Background

Royal Papworth Hospital is the UK’s leading heart and lung hospital, treating more than 100,000 patients each year from across the UK. The hospital has established an international reputation for excellence in research and innovation, top surgical results and the very best patient care. One of the best ways to improve patient care is by pro-actively monitoring patients. The Early Warning Score (EWS) standard offers important tools in helping to identify patients at risk of deterioration, including sepsis, and in escalating them to get appropriate treatment as promptly as possible. NEWS2, the updated national Early warning scoring system in the UK, has been endorsed by NHS England and NHS Improvement, for use in acute and ambulance setting.

Challenge

When the hospital started to plan the move to a brand new, state-of-the-art building on the Cambridge Biomedical Campus in May 2019, they wanted to use the opportunity to improve their current EWS monitoring workflow. In the old setting, the EWS-observations were taken with mobile spot-check monitors and the nursing staff had to notify the ALERT-team (rapid response team) when certain key thresholds were reached and (urgent) clinical intervention was required. The goal after the move was to provide the ALERT-team with an easy-to-use tool for getting a hospital-wide overview of the most recent state for each patient, together with an automated system for notifications on patients whom require the follow-up of the ALERT-team.

Solution

The new workflow had to focus on keeping the advantages of EWS monitoring, while reducing the time spend to monitor, report and follow-up. To accomplish this, papworth hospital re-defined the workflow from start to finish.

In their new campus all rooms are now equipped with bedside EWS monitors. This facilitates the monitoring for the nurses and automates the communication of the measured parameters. All the captured parameters and combined NEWS2-scores are automatically sent to the M-ighty EAGLE-View dashboard. The EAGLE-View dashboard provides a realtime overview, showing the latest NEWS2-observation for each patient, in an application that runs on any PC or mobile device. Immediately when a new observation is received, all dashboards are automatically updated.

Following the NEWS2-guidelines, when an observation is received that requires the specialised follow-up from the ALERT-team, the EAGLE-View application triggers a notification to the mobile phone of the on-duty nurses of the ALERT team. From the notification, the nurse can access the patient’s detail with most recent EWS history and act accordingly. Using this secure notification system allows the ALERT-team to monitor patients hospital-wide, seeing EWS scores in real-time and focus on what is important.

By implementing this new workflow in combination with the new technology some impressive outcomes where realised: