Ensuring early intervention for deteriorating patients at NHS Fife
When vital signs observations are confined to paper charts, healthcare professionals have no way of quickly identifying the hospital’s sickest patients easily to ensure they receive the timely care they need.
Miya Observations and Assessments (formerly Patientrack) was introduced at NHS Fife in 2011 when a small pilot was undertaken to assess whether the system would raise awareness of deteriorating patients in their wards.
In 2017, NHS Fife adopted Miya Obs & Assessments to record Peripheral Vascular Catheter (PVC) management, replacing onerous manual processes. Nursing staff were instantly alerted when a PVC needs to be reviewed or removed, and wards starting achieving their process measures over 95% of the time.
Senior change nurses on each ward are now informed weekly of their ward’s compliance with local standards and the infection prevention team can focus their support on wards in difficulty.
Since introducing the PVC module, NHS Fife has rolled out similar initiatives to meet reduction targets set out by the Scottish Patient Safety Programme (SPSP)
“Ensuring a patient has an optimal experience in hospital and ensuring they do not come to any harm while in hospital are fundamental expectations. Patientrack in NHS Fife has improved the ability to identify any patients who are at risk of acute deterioration and helped improve our management of known risk factors which can lead to patient deterioration.
Since its comprehensive roll out to the acute receiving Victoria Hospital in July 2015, the system has seen the recording and communication of over 70,000 sets of patient observations per month. Sharing of this information has ensured that nurses and doctors are able to quickly see and respond with certainty to the patients who are most at risk. Since its launch, we have seen a significant increase in our ability to ensure vital observations are taken accurately and on time for all patients; our ability to make early clinical decisions has improved and our cardiac arrest rate has halved.”
– Gavin Simpson, Consultant ITU/Anaesthetics and project clinical lead
Pivoting during Covid
In March 2020, an additional 42 inpatient wards and day case areas were identified as potential beneficiaries of observation capture and use of the assessment tools. This included provision across six community hospitals (including one with three mental health wards); two mental health hospitals and one learning disabilities hospital. 450 staff were trained remotely with many areas also cascading training to their staff.
In partnership with Alcidion, the Scottish Paediatric Early Warning score (PEWS) was built as a new assessment. This was tested and validated by the service before going live in August 2020 – just four months from specification to implementation.
Since the first pilot in 2011, over 34 million individual assessments have been completed – streamlining processes, creating an audit trail, and vastly improving patient outcomes.