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Vitalpac improves safety at Croydon by improving patient observations

25 September 2017

Croydon Health Services NHS Trust deployed Vitalpac to ensure nurses take patient observations on time and in full. Since its introduction, observations taken on time increased from under 60% to over 85% for all patients. Observations are better distributed during each shift, with sicker patients receiving more frequent observations. At night, observations increased from 40% to 100% of those required. Over 99% of observations now include a complete set of vital signs, making the hospital safer for patients.

The problem

Inconsistent observations and unreliable escalations

Patient observations were inconsistently recorded at Croydon University Hospital. This problem was particularly pronounced at night. Six serious incidents had already occurred in the previous 12 months because staff  failed to recognise or respond to a patient’s deteriorating condition. These cases could have been avoided with better patient observation.

In hospitals, observation rounds are typically based on timing, not how ill a patient is. To measure sickness, nurses need to calculate an Early Warning Score (EWS). But this requires complex maths, and when done manually, is miscalculated up to 80% of the time.

The solution

The Trust overhauled their observation and escalation process using Vitalpac. All wards were completely paperless within six months, recording all information on Vitalpac.

To emphasise the system’s impact, the Trust introduced new ‘dashboards’ on each ward which display ward-by-ward information on the number of late observations, the percentage of night-time observations, responses to escalations of care and the number of patients admitted unexpectedly to ICU. The impact was immediate and impressive as ward staff  started competing to achieve the best compliance rates in the hospital.

Charles Soper, a consultant Physician at Croydon explains why Vitalpac was the obvious choice to improve compliance: “I saw Vitalpac and thought, ‘this is the future’. Vitalpac ensures that all vital signs are recorded on time, accurately and comprehensively. It calculates the EWS, eliminating human error and helping clinical staff assess how ill a patient is, and how to respond. There is great potential for scalability and sustained improvement using Vitalpac.” 

The results

More observations complete and on time, and a 300% increase in night-time observations

Night-time observations

  • Care for patients at night also improved
  • Nurses increased the number of observations taken on time by 300%

Timeline:

  • 2009 Observations taken on time just 60% in the day and 50% at night
  • May 2010 Trust deploys Vitalpac
  • 2011-12 Consistant increase in observations
  • 2013 90% day-time observations are on time and 100% complete night-time observations among the expected group

“Vitalpac really ticks all the boxes - it’s flexible, responsive and intuitive to use and the company has been an excellent partner throughout the process. We’ve met our quality and safety objectives, in terms of better handling of deteriorating patients. We are currently working with Vitalpac to explore what other problems they can help us solve.”

Dr Tony Newman-Sanders, Medical Director (at time of deployment)