Wireless technology provides real time availability of patient data and improved patient care

Homerton University Hospital NHS Foundation Trust is an acute single-site hospital providing general hospital services to Hackney and the City of London and specialist care in perinatal services, fetal medicine and neurorehabilitation. Homerton is a major training centre for clinical staff, working closely with Queen Mary College, City University and University of East London.

The challenges
Medical staff in the large, very busy hospital found their work hindered because of the physical difficulty of getting data in and out of the hospital's system. The IT system itself was in good shape, but you had to find a work-station every time you needed to enter or access data - even if you were with a patient, which meant a frustrating situation for both parties. 

Clinical staff needed to access and enter data in real time whilst they were with their patient to increase continuity and the efficiency in which they could consult. At Accident & Emergency (A&E) things were worse.  Jon Dingle, a WCI consultant on the wireless project, says:

"A&E is a very fast-paced area and there simply isn't room to fill it with work-stations. Staff used to get as far as they could with a patient and then go looking for a work-station in the hospital with the shortest queue. When they finally got online, they'd just enter essential record data, a decision if possible and place a drug order. They waited for confirmation and returned to the ward, usually with someone 'collaring' them for help with another task on the way back. 

When they did eventually get back to the patient, they did whatever they could and then set off again to report it at a work-station...what could have been twenty minutes turned into an hour and a half."

In any acute situation, what you do next is always contingent upon the results of what you just did, or the answer to the question you were just asked. And it's all time-critical. A&E staff worked from memory or hand-written notes and the pressure the were under made them reluctant to get into too much detail online. The potential for error is all too evident and staff were frustrated because they couldn't always give the excellent care they wanted to. The trend had to be reversed, and swiftly. Staff had to have better online access at the point and time of need.  They needed to be able to use online data live and interactively at the bedside.  Access therefore had to be with the medic, not the system. It looked like a mobile solution.

The Solution
The Trust approached WCI to discuss the possibilities of using mobile technology. The solution was a wireless network, accessed through mobile tablets and laptops.

The Trust proposed to pilot mobile technology in A&E and if this proved successful then to roll it out throughout the entire hospital. The pilot covered 25 staff and after just three months was judged a clear success. The Cisco wireless system installed supported a range of tablets and a standard hospital laptop. The infrastructure has been key to the success of the wireless technology: because the site's core and peripheral IT was already Cisco, there was strong end-to-end coherence.  This helped enormously - in this environment you can't stop for four weeks to get the IT in!  As people tried out and learned more about the new technology, they made advances in how it was used and their feedback was central to the success of the project. Their results meant the Trust opted for tablets and the laptop as the most useful of devices. The standard laptop now has wireless capability built into it. Jon continues;

"Because of the environment, security was key from the start and always met the National Standard.  As we have rolled out the technology across the whole Trust, working with the hospital's IT specialists, we have implemented a more robust layer of security and management. Today, it exceeds the National Standard."

WCI worked closely with the IT department to show them how to use and configure the equipment, the network and the security. There are now 150 users working in a mobile environment and people's knowledge and confidence has grown with the rising numbers of staff getting on board.

The Benefits
Mobile access has allowed access to email anywhere in the hospital, allowing more time with the patient.  The wireless element and general growth in confidence means staff are using the hospital's IT more overall - laptops are in use in their offices, in the canteen, even in the corridor, as well as on the ward.

Thus, productivity levels have greatly increased. Stress levels are lower and staff's working lives are improving - because they are achieving the kind of patient care they aspire to, with less effort and frustration. The management tools which are part of the system enable IT staff to manage the entire wireless structure and its use from a single location.  The new system did not bring new workload. Jon says;

"So far, wireless is in place, it's working and people like it. The Trust is very happy with the solution and they're looking forward to a big take-up and continuing improvement. What we've done as a team, working with the hospital people, may be technically pretty, but it had to work for patients, and it does!"