Improving Access October 2017 HAVE YOU REGISTERED YOUR CAR FOR - PowerPoint PPT Presentation

Improving Access October 2017

HAVE YOU REGISTERED YOUR CAR FOR PARKING???? New regulations are in place and although the parking is free, you do need to enter your registration number at the parking machine, if not you WILL incur a fine!

Live participation: How to use Slido • Connect to Somerdale Pavilion wifi network on your laptop, tablet or smartphone: Network: SOM_Guest Password: Aqu4t3rr4 • Open slido.com • Enter the code: #GPClusterOctober

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Running order 2:00 Welcome IT changes at RUH – Dr Mike Price 2:05 2:30 3 Straw Men 2:50 Questions 3:00 Breakout 3:45 Tea 4:15 Development of draft model 4:45 Next Steps

The Big 3 IT changes @ RUH

Roll-Out of the Electronic Patient Record – The Big 3 Mike Price, SRO for FirstNet, CCIO (EM doctor)

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD Context The Trust is already one of the most  digitally advanced in the region. However, it recognises there are  significant quality and financial benefits in the extended use of digital technology. The current capital plan allocates £6.5m  to IM&T projects and infrastructure in 2017/18. The Trust plans to invest £11.3m capital  in IM&T over the next 5 years.

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD Big 3 We’re proposing to add the following additional functionality into the Trust  EPR, starting on Saturday 4 th November Electronic Prescribing & Medications administration (ePMA)  Emergency Department – full replacement of Patient First with Millennium version  (FirstNet) Requesting & endorsing radiology & pathology in Millennium (Order Comms)  Detailed planning over the sequencing of the Big 3 roll-out is underway, and  will be informed by a lessons learned paper from our provider (Cerner) The Clinical Informatics Board (and the 3 clinical Project Boards for each  project) has considered the options for deployment, and our plan is to implement the roll-out over a 2 week go-live period

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD High-level Roll-Out Plan Sat 4 th Nov Sat 18 th Nov 3-4 days later i. Prep Phase ii. ePMA Go-live iii. ED & iv. Post Go-live Order Comms Go-live Up to 650 inpatients’ meds will need to be transcribed Significant We’ll need to Likely that change for train c2,500 flow will be ED – likely impacted – clinical impact on 4 colleagues how we hours minimise and We’ll need correct? c150 Super- Users to cover a 12 hour period

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD Why are we doing it? Shared diagnosis, assessment, Already generic benefits in ICE Legibility and consistency of risk alert information from ED for Moving into Millennium will save information. inpatients time and errors by not having to Clinical Decision Support. Reduction in the use of paper switch between two systems notes Real-time Information and Enables the use of mobiles devices Reporting. Streamlining of the process for that will reduce transposing results booking and moving patients into onto paper Improved patient outcomes. the hospital Endorsing of results in clinician Improved patient flow. ‘message centre’ Simplification of booking outpatient Full audit and alerting capability. referral from ED Ability to combine orders for tests Reduction in Missed Doses. with requests for medication – Reduced interface issues between Patient First and Millennium develop condition-specific order Reduction in Medical errors. sets Enables further tools to support Reduced printing of paper charts bed management

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD Summary of changes for external partners ePMA FirstNet • New discharge summary format • Tabular format to show prescribing record (meds on • Electronic distribution of discharge summaries admission, prescribed during stay and TTAs on • Compliance with new Emergency Care Data Set discharge summary) (ECDS) reporting requirement • 4 hour impact • Removal of FP10s for patients receiving prescriptions to be dispensed by RUH outpatient dispensary Order Comms Within the RUH and our Community Services we will: a. Stop ordering Pathology and Radiology Tests on ICE and Start ordering on Millennium b. Start endorsing all results on Millennium improving Patient Care and Safety GPs will continue to use ICE both to Order Pathology and Radiology Tests and view results (including results that were ordered by clinicians at the RUH) GP Practices will no longer be able to print labels from ICE for tests that were ordered at the RUH - Given this Patients who needs bloods to be taken at the GP (but ordered at the RUH) will be given the appropriate Pathology Labels by the RUH to take to the GP Practice

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD Reporting (learning from other sites)

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD Risks There are significant risks associated  with any IM&T deployment. The Trust can build on successful  previous deployments. Further work is in progress to quantify  and mitigate all known risks to patient safety, experience, flow, reputation and finance. Risks are being managed through a  agreed programme structure HOWEVER A large part of the success of this  deployment will rest on the ability of the organisation to engage with the planned changes in work flows.

ROLL-OUT OF THE ELECTRONIC PATIENT RECORD Thanks – Any Questions?

Improving Access Timeline June 2017: CCG / NHSE, Cluster meeting / Your Health Your Voice engagement sessions Summer 2017: Review of feedback within CCG / NHSE • BEMS update to August Cluster meeting summarising feedback so far Autumn 2017: • Further engagement sessions at Cluster / Primary Care Forum • NHSE GPFV Time for Care session 14 Nov • Options discussed and agreed Autumn / Winter 2017: Refined plans submitted to NHSE • NHSE procurement webinar 21 Nov Schemes mobilised during 2018/19 to be at full capacity by 31 March 2019

Example 1 – Oxfed - Oxfordshire CCG • GP Federation - 1 practice based hub • Multidisciplinary Staff Model – GP appt available at all times - 24% of capacity Core Requirement Delivery Model Met 210,000 population – 106 Hours ✓ minimum additional 30 minutes consultation capacity per 1000 population, rising to 45 minutes per 1000 population 30 mins per 1000 population weekday provision of access to pre-bookable and same day ✓ 5pm - 8pm weekdays (1 ½ hours in core, 1 ½ hours in “evening”) appointments to general practice services in evenings (after 6:30pm) – to provide an additional 1.5 hours a day ✓ weekend provision of access to pre-bookable and same day 10am - 3pm Sat & Sun appointments on both Saturdays and Sundays to meet local population needs ✓ provide robust evidence, based on utilisation rates, for the Open 25 hours per week proposed disposition of services throughout the week 31% capacity in Core Hours 31% in Evenings 38% at Weekends Core Evening Weekend Hours Open / Total Mon Tue Wed Thu Fri Total Mon Tue Wed Thu Fri Total Sat Sun Total Workforce Hours Hours Mon - Fri Mon - Fri Sat -Sun Hours Hub Open 1.5 1.5 1.5 1.5 1.5 7.5 1.5 1.5 1.5 1.5 1.5 7.5 5 5 10 25 GP 1.5 1.5 1.5 1.5 1.5 7.5 1.5 1.5 1.5 1.5 1.5 7.5 1 1 10 25 ANP 1.5 1.5 1.5 1.5 1.5 7.5 1.5 1.5 1.5 1.5 1.5 7.5 1 1 10 25 Nurse 3 3 6 3 3 6 0 12 Pharmacist 1.5 1.5 1.5 1.5 6 1.5 1.5 1.5 1.5 6 1 1 10 22 Phlebotomist 1.5 1.5 1.5 1.5 6 1.5 1.5 1.5 1.5 6 1 1 10 22 Total Hours 9 6 6 6 6 33 9 6 6 6 6 33 20 20 40 106 21