NHS pushed into upgrading its monitoring system following avoidable death
A 42-year-old woman was admitted to East Sussex Healthcare NHS Trust hospital on a Friday evening with a liver abscess and sepsis. Her condition rapidly deteriorated over the weekend and she tragically died two days later of multiple organ failure.
This death was confirmed to have been entirely preventable.
This incident was apparently the last straw for the Trust’s critical-care lead, Dr Kate Murray. Prior to this incident, Murray was unhappy with an abundance of problems with how the hospital take patient observations, and as a result of the incident, she sought to do something about it.
Problems reported included:
- Long delays until patients receive observations
- Patient observations not done properly or inaccurately
- Patient observation not done at the right time
- Patient early warning scores totted up incorrectly
Speaking of the recent patient death, Murray noted the incident was where she got the, “drive to get the electronic observation system in place.” She explained that, “if we had a transparent and visible system then her situation could have been seen [quicker] and could have been acted upon.”
That devastating weekend prompted Murray to bring in the Vitalpac electronic observation system to the East Sussex NHS hospital. The system utilises iPod touches and iPads to electronically monitor and analyse the patient’s vital signs, flagging and deteriorating conditions. The change has transformed the way doctors and nurses can provide care for their patients for the better.
Vitals e-observations system is aimed at helping hospitals save time and improve patient safety. It recognises that staff are thinly-stretched and provides key information to help them stay on top of patient conditions. The useful system is already being utilised in 33 Trust hospitals – in more than 750 wards – taking over 6.5 million observations a month.
Key elements of the system include:
| Electronic observation: Clinicians can take patient observations directly on the connected device where it can be viewed by other staff. Observation schedules can be easily managed based on clinical needs. Early detection of patient deterioration will be alerted to relevant doctors to ensure relevant care is provided quickly |
| Assessments and screening: patient vital assessments can be done at the bedside. This includes screening for dementia, VTE, nutrition and alcohol |
| Scalable alerts: to notify relevant staff of patient conditions and updates |
| Fluid management: This helps staff to check fluid balance accurately. Timely charting also makes it easier for staff to make critical decisions quickly |
| Sepsis: Identifying potential sepsis symptoms and calculating warning scores quickly will help clinicians to prevent and reduce the impact of serious infection |
By taking the place of “paper records and manual calculations of observations for people who are acutely ill in hospital,” the system increases efficiency while lowering the risk for human error. Splitting the annual licence cost for the system per-monitored bed per day, 50-70p seems more than reasonable.
This new tech seems sensible in a world where everything is becoming digitalised and electronic. However, it’s not a total replacement as it still requires staff to be able to utilise the system for the most efficient output. This means the devices need to be properly used and taken care of and staff receive adequate training to ensure the same.
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