How we introduced new technology to improve nurse efficiency and give them the freedom to care
Virgin Care invested in the introduction of mobile working with secure access to clinical records on tablet devices across our Devon Public Health Nursing service eliminating paperwork, supporting clinicians’ normal ways of working and providing real time information at the point of patient care, even where mobile network signal is weak.
The Public Health Nursing Service in Devon, which Virgin Care runs as part of our Devon Integrated Children’s Services contract, work with and support families and their babies in the early stages of life. Families are offered a range of health-enhancing activities through the Healthy Child Programme, including immunisations and health reviews over the course of five visits from birth until the child is two and a half years old.
When we took on the service, we inherited major challenges around historic ways of working including a reliance on paper records and old, outdated IT systems. With increasing demand, Public Health Nursing needs to evolve and adapt, in order to continue supporting parents and families.
In 2016 we invested heavily in the introduction of a mobile working platform, which has been tried and tested across our services, and uses secure access to medical records, eliminates paperwork almost completely and gives our teams the freedom to work without returning to office bases to collect information and update their clinical records.
We trained our colleagues in the use of the new systems and technology, while also allowing them a two week period to test to help build their confidence.
We rolled out Apple iPads to all of our health visitors and community health workers running our mobile working software giving them access to previous notes, and electronic forms as well as apps such as British National Formulary (BNF) and NICE Guidelines in their pockets 24/7 to help avoid any doubt, the translator app and a navigation system (GPS). The apps help our colleagues to get from A to B around the community using the built-in GPS, while a translator app can help improve communication between health visitors and families.
Since launch we have improved our colleagues ways of working, with all teams seeing a reduction in time spent on manual paperwork and record keeping, which has resulted in additional quality time for use on other patient care activities.
We also saw an increase in our health visitors’ overall satisfaction of using a mobile working platform compared to pre-go live.
We met our own deadlines, rolling out more than 100 iPad devices to Health Visitors by December 2016.
Historic ways of working
As with many of our services, the major challenges are around historic ways of working.
In Public Health Nursing, there has been a reliance on paper records and the use of old IT systems, with a lot of time spent on manual paperwork and record keeping – which in some cases meant inputting data multiple times, into different systems.
This repetition not only introduces risks, because multiple copies of notes can exist at the same time or paper copies can be lost.
It can also take up valuable time, especially when preparing for a visit, which clinical colleagues could be spending with patients.
We knew from initial work with the teams that colleagues wanted extra time to get used to using the new technology. They’d told us they were unsure how comfortable they would feel using their iPad during an appointment, and said they wanted plenty of time to get used to the system and where to find things before using the system for real.
Investing in mobile technology
Following the success of a platform we’ve worked with extensively elsewhere in England, Virgin Care continued to invest heavily in mobile working to help support our Health Visiting Service in Devon become more efficient and offer our colleagues better access to scheduling and medical record keeping.
The mobile healthcare platform, introduced early last year, helps achieve efficiencies by eliminating paperwork and giving colleagues more freedom to work without the need to travel back to their hubs to update patient records.
38,000 children under 5 will be supported by the new system and procedures
It also helps provide real time information at the point of patient care, and support their working days with the use of electronic diaries which helps offer health visitors better access to scheduling.
Before roll out, Virgin Care offered our health visitors three aspects of training to help with the change and to better understand how to use the new systems and technology, this included:
- Standard operating procedure training and guidance on how the systems would change
- iPad set-up to help colleagues login and get started
- A full day of iPad training, allowing them to get familiar with the system
We then used a two-week test period to allow our colleagues to build their confidence and learn how to do their day-to-day tasks on the new system.
By December 2016, the system was rolled out across all 39 Public Health Nursing service teams in Devon during, with health visitors supporting more than 38,000 children under 5 using the new system and procedures.
More than 220 people were involved with full rollout and all services were live on the mobile working system by December 2016, as planned.
Better scheduling, easier access to records and more freedom to focus on caren
The introduction of the mobile working platform has meant our Public Health Nursing Teams have easier, secure access to medical data and tools and applications to help improve the way they work, such as access to scheduling information, best practice information from the BNF and NICE as well as access to emails on the move to help keep the whole service better connected, and better informed.
More than 200 iPads invested in for 39 Health Visiting teams
We invested in more than 200 iPads for all 39 Health Visiting teams which has given colleagues the freedom to focus on what they are trained to do, and avoid unnecessary trips to offices as well as removing the risk of duplicate records.
This has resulted in:
- Positive feedback from our colleagues, who have given the system and new ways of working a thumbs up after full-deployment
- Almost 100% of work is now recorded using iPads
- 100% of teams are managing their diaries electronically, giving better oversight of the service and allowing us to better meet demand across the entire service
- We’ve seen a reduction in the time our teams spend completing forms, which as teams get used to the system will create more time to spend with patients
- We’ve seen up to 25% reductions in ‘preparation’ time at the start of each Health Visitor’s day
- Colleague engagement is up – our teams say they are “excited” about the new system
In the future:
We have invested more than £2 million in technology across our Devon services, and during 2017 we intend to deliver almost 2,000 Apple iPhones to our colleagues who do not need a full tablet with access to records. This will allow our teams to stay connected, to access emails wherever they are, and to communicate more effectively without having to return to base.
We’ll continue to review the progress of our mobile working platform to maximise and demonstrate the benefits to increase our patients’ experience and colleague satisfaction.
We also plan to explore further possible functionalities within the system, with a long term goal of rolling out the solution to other Public Health Nursing services we run, including in Bath and North East Somerset.