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Cardiology Team win Silver Award

Outpatients aim to Never Let a Slot Go Free

ICE Update

Blanche Heriot Unit goes Paper Free

Dates for your Diary

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November 2011


Cardiology Team win Silver Award for Ashford and St. Peter’s

Ashford and St Peter’s Hospitals NHS Foundation Trust’s Cardiology Department is the proud receiver of the ‘Silver Award’ for being the first centre in the UK to register over 100 active users on the Biotronik Home Monitoring systems for pacemaker and ICD (Implantable Cardiovertor Defibrillator) patients.



The team were presented with the award at a short ceremony at St Peter’s hospital on Friday 21st October. Ian Clement, Lead Cardiac Physiologist at the Trust, commented: “This pacemaker and ICD service we run using the manufacturer Biotronik is currently at 138 patients. We are the biggest centre for Biotronik Home Monitoring and only need to have 150 patients to receive the ‘Gold Award’.” In August 2010 there were approximately 80 patients using the service, and since then Ian has driven this forward by recommending home monitoring to all appropriate patients.

The home monitoring device works alongside all Biotronik pacemakers and defibrillators and is placed at patients’ bed sides. The monitor transmits readings via a satellite to the Biotronik control centre in Berlin, Germany, which then gets sent back to a computer at the hospital loaded with Biotronik software. Being able to follow a patient’s heart rate remotely allows the detection of atrial fibrillation before the patient really notices. Device malfunction can also be detected before it becomes an issue.

Biotronik Home Monitoring was first introduced to St Peter's Hospital in 2004 as a result of the Home-CARE trial. We currently have the largest number of patients on Biotronik Home Monitoring in the UK, and still growing. this month we received a Silver Award for being the first centre to recruit over 100 active patients. Our current number stands at 141, leaving 9 more to go until we receive our Gold Award.



Home Monitoring is an essential tool in patient device and rhythm management. The patient has a small modem sized monitor that sits beside their bed sending messages via satellite to our database in the department. It allows early detection of any potential device issue, or heart rhythm disturbance - particularly AF. In patients without Home Monitoring, they may go up to a year without having their AF detected. With Home Monitoring, alerts are sent as soon as the rhythm has been detected, so that appropriate action can be taken. This may also reduce the number of times a patient has to physically come to the clinic to have their pacemaker or ICD checked. At St Peter's, we offer any patient, if deemed appropriate, Home Monitoring (if their device supports it).

A delegation from the Trust, including Ian Clement, presented the subject of home monitoring to over 100 attendees in a symposium at the Heart Rhythm Congress 2011, which was held in Birmingham at the beginning of October.



Outpatients aim to Never Let a Slot Go Free

Ashford and St Peters Hospital Trust has embarked on a major efficiency drive within its Outpatients Department, with the principle of ‘Never Let a Slot Go Free’, the Outpatient Efficiency Project’s desired outcome is to run planned clinics in core hours where appointment slots are fully utilised.

In doing so, the Trust will be able to offer patients an enhanced experience and appointments which are competitive with local best performing providers.



Ashford host 200 clinics per week and has 120,000 patient attendances a year. At St. Peter’s there are 220 clinics per week, with patient attendances totalling 150,000, so it is imperative that these attendances are managed effectivley and efficiently.

The project will be looking to deliver the following efficiency savings and associated improvements:
  • Improving Patient experience by reducing waiting times and complaints.
     
  • Reduction in DNA [Did Not Attend] rates
     
  • Standardisation of Outpatient Clinic Templates – ensuring clinics run to time
     
  • Avoid lost revenue by adhering to the New to Follow-Up ratios in line with National Guidelines.

The initial phase was to implement a telephone reminder service, providing all patients booked in for a first appointment with a reminder call, using recorded message and providing the patient with options to confirm, cancel or request to speak to someone (an “agent”), who can deal with their reminder. If this call is not answered, or the call is not completed, it will be retired twice at different times, and then an attempt will be made to call the patient to discuss the appointment with them.


Whilst there have been a few minor issues with the system, the feedback from patients has been very positive and Hannah Donoghue, the Patient Access Manager for the Trust who has managed the implementation is pleased to report a major reduction of around 35% in DNA’s over the first 6 weeks of the service.

An additional benefit of the services has been the ability to be notified of cancellations and book other patients into the freed up slots.

The second phase of the project is to look at the processes and procedures that the Trust use to manage from referral, through booking and clinics, treatment etc. to develop an effective and efficient patient journey and patient experience.

By following the Trusts EQUIP service improvement framework, the plan is to build on work underway with Ophthalmology and Dermatology and roll out across the other specialties over the next 6 months.


The key performance indicators for the project are to see, along with a reduction in DNA rates:
  • increased clinic utilisations,
     
  • increased self booking via Choose and Book
     
  • reduction in late Clinic Cancellations by the Trust
     
  • reduced over bookings into clinics
     
  • improved performance relating to the Waiting List (RTT) targets
     
  • first to follow-up ratios that meet national targets
     
  • patients seen on time in clinics
     

These objectives will be achieved by introducing standard operation procedures across all specialties, using existing technology where applicable and ensuring adherence to relevant Trust policy.

The very nature of this project, working across multi-discipline, multi-specialty services is in itself complex, but added to this are other corporate projects, such as a refurbishment of the Outpatients department at Ashford, improved signage and various workforce reviews have resulted in the need for a collaborative approach to the project.


Further details will be provided in future editions of GP news, but in the meantime if you need any further information relating to this project please contact:

Hannah Donoghue, Patient Access Manager
e-mail: hannah.donoghue@asph.nhs.uk

or

Pam Coward, Appointments Centre Manager
e-mail pam.coward@asph.nhs.uk



ICE Update

We would like to make GPs aware that we recently had an incident whereby a GP selected the wrong patient on the Pathology ICE requesting and reporting system. The surname and forename were the same and the patients lived in the same street, and the correct patient did not notice that the date of birth was different when the GP checked the details. Blood was therefore sent to the path lab with the wrong patient details attached.

The results were abnormal and the path lab contacted Thamesdoc who went to the patient’s home, only to find that the patient had not had a blood test.

At this point the GP was contacted who realised they had made an error when selecting the patient details on the computer.

The correct patient was contacted and no harm had come to the correct patient.

We would be very grateful if GPs could double check that they are using the correct data when requesting tests. A good failsafe (and a requirement of the Trust’s specimen labeling policy) is to ask the patient to state their full name, date of birth and postcode and cross check the information with the system, which should prevent a reoccurrence of this issue.




Blanche Heriot Unit goes Paper Free

For some years, the Blanche Heriot Unit (BHU) has worked towards a paper free environment ... this has now been achieved!



Since 1 September 2011, BHU has been paper free for all genito-urinary medicine (GUM) patients.

There is no change in the ways of accessing the service and GPs can still refer by paper referral or by filling in the referral form on the Trust Extranet.

This means that patients’ medical notes and registrations are stored electronically. All documentation has been scanned, which means no filing.

The department even uses mobile technology to improve the service for patients. Appointment reminders and results are sent by text to patients. Patients can also text back to change or cancel their appointments, reducing the DNA rate.

The computers at BHU have separate systems - one connected to the hospital and the other to the unit only. This is due to the nature of information handled.

They back their system up twice a day and a disaster recovery plan is in place.


Dr Jillian Pritchard stated, “100% commitment, hard work and determination has been put in by the whole team, with particular mention to our Systems Co-ordinator Shirley Cumming.

The new system is working really well and although at times it has been stressful it has been totally worth it.”

A new web site has also been launched which gives details of clinic opening times and plenty of other helpful information. It can be accessed through the Trust web site or directly at:


Dates for your Diary

Ashford (Education Centre) Subject Speaker(s)
Thursday 10th November 1:00pm SPOTTING THE SICK CHILD
Managing Acute Respiratory Infections in the community: when to refer
Dr Tariq Bhatti
Consultant Paediatrician
Ashford & St Peter’s Hospitals
USING ANTIPYRETICSPCT Pharmacists
1:45pm SAFEGUARDING CHILDREN Dr Tara Jones
PCT lead GP for Safeguarding
Wednesday 7th December 1:00pm DEMENTIA – Legal issues: consent and capacityDr Rejin Dayandanan
Consultant Psychogeriatrician
PRESCRIBING in DEMENTIA UPDATEPCT pharmacists and Dr Dayandanan
1:45pm END OF LIFE CARE IN THE COMMUNITY FOR NON CANCER PATIENTS Dr Fiona Bailey Consultant in Palliative Care ASPH
St Peter’s (PGEC) Subject Speaker(s)
Tuesday 6th December 2011
12.45pm start
Ophthalmology (programme TBC) Mr Mike Tappin
Mr Namir Kafil-Hussain
Thursday 8th December 2011
19.00—21.00
Revalidation update for locum, salaried and ST3 GPs. See separate flyer for full details


Car Parking

With the introduction of the new barrier car parking, the situation has greatly improved for patients and visitors to the Trust. If you are attending an educational event please display your ASPH Parking permit and park in the car park with a barrier. Tickets to allow free access out of the barrier car parks are available from Gladys Essien in the PGEC at the end of each session.



Contacts

You have any feedback or require any further information about the Ashford and St Peter’s NHS Hospitals Foundation Trust or require this document electronically please contact:

Sue Robertson,
Marketing Manager
01932 722420
Sue.Robertson@asph.nhs.uk

Debbie Beesley,
CAB Manager
01932 723511
Debbie.beesley@asph.nhs.uk