A&E Patient Monitoring System

The East and North Hertfordshire NHS Trust has implemented an A&E Patient Monitoring System, developed by Blueberry, to streamline the management of accident and emergency traffic and help achieve the Department of Health’s national target to treat, discharge, transfer or admit patients within four hours of arrival.

[ClickPress, Fri Sep 14 2007] The system consists of an interface to the Patients Administration System (PAS), a patient database and a whiteboard interface for the A&E staff, has helped the Trust reduce the number of four hour ‘breaches’, by providing a real time visual record of patient activity.

The length of time patients have to wait in A&E is one of the key issues for the health service and much effort has been put into improving these by hospital trusts.

In line with recommendations made in the Government's NHS Plan for England, a ‘see and treat’ incentive scheme has been in place since 2004, aimed at reducing A&E waiting times to within 4 hours. The Government incentive consists of an award of up to £100,000 to hospitals for meeting the four hour targets.

The East and North Hertfordshire NHS Trust had previously been recording patient information using a manual method of writing on a whiteboard.

Teri-ann Grange, who works for the Trust as its I.T. Projects Manager, wanted an automated patient monitoring system which would reduce the incidence of breaches to the 4-hour waiting limit, whilst also helping focus clinical staff in their frontline duties.

If successfully implemented, Teri-Ann planned to roll out the system to the Trust’s three busy hospitals: Hertford County in Hertford, the Lister in Stevenage and the Queen Elizabeth II in Welwyn Garden City.

Called ‘Klok’, the project was put out to tender in 2006 and subsequently won by Blueberry Consultants.

Key to the Klok system is the patient tracking software, which helps clinical staff identify and minimise the risk of breaches – whilst also aiding resource planning by A&E staff, who can see immediately the number and status of patients in the department.

Now, when a patient arrives in A&E, they are registered on the standard patient administration system (PAS) - which links to Klok. The patient’s movement through the A&E department is then recorded by Klok at every stage of treatment.

Teri-Ann Grange said: “The new Klok system allows staff to monitor the A&E department in real time, and to review and change any procedures that lead to breaches to the 4-hour rule.

“Now that the Klok system has been operational for some time at the Lister and QEII hospitals, the benefits are really starting to emerge. It’s substantially reduced the incidence of breach, and it’s seeing off some initial reservations staff had to using a computer-based system, particularly the concerns regarding having enough PCs to readily access the application.

“The features seen as most useful by our A&E staff is the ‘white’ display indicating the allocation of a doctor or clinician to a patient, and their accompanying medical notes. Patient care has been significantly improved because the Klok system shows requests for x-rays and medical records. Because the bed managers can also see the Klok system, the process of requesting and allocating beds has become more efficient.

“Incorporating actual Bed Management information and Medical Record Reports into the Klok system is a pending development, but seen as invaluable to our A&E staff.”

“To help integrate the system into our working practices, we’ve extended our equipment to include satellite PCs on trolleys, as well as large VDU screens.”

The system can also be used by other display devices, such as PDAs and mobile devices.

Teri-Ann Grange said: “Previously, it would have been a case of walking around with a pen and paper; now the Klok system gives us a visual cue as to what’s happening in the department at any instant. If someone is starting to near breach point you can take action immediately.”

Martin Green, Managing Director of Blueberry, said: “Blueberry is very pleased to be involved in this project. Using a web-based approach means that all A&E personnel now have real-time information on all patients in the department, allowing information maintenance and distribution by staff.

“The Klok system has become invaluable at the Lister and QEII hospitals as a tool to help keep waiting times within Government guidelines, and we now have the opportunity to supply this tested and proven system to other A&E departments throughout the country.”

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