Oxford deploy new electronic discharge system

Around 4000 staff at the Oxford Radcliffe Hospitals NHS Trust are using a new Immediate Discharge Document (e-IDD) software package from CSW to enable hospital-wide collaboration when each inpatient is discharged.

The busy hospital currently has approximately 521,000 outpatient appointments every year and wanted a way of enabling its ward-based doctors and pharmacists to work together when finalising discharge arrangements.

Speaking at the Healthcare Computing event in Harrogate, CSW’s clinical director for the project, Debbie Hagger, said: “This project has been ongoing since 1997 in an effort to combine discharge information between all clinical staff in the hospitals, ensuring that all parties involved have signed and approved the discharge papers, before they are sent to the patient’s GP.”

Following pilots in the paediatrics, geriatology, cardiac and dietician departments overt the last few years, the system has been upgraded before being rolled out across the trust. 

Once the final phase of roll out is complete the system will be used by over 4,000 clinicians, helping ensure more timely and efficient transfer of patient discharge documentation to GP Practices.

Hagger said: “The hospital wanted a system that everyone could use to standardise discharge procedures across the hospital. In our pilot sites, we found doctors who transferred to other wards, missed this way of working, which helped us push towards trust-wide implementation.

“As it met the needs for PCTs to get discharge directives within 48 hours under Payment by Results, this also helped encourage the trust to sign-off deployment.”

Based on CSW’s Case Notes, the software offers a standard form for doctors to complete on discharge. These are then sent to pharmacists for drug checking before any drugs can be dispensed. Once signed off, the patient can pick up their medicines.  The discharge form is sent electronically to the GP’s own Case Notes intray

The trust already uses Case Notes to record lab results and 75% of GPs were using the software. In order to ensure it met the differing needs across the trust departments, a multi-disciplinary review team was put together to agree on its specification, configured to suit trust requirements.

Hagger said: “The multi-disciplinary group was essential to this project as it allowed us to pursue clinicians as they used the system and come up with a specification agreed by them, based on their input. Seeking this vision was a relentless task, but I think it paid off.

“This approach demonstrates how static specifications raise questions such as: was this what we really wanted? With one standard workflow for all users, it becomes easy for staff to understand and so easy to put into operation. Keep talking to find all the variables and you should succeed.”

For CSW, this is the first deployment of e-IDD and Hagger told EHI she believes represents the future direction of development.

“Although this project has taken years to achieve, I believe it has demonstrated the worthiness of working closely with your users. One size does not fit all and systems like this will prove worthwhile as trusts look to deploy technology that will inevitably make patients hospital stays that little bit more pleasant.”

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