Connecting care across Fife’s acute, community and mental health hospitals

TrakCareNHS Fife made a big step this year in connecting the care we provide across our acute, community and mental health hospitals. When we switched on our TrakCare patient information system in April, it gave us unprecedented visibility of all our beds and the location of our patients across the health board.

Crucial information has been moved away from the confines of pieces of paper and isolated legacy systems, to a point where vital details can be far better accessed online, in an appropriate and secure way, by those working to deliver the best for patients at the point of care.

The go-live, which happened across all 10 of our acute and community hospitals in a single weekend, was the result of a great deal of commitment, collaboration, preparation and planning.

Importantly, this was not about activating a piece of software – it is about supporting our healthcare professionals to deliver the best care possible by providing them with the building blocks to change how information is used in real-time to enhance workflow and ultimately achieve better patient outcomes.

TrakCare: meaningful real-time data for better care

The immediacy of real-time information is already having a significant impact. Real-time bed management provides staff with an accurate bed status across the health board’s acute, mental health and community areas, helping to manage capacity and ensure patients are discharged in a timely manner.

This live bed status means that we no longer need to look at different spreadsheets to manage beds on wards. Instead, clinicians can access a visual plan of beds to help prioritise their patients. Clinicians in the emergency department are too benefiting from much better visibility of where their patients are.

We are also saving valuable time in areas like the emergency department, where TrakCare is eliminating duplication in data entry. Staff are consequently freed up to areas of the hospital where they are most needed.

And we are better managing patients with specific conditions through TrakCare. Electronic questionnaires around stroke and diabetes, for example, have been built directly into the system. All of this is just the beginning. By consolidating once disparate information into TrakCare, we can do far more than we have ever done before with technology.

Moving to paperlite gradually

We are working closely with our clinicians and our technology provider to ensure that we get the most from the system. The TrakCare project has been a success to date because of buy-in at every level, right from our chief executive, through to frontline staff who understand the value of access to the right information when making decisions for and with patients.

We engaged in creative communications ahead of the initial deployment – including the use of ‘pink ladies’ – floor walkers dressed in hi-vis pink, who proved a valuable and visible resource during the go-live weekend.

Now we are continuing to support staff as we do more to remove paper from the hospital environment, moving forward paperlite ambitions in a gradual way.

Our next big milestone will be the digitisation of order communications, which will streamline the sharing of important patient results with clinical staff.

This will allow us to eliminate a lot of paper results, and take out manual processes. Currently we have a mixed economy of paper and electronic. Fully electronic requesting of tests from diagnostic departments like radiology will reduce the challenges that can be associated with paper – such as the possibility of tests going missing. We will have an audit trail, telling us when a result has been received and reviewed.

For the laboratory, we will have one system to manage appointments, and to highlight tests that have been requested, that are outstanding, and tests that show abnormalities requiring a clinical response.

Importantly, the system will also allow people in the acute setting to see when a request has been made from somewhere else. For patients, we will for example be able to see when they have had their blood test taken by their GP – meaning that we will not have to bleed patients unnecessarily.

A closer community for co-ordinate care

TrakCare is tried and tested in Scotland – with NHS Fife being the 11th health board to use the patient information system, provided by national technology partner InterSystems.

It brings us another step closer to a wider community of hospitals across Scotland, with which we can share learnings on how technology can be used to improve patient care. Unlike with our previous system, which was only used by NHS Fife, we can now collectively engage our technology partner to help us meet national healthcare objectives and to ensure we remain responsive to the needs of our own frontline.

TrakCare also means that we are better connected as a local healthcare community within the Kingdom of Fife, where we support 370,000 residents across a large rural area.

Having better, secure access to information is an essential part of delivering effective care. Our TrakCare deployment is a key component in modernising the hospital environment so that it can better respond to the needs of our clinicians and their patients.

Andrea Wilson is general manager for clinical support and access at NHS Fife.