Barts Health NHS Trust is one of the largest healthcare providers in the UK, with the largest intensive care wards in the country. Currently, patient data is recorded on paper in Barts Health critical care units and theatres. This is time consuming and hard to audit. Digitising this system allows teams to better detect patients who are deteriorating and intervene quickly.
Providing almost real-time patient data
We have awarded £4.4m to Barts Health to bring the benefits of electronic record keeping to critically ill patients. It will involve integrating ‘vital signs‘ data, including temperature, pulse rate, blood pressure and breathing rate, as well as data from ventilators, anaesthetic machines and blood purifying machines, with patients’ electronic records. This system of bespoke electronic record keeping will provide almost real-time patient data to staff, removing the need for manual data input, freeing up nurses’ time to spend with patients.
This funding builds on the amazing work already undertaken by Dr Dan Melley, Consultant in Intensive Care and Deputy Chief Clinical Information Officer, and colleagues at Barts Health.
In 2019, we awarded £630,000, supported with a gift from Fidelity, to digitise the recording of ‘vital signs’ at the bedside on general wards at St Bartholomew’s Hospital – such as temperature, heart rate, blood pressure, breathing rate and oxygen levels. The data has been used to create a reporting dashboard that can alert staff to patient deterioration, part of a project aiming to improve delivery of antibiotics to patients with sepsis.
This dashboard displays accurate data which updates every 15 minutes. It currently contains over 12 million vital signs measurements from 240,000 individual patients.
So far, the impact of this work has been:
- A 20-fold increase in patient escalation forms completed so that patients who are becoming seriously unwell are taken to intensive care more quickly.
- A 25-fold increase in patients being screened for sepsis resulting in more patients rapidly receiving the antibiotics they need.
The early success of the project resulted in Barts Health funding the Trust-wide rollout of digitally recording ‘vital signs’, making Barts Health an early adopter of this approach nationally.
During the peak of the COVID-19 pandemic, running out of oxygen for patients was a serious concern. As the vital signs monitors collect data related to individual patient oxygen levels, it was possible to build a dashboard monitoring oxygen use across Barts Health hospitals. This enabled the team to reduce unnecessary oxygen use avoiding a potentially catastrophic oxygen supply failure when supplies of oxygen were low.
Scaling up data to transform patient care
Our new funding forms part of a wider programme of digitisation aiming to use technology to transform patient care. The scale of Barts Health means the team will be able to collect a huge number of data points for analysis and research to improve patient care.
Not only will the data support healthcare staff to monitor patients, but it will help clinical analysts benchmark against best practice guidelines, including identifying training needs.
Improving ventilation targets
Evidence shows that lower ventilation levels lead to better patient outcomes, but these ventilation targets are often missed. An early aim for this project is to measure the amount of air moving in and out of the lungs during ventilation to see how well ventilation targets are being met. The team will then use the newly available ventilator data in the electronic patient record to lower ventilation levels in patients with severe respiratory conditions, which could help to improve outcomes and reduce the length of their stay in hospital.
We have shown through our early work that clinical data improves care and enables nurses to spend more time with their patients, providing crucial care. We are excited that, with new funding, we can bring this to the most critically ill patients at Barts Health NHS Trust. The data we capture will enable clinical staff to monitor and respond to patients when they most need it, faster than before, improving how care is given and delivered. We are so grateful to the charity for this support.Dr Dan Melley, Consultant in Intensive Care and Deputy Chief Clinical Information Officer
We are delighted to support this ambitious programme of digital transformation for intensive care units and operating theatres at Barts Health NHS Trust. It will help staff deliver the best care and improve health outcomes for patients in East London, building on the outstanding success of our previous funding which enabled the adoption of this approach across general wards.Fiona Miller Smith, CEO at Barts Charity