This is the last of my posts relating to my pledge for last year’s NHS Change Day, where I wanted to put more effort into visiting frontline services.  My last visit during the year was to meet the informatics team and lead informatics nurse at Liverpool Heart and Chest Hospital NHS Foundation Trust.

A few facts first about the hospital; it’s one of the largest specialist heart and chest hospitals in the UK, providing specialist services in cardiothoracic surgery, cardiology, respiratory medicine including adult cystic fibrosis and diagnostic imaging.  In 2012 the Trust was rated as the top performing hospital for “overall patient care” in the Care Quality Commission’s National Inpatient Survey for the sixth year running and was awarded the HSJ ‘Provider of the Year’ award in 2012.  The hospital is sited with a number of other NHS providers on the same site but as soon as I walked through into the main entrance I was impressed, not just by the environment, although this was modern and welcoming, but also by the staff who were all amazingly friendly and helpful.

Penguin outside entrance to Liverpool Heart and Chest Hospital

It was a long walk through the hospital to the Trust HQ – sited in portacabins outside the main building.  The reason why?  The HQ had been converted into a great new ward facility!

The Trust deployed the AllScripts electronic patient record system in June 2012.  I met the incredibly enthusiastic Lyndsey, the nursing lead for informatics and she took me to the wards where I met front-line staff and saw the hardware they were using on the wards.  There seemed to be no lack of equipment but Lyndsey explained that the nurses were keen to move towards more flexible mobile technology – tablets – a trend that I am hearing from lots of different places.  Nurses don’t want to be tethered to desktops or even laptops – they want to be able to hold the technology in their hands at the bedside.

The deployment at LHCH was a big-bang deployment and I reflected on the courage and leadership that will have taken from the whole informatics team.  They managed the risks well, they used champions from the front line, 10% of staff were trained as champions (a significant commitment from the Trust), and Lyndsey and the CCIO worked really hard to make sure safety was paramount.  They also made it clear that they had been well supported by their supplier, AllScripts, which is also great to hear.

I was impressed by the evidence of clinical leadership and respect that I observed.  Lyndsey was no nurse leader hidden away in an informatics department.  She knew nearly all the staff we met on the wards and was clearly liked and respected – after all she is one of them.

I asked a ward sister what she thought was the best thing about the deployment and her answer was – ‘It’s great.  The nurses spend more time at the bedside! I don’t see nurses sat at the nurses station writing up their notes because they do this with the technology with the patients’.  A great answer that gives me hope.

The Trust’s journey doesn’t end here though.  Dr Mark Jackson, Director of Research and Informatics took up his portfolio fairly recently.  It was a pleasure to meet him too.  His background in research means that he places high value on the understanding that can be gained through information and the opportunities that a new electronic record system can create.  I think he will be looking to make best use of the data assets they are building.

Overall this experience was a fitting and optimistic end to my 6 visits during 2013.  What did I learn in Liverpool?  That optimistic and clear clinical leadership definitely makes a difference in informatics.  I saw very little paper in the Trust.  But there was also a little jangling worry too.  As I was leaving the ward I saw a Fax machine – ‘What’s that?’ says I.  Apparently its the only way the local community nursing provider will take referrals – it sort of made me want to howl with frustration!  I suspect the Trust staff feel the same 🙂

So #NHSChangeDay2013 for me is done, but not done!  I have gained so much understanding through my visits that I am using in my national role that I am determined to continue to visit sites! Volunteers for a visit are welcomed!