Implementation of the Safety Thermometer App at Mid Yorks Hospitals NHS Trust.
The Safety Thermometer App, built by the NHS Quality Observatory and supported by Haelo, has been introduced to Mid Yorkshire Hospitals NHS Trust to revolutionise the monthly audit of data. The audit, a national requirement, aims to monitor harm-free care across the nation.
The Safety Thermometer, contrary to popular belief, has nothing to do with temperature! It is a monthly audit that is routinely undertaken on the same day each month, trust-wide including community services, to provide a snapshot of harm-free care.
On a set day, each ward collects data on a wide range of health issues such as; the old and new pressure ulcers, falls, VTEs (Venous Thrombo-Embolisms), catheters and UTIs (Urinary Tract Infections) to measure the number of patient harms for a specified time period. The information was then inputted into an Excel template, which was in turn emailed to the Nursing Directorate to transfer into a central spreadsheet for submission to HSCIC (Health and Social Care Information Centre). Dashboards were then produced, both by HSCIC and the Trust, to show local and national trends of harm-free care, as an indicator of how safe the ward or hospital is.
The process was extremely time-consuming and inefficient for both the ward staff and the Nursing Directorate, and there was a general sense that the time spent on collecting and submitting the data was disproportionate to its value, leaving very little time to analyse the results and focus on improvements. As a result, there was a higher risk of inputting incorrect data when transcribing the information and the cumbersome nature of the process meant that ward staff were restricted to who was able to conduct the audit.
On average it was estimated that 76.25 hours were spent in total per month on collecting and processing the information for submission in the acute setting alone (excluding paediatrics and maternity).
The Digitalisation of Data
After initial research, mobile applications were found to be available which have the capability of allowing users to input the data directly into an iPod or tablet to streamline the collection process. After reviewing several applications, Mid Yorkshire Hospitals NHS Trust trialled an app developed by the NHS Quality Observatory supported by Haelo. The app has many benefits including; simple to use and helpful built in guidance, can be easily installed on existing VitalPAC iPads, has offline functionality – allowing collection of the data in cases where wifi is unavailable, it does not collect any patient-identifiable data so confidentiality is not compromised and no data is stored on the device once the audit has been uploaded. Best of all, the app is free!
With the new process, the registered nurse uses the Safety Thermometer app to collect the data and then uploads it directly to the Safety Thermometer website. The Nursing Directorate can then export all the audits and merge them with the HSCIC template for submission to HSCIC. It is estimated that, in the acute setting, the new process will save on average 58 hours per month– that’s 696 hours per year! Of this, 73% (507 hours) are clinical hours. That equates to approximately £11.5k per annum and, although the savings are time releasing and not cash releasing, the figures are significant. Due to the nature of the app and its integrated guidance, the audit can be easily carried out by other registered nurses on the ward, enabling the ward managers to use their time more effectively.
Feedback from Mid Yorkshire Hospitals NHS Trust wards has been very positive, even from those who are reluctant to embrace technology. Comments include how much time has been saved, how easy it is to use and understand and how refreshing it is to be able to come on shift to do the audit to find it has already been done by another member of staff with little to no supervision.
The Safety Thermometer app has been a great success and is now been rolled out to all adult inpatient areas in Mid Yorkshire Hospitals NHS Trust. The Nursing Directorate is using this as an opportunity to relaunch the Safety Thermometer process and clarify guidance. IT Services will continue to support the process as it embeds and will then look at how the process can be rolled out to Community services. Following that, Maternity, Paediatrics and Medication Safety Thermometer collections will be reviewed to assess the possibilities for rolling out a similar process.