LONDON - April 12, 2010 - Nottingham University Hospitals NHS Trust (NUH) has used a Cisco® network and telephony system to significantly improve its Emergency Department operations and to streamline patient care.
Key benefits of the new solution include:
- A reduction in the patient journey time of 23 per cent for adult patients and 33 per cent for paediatric patients
- An increase in the productivity of doctors treating minor injury patients equating to a potential time saving of over seven hours per day, or one doctor per year – a total annual cost saving of nearly £77,000
- A full return on investment in the new technology realised in just 14 months
In addition, clinical and nursing staff have benefited from improved interdepartmental communication and a more collaborative working environment, both of which have boosted staff morale.
The results and benefits of the implementation have been published in a recent research report titled 'Collaboration and communication technology at the heart of hospital transformation', published by ACCA (the Association of Chartered Certified Accountants) in collaboration with the European Commission.
- NUH is the fourth-largest teaching hospital in the country, with over 12,000 staff, providing acute medical services to a local population of 650,000 and a range of specialist services to a wider population of around 2.5 million.
- The vast size of NUH Emergency Department (ED) had led to severe communication problems, which were causing delays in patient care and causing additional pressure on the Trust's ability to meet the maximum four-hour time limit set by the government for treating emergency patients.
- A review undertaken by Cisco found that existing processes were reliant on ageing and increasingly unreliable technology, leading in many cases to duplicate and inaccurate information.
- The solution, proposed and developed by Cisco, working in association with both its delivery partners and NUH staff, was a medical-grade network to provide both wired and wireless (Wi-Fi) network foundation and architectures to enable all communication, including advanced clinical applications and biomedical devices, to operate in a protected, interactive, resilient and responsive environment.
- A fundamental element of this is telephony services, which are provided by both fixed and portable handsets, with the portable units utilising the Wi-Fi network. The portable Wi-Fi phones can be used for internal calls throughout the hospital at zero cost, and they offer a range of "smart" messaging options, including automatic updates from clinical systems and the ability to provide the location and work status of users.
- Following from this review, the NUH agreed to a significant investment with NextiraOne (a Cisco Gold Certified Partner) which, in addition to the supporting infrastructure, incorporated leading health technologies including:
- Wireless data access to give staff access to information systems at the point of care
- Wireless telephony, unified communications and presence to show the real-time availability of staff and to enable staff to be contacted wherever they are in the hospital
- Cisco Unified Application Environment, a messaging system linking the Emergency Department to Pathology and Radiology systems for notification of when results are ready and patients ready for collection from X-ray
- Radio frequency identification (RFID) and tracking to enable the geographic location of equipment
- Before the new technology was introduced, staff spent up to 20 per cent of their time searching for people and equipment. With the new handheld wireless phones, locating and contacting staff is instant.
- In a study of patient journeys for patients suffering from a minor injury or illness, the percentage of time spent waiting was significant. On average, about 75 per cent of the time for adult patients, and 71 per cent of the time for paediatric patients, was spent waiting. They waited to be streamed, to be provided with a wheelchair, to receive an Emergency Department Assistant (EDA), to receive medication, to be seen by a specialist doctor, to get a blood test, to be taken to the X-ray department, to be collected from X-ray, to have a doctor receive and then review results, to be admitted to a ward, or to be discharged home.
- After the new technology was fully operational in the Emergency Department, data showed that waiting times were now significantly shorter; for adult patients the waiting time had decreased by 21 minutes (28 per cent) and for paediatric patients by 29 minutes (40 per cent)
- The reduction in total length of each patient journey is important, not just for the patient, but also for capacity management.
- The total time saving for clinicians of nearly seven hours per day, or one full-time doctor per year, equates to a total annual cost saving of over £75,000.
- Neil Crockett, managing director, Public Sector Cisco UK & Ireland:
- Dean Westcott, ACCA vice president:
- Ian Smith, deputy director of ICT Services, NUH :
- Richard Tucker, superintendent radiographer, Emergency Department, NUH:
"Good communication is key to the delivery of quality health care: improving efficiency, reducing cost, speeding up the patient journey, and improving the overall patient experience," says Neil. "The new system at NUH has helped solve the communication problems, meaning that staff now have more time to spend on their patients and immediate access to the vital information required for clinical decision making."
"In an era of ageing populations and escalating modern health care costs, research of this nature, based on sound clinical and economic evidence, sets out a road map for policy makers that there are significant benefits both in terms of patient care and cost effectiveness to be realised from the increased use of e-health technologies."
"The time was right to link together the opportunities presented through the infrastructure investment and the aims and goals of the Emergency Department in its future state."
"The new system still has the human factor: You ring and can talk to someone at the other end, which radiographers like. This human element mixed with technology supports a more collaborative working environment."
- Cisco Voice and Unified Communications
- Collaboration and communication technology at the heart of hospital transformation, March 2010
Cisco, Nottingham University Hospital, NUH, communications, NHS, ACCA, European Commission