Since introducing electronic observations software across the Trust’s two acute hospitals, East Sussex Healthcare Trust (ESHT) has seen marked improvements in patient safety – notably with reduced cardiac arrest rates and improving outcomes for patients.  Other benefits include smarter, more pro-active working and earlier interventions.  The software has also helped the Trust develop a culture of improvement, using real-time data to drive change.

The Trust’s implementation and use of CareFlow Vitals (formerly Vitalpac) by its Outreach Team is praised by the CQC as an area of excellence.

The Timeline

It took just over four months for ESHT to go live with Vitals across all 38 wards (781 beds across two sites).  All Trust wards were paper-free within 17 weeks of starting the deployment.

The Rationale

ESHT made the introduction of an electronic observations system a priority following a number of patient safety incidents. Dr Kate Murray, critical care consultant and chair of the urgent care board, said the most serious case was a 40-year old woman with a liver abscess who deteriorated on a medical ward with severe sepsis over the course of a weekend, only to be escalated to intensive care when she was peri-arrest.

“She died of multiple organ failure and I had to explain to her 16-year old son that we had made mistakes. It wasn’t comfortable.  However, we promised to learn from our mistakes and the bid for funding for ward-based electronic observation charts began in earnest.”

The Solution at East Sussex Hospitals

ESHT bought our CareFlow Vitals solution in 2014, and nursing teams throughout the Trust are using the software on iPods at the bedside and iPads at ward and Trust level. It provides:

  • Real-time, bedside capture of patient assessments & monitoring
  • Immediate calculation of National Early Warning Score (NEWS)
  • Guidance on next steps – when to repeat observations, when to escalate care
  • A view of data anywhere via hospital intranet, allowing for proactive intervention by specialists and outreach teams

The Trust says the solution’s ease of use and its interoperability have been key to user acceptance and its popularity with nursing staff. The Vitals software has been integrated with ESHT’s own in-house portal, so staff can either enter via the portal using a patient ID and view charts at the patient level, or they can go directly through the front face of the Vitals software and get a different, Trust-wide, view.

“Vitals has enabled us to embed mobile working and we now feel well-placed to springboard forward in terms of our use of clinical IT. Next steps include adding System C’s CareFlow Connect (instant messaging) capabilities, which will allow us to develop integrated workflows between teams. As an acute and community Trust, this is particularly exciting for us.” – Dr Kate Murray, critical care consultant and chair of urgent care board, East Sussex Healthcare Trust

The Benefits

Before implementing the Vitals software, ESHT was struggling with incomplete (32%) and delayed (40%) observations.  A massive 50-80% of those that were taken were inaccurate. And only 5% of observations were taken overnight. This performance led to a 46% failure to escalate and a 20% failure to respond.

Today the picture is very different. 99.98% of observations across the Trust are complete, 94% of them are done on time and NEWS scores are now 100% accurate.

“Many of the errors that led to our failure to rescue that 40-year old lady would now simply not occur.” – Dr Kate Murray

Next Steps

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