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Hospital ‘axes the fax’ with paperless clinician-to-clinician referrals

Northampton strengthens clinical collaboration for faster, safer care with CareFlow Connect.

Northampton General Hospital NHS Trust (NGH) has replaced a paper-based internal referral process that relied on fax machines with a secure paperless system powered by System C’s clinical collaboration system – CareFlow Connect.

With the new system, internal referrals can be completed and sent between clinicians electronically in real-time on mobile devices with improved clinical coordination that delivers faster, safer care.

NGH operates out of one main hospital site which provides general acute services for a population of 380,000.

Rationale

Before introducing CareFlow Connect, NGH used a paper-based system, called green cards, for clinicians to contact each other internally if they wanted to refer a patient to a colleague from a different speciality for diagnosis and/or treatment.

The system consisted of filling out a form that was printed on green card, hence the name, and faxing it between departments for a team member to pick up and review. If the review was deemed urgent the clinicians would call the clinician or speciality and then follow this up by faxing the green card with the relevant information. Unfortunately, this approach meant that non-urgent referrals could take longer to be reviewed and delay a response.

The physical faxes were not always legible due to people’s handwriting. Lines could appear on the fax paper, owing to the outdated equipment, that would obscure vital information which caused referral delays while staff spent time clarifying details. NGH was also unable to gather any metrics on the number of internal referrals being made and how quickly they were being actioned.

NGH decided that a more efficient and safer system needed to be adopted. In addition, it needed an electronic solution to support the Trust’s commitment to becoming a paperlite organisation.

Solution

Clinicians reviewed several solutions and decided to go with CareFlow Connect to resolve the challenges NGH was facing. On top of its functionality, deciding factors included the fact that CareFlow Connect is a very intuitive app, like Facebook and WhatsApp, and also that it can be integrated with the CareFlow Vitals e-observations system, which the hospital was already using to record patient vital signs.

CareFlow has enabled NGH to create specialty teams and invite the clinicians in each specialty to join their team and send patient referrals using SBAR (Situation, Background, Assessment and Recommendation) format.

Clinicians within the relevant group are notified of a new referral as soon as its been submitted, either by email or by a push notification on their mobile device. The clinician on duty can pick up the referral, review it, ask for more information if required and accept/decline/cancel the referral. Like the previous process, if a referral is urgent the clinician will call the relevant speciality to discuss and then complete the CareFlow referral as confirmation of the discussion. All referrals are visible and leave an audit trail.

The improvements and benefits

Improved efficiency and patient safety CareFlow Connect has replaced handwritten information with clearer electronic text which avoids ambiguity and delays that could put patients at risk.

Referrals using the real-time system can be dealt with in much shorter timescales. For example, the system delivers the referral instantly rather than via slow fax transmissions and physical green cards with vital information can no longer be mislaid and cause delay to patient care. Anyone within a group can review a referral making the response turnaround time quicker as the system doesn’t rely on a physical green card being delivered to one individual’s desk. Clinicians can also respond wherever they are, when it’s convenient, using their mobile device.

Supports national IT initiatives and strategic objectives

Adopting CareFlow Connect is part of NGH’s strategy to meet the national target for removing fax machines from NHS Trusts. The solution supports the NHS Long Term plan by delivering timely clinical information when and where it is needed and paperless working.

Improved metrics and audit

NGH now has visibility and traceability of internal referrals which it couldn’t previously capture. To date there have been 10,690 referrals sent between the specialities. The new data will help to inform process improvements and efficiency gains. The system is completely auditable so that staff can see who has viewed or updated the information.

Ease of use and cost savings CareFlow Connect’s intuitive design meant that NGH didn’t have to engage in a comprehensive training programme prior to implementing and the go live went smoothly, with very few issues recorded. Users were also happy that they could download the system onto their personal mobile devices rather than having to carry an additional device and Northampton had the added benefit of not having to buy additional hardware.

The system can be accessed via a web link or through an app. Because it is a cloud-based solution, no information is stored directly on any mobile device and there is a two-factor authentication in order to log onto it.

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