• are prepared
• give consent
• have the procedure
• are discharged

The Trust also wanted:

• to introduce a single digital platform that updates in real-time and can be accessed by all staff using a web browser
• the platform to be natural and simple for staff to use, minimising training time
• to enable staff in all clinical areas to update the system for immediate seamless communication, without needing phone calls or pagers
• to present procedure-specific safety checklists in a visual and structured form to improve teamwork, culture and patient outcomes
• a simple to use and robust reporting suite to review performance over time
• to eliminate waste and treat more patients with existing resources

Solution

LHCH uses CareCube to simplify and centralise scheduling and tracking patients.

The software has 4 modules:

• scheduling
• patient safety checklist
• patient tracking status
• reporting for performance reviews and audits

The system has been used since 2018 and is central to the operation of the unit.

Each procedure room has a large touchscreen monitor. Using this, teams can complete checklists and exchange information at the team briefing and during the procedure.

Impact

With the introduction of the new system, LHCH increased the procedure ‘touch-time’ to more than 85%. This is equivalent to each procedure room gaining an extra working day every week.

Functionality

• CareCube is deployed to the local virtual server.
• It integrates with the hospital’s patient administration system and electronic patient record (EPR).
• Data can be exported from CareCube to other systems like EPR.
• A login and password is needed to access the system. This can be the same login system the hospital already uses, for example Windows login.
• Different permissions (read, edit or none) can be granted to users for each module.
• Local administrators have permissions to maintain local lists, like staff names.
• Raw data can be extracted for more unusual or complex analyses.

Capabilities

• CareCube allows all teams who schedule patients to the lab to work on 1 real-time system.
• Wards and labs are connected seamlessly as operating lists evolve throughout the day.
• The information is automatically exchanged which eliminates uncertainty and the need for multiple phone calls.
• Checklists are performed using CareCube’s visual interface on in-lab touch screens.
• A bespoke reporting module helps teams to identify, plan and progress service improvements with one-click reporting of key performance metrics. These meet local and national metrics.

Scope

Over 300 users interact with the system every working day.

The CareCube system has been successfully installed in the Lancashire Cardiac Centre and additional centres are in line to follow.

Key quotes

"Today we continue to benefit from the important data produced by CareCube which informs our decision making across a range of key metrics, supporting new efficiency initiatives and service developments. It is a testament to the leadership and clinical teams who work so hard to drive forward change."

Jeanette Broome, Cardiac Cath Lab Manager, LHCH

“The real-time nature of CareCube, that connects all of our teams both inside and outside of the cath lab, is already enabling us to seamlessly evolve our service and achieve improvements in the utilisation of our resources.”

Dr Billal Patel, Director of Cardiology, Lancashire Cardiac Centre

“I was facing a complex procedure. Being involved in the team brief gave me confidence in the team and in the level of planning and preparation. As a result, I felt safe and more confident.”

Mr A.G.O, a patient at LHCH

Find out more

Cath Lab Digest LHCH case study

Key contact

Professor Rod Stables, Consultant Cardiologist, Liverpool Heart and Chest Hospital

rod.stables@lhch.nhs.uk

Jeanette Broome, Cardiac Cath Lab Manager, Liverpool Heart and Chest Hospital

jeanette.broome@lhch.nhs.uk

Tim Coutts, CEO, CareCube

tim.c@carecube.co.uk