Midlands Partnership NHS Foundation Trust uses mobile EPR app to reduce administrative burden, increase efficiency and improve wellbeing
Background
Traditionally, community nursing staff in Midlands Partnership NHS Foundation Trust (MPFT) would return to an office after every visit to access and update patient records. This process was very time-consuming and created an administrative burden that impacted the number of patients they could see per shift. It was common for nursing staff to update patient notes in their own time, increasing the risk of staff burnout.
Situation
Returning to an office to update and view patient records before and after visits was proving to be a significant strain on resource. Not only were community nursing staff unable to see as many patients in a day as they needed to, but there was also a higher risk of misfiling or forgetting information. There were also significant environmental costs linked to this, such as unnecessary travel and paper use. Using laptops to access electronic patient records during home visits required a Wi-Fi connection, which was not always accessible.
Aspiration
MPFT wanted to reduce the administrative burden on its community nursing staff by enabling them to access patient records at the point of care and make real-time updates during appointments. For this, it required a mobile app that would provide offline access to its EPR for when connectivity wasn’t available.
Solution and impact
Access Rio offers a Rio Mobilise app that provides mobile users with access to appointment data for the patient they are seeing, assessment forms and progress notes, even when offline. Once the information has been updated and if the device has connectivity, then the patient record will sync with the Rio EPR. If the device does not have connectivity, the data will be cached on the device until connectivity is restored. Rio Mobilise is being used by community nursing staff at the Trust to make it easier to access and review patient records before, during and after home visits. The software is used on a portable tablet which allows staff to digitally take notes and access patient information. Mobile management of the solution is powered by Totalmobile who have supported the Trust in mobilising assessment forms and progress notes into the application, and they were integral to the implementation and training process.
Since providing the software and tablets, the trust has seen an 8% cost reduction in mileage claims. Staff visits to base have reduced by 15%, and there has been a 35% reduction in printing costs.
The impact that Rio Mobilise has had for nursing staff at MPFT is significant. Based on the data of 12 staff using the solution, it has considerably reduced the amount of admin time per consultation, allowing 165 extra patient visits per nurse, per year. Staff are able to start and complete everything necessary with patients at the point of care through the app. This enables better quality care, better service and leads to better outcomes. Patients also feel more reassured as a result of activities such as referrals, or equipment sourcing being completed immediately during appointments.
Rio Mobilise has been a key factor in boosting morale across the Trust. With a higher likelihood of completing work on time staff are reporting higher satisfaction rates. Using the software, they feel like they can monitor patients with assurance, without risk of miss-filing or losing paper notes.
A senior staff nurse at MPFT said that with the software
you know that when you go into see a patient you’ve done everything before you leave, instead of thinking I’ve got a thousand notes in my pocket that I need to do when I get back to the office.
The innovation saw a big change in technology usage and behaviour for the nursing teams. Due to staff having varied levels of digital literacy and confidence, a robust training programme was required to equip staff with the skills to use the app and tablets effectively. A thorough virtual and in-person training programme has led to roughly 716 devices out of the 796 deployed being used regularly.
Jack Gould, Senior IM&T Project Manager at MPFT highlighted the role collaboration has had on the success of the roll out:
The real success of Rio Mobilise stems from collaborative working, which has been in place from the very start of the project. MPFT’s digital and nursing teams have worked closely together to consider what is needed from the application. We wanted to look into how digital note-taking can help staff free up time. As we worked closely with nursing teams, we have received widespread support for the solution from nurses. Nursing staff have endorsed, championed and encouraged others to adopt the application into their regular working day.
Functionality
The Rio Mobilise app:
- Works on any tablet.
- Loads almost instantly.
- Works offline, so patient notes can be accessed and updated even when there is no signal.
- Is portable and secure.
Capabilities
The Rio Mobilise app enables nursing staff to:
- Record and access patient notes at the point of care.
- Efficiently record patient information quickly and easily, on forms designed for mobile devices.
- Reduce staff admin time meaning they can see more patients every day.
- Send referrals and equipment orders while staff are with patients, reassuring them that they are receiving the necessary care.
Scope of capacity
- The software can be used by trained nursing staff.
- It is for use during patient visits which can be in the home or in care homes.
Key learning points
- This software shows the importance of remote and digital note-taking in increasing efficiency levels across the trust.
- Allowing staff to take notes remotely with assurance of them being recorded securely and accurately significantly frees up their time, allowing them to see more patients.
- Mobile access to appointment data for patients, and progress notes reduces printing costs and mileage claims by staff.
- It is important not to underestimate the need for virtual and in-person training which should be delivered on the user's terms, at a time and place convenient to them.
- Peer support was crucial in encouraging nursing teams to adopt the software and commit to training for the technology.
Digital equalities
- Virtual and in-person training is offered to support staff with varying digital experience adapt to the technology.
- A number of early adopters within the teams with good digital skills were identified to provide enthusiasm and support.
- Peer support is highly effective and far better than solely relying on digital training specialists during implementation.
Key figures/ quotes
After implementing Rio Mobilise:
- Based on a data set from 12 staff, there have been 165 extra patient visits per nurse, per year.
- Milage claim costs have been reduced by 8%.
- Staff office visits have been reduced by 15%.
- Printing costs have been cut by 35%.
Rob Ratcliffe, Clinical Lead and District Nurse at MPFT said:
It’s completely changed the way we document within community nursing services, which enables us to provide better quality of care, better service and better outcomes for patients. The app starts virtually straight away; there’s no waiting for it to load and the battery life is so much better. When we arrive in a patient's home, we can review notes easily. We can then start the visit and complete all our notes within the patient’s property, and then end the visit at that point. So, there’s no bringing back paper, there’s no filing, and it reduces the fact that staff have to return back to the office throughout their working day. We find it reassures patients. The fact that we can send off referrals straight away rather than having to wait to get back to an office gives patients reassurance that we’ve taken them seriously and that their referral has been sent. I think the ability to use an app and have those notes on a clinical system straight away, at the point of care, is a far safer way to do any form of nursing documentation.
Amy Machin, Staff Nurse at MPFT said:
As long as my contacts are on, I can complete my work no matter where I am, without signal. In our team it’s benefitted staff morale because we’re not having hours of administration time. If we have a poorly patient who needs some urgent equipment, I can open the tablet up, order the equipment, and reassure the patient that it’s been done.
Michaela Whitehurst, Senior Staff Nurse at MPFT said:
It benefits me because it helps me manage my time better. You know that when you go in to see a patient, you have done everything for that patient before you leave instead of thinking I’ve got a thousand notes in my pocket that I need to do when I get back to the office. If there’s any issues, or there’s anything you need to take in or to check up on, you can do it because you’ve got the information right there in front of you. I don’t feel as stressed since using the tablets. My morale is up, I feel good to be working here.
Find out more
Key contact
Jack Gould, Senior Information Management and Technology Project Manager, Midlands Partnership NHS Foundation Trust
Jack.Gould@mpft.nhs.uk
Lee Meredith, Head of Product for Healthcare, Access Health and Social Care
lee.meredith@theaccessgroup.com
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Page last updated: October 2022