Patient Safety - An IMS MAXIMS Deep Dive
Background
Patient safety is a cornerstone of any care process, whether it is digitised or not. All stakeholders in the patient workflow chain should be aware of, engaged in, and able to consider patient safety aspects of the care processes in which they are involved. For technology vendors this presents opportunities and challenges, to ensure digitised workflows are built in a safe way but also that they are beneficial for clinical end-users to carry out their roles in a more safety-centric way.
IMS MAXIMS fully supports the recently published Digital Clinical Safety Strategy and maintains the highest standards in clinical safety when building and maintaining our technology (through a rigorous upkeep of the mandatory DCB0129 standard and our in-house clinical safety officer team). From a technology creation perspective, adherence to the best-practice standards ensures that what is used by healthcare organisations is safe to deploy. However, how can MAXIMS be used to support clinical pathways and truly deliver step changes in patient safety outcomes?
The Wider Safety Context
Clinical care pathways and patient safety outcomes obviously go hand in hand. The NHS Patient Safety Strategy was released in 2019 which defines the steps that will be taken to attempt to improve patient safety over the coming decade. This document sits alongside the NHS Long Term Plan and covers three main strategic aims:
Insight – Improving an understanding of safety by drawing from multiple sources of patient safety information
Involvement – Equipping all stakeholders with the skills and opportunities to improve safety throughout the whole system
Improvement – Designing and supporting programmes that deliver effective and sustainable change in the most important areas
A number of improvement programmes and reporting systems have been devised or supported as a result of this document, but one of the key aspects of patient safety management is the collaborative, multi-disciplinary aspect of it. No one stakeholder can manage ‘patient safety’ as an entity, but if individuals and organisations are aware of their potential impact on safety then they can be best placed to ensure their role in the safety chain is managed as best as possible.
The case for change and continuing quality in regard to patient safety is still extremely strong. Although many positive steps have been taken in the last few decades, the NHS estimates that it fails to save around 11,000 lives a year due to safety concerns, with that burden falling most heavily on older patients. In addition to the human cost, there is also the financial consideration, with the extra treatment required following safety incidents estimated at nearly £1 billion. Investing in and maintaining safety-led systems can help support a reduction in patient morbidity and mortality, improve care pathways and provide more cost-effective care.
“When patients entrust themselves to clinical care, the last thing that they deserve is for their situation to be made worse. Indeed, when newly qualified, the first declaration that clinicians make is to oblige themselves above all to not do this. Given the complexity of modern medicine, and the efficiency with which it must be delivered, it was inevitable that computerisation of healthcare processes would follow. So how then do we ensure the safety of patients if their care depends on the safety of these tools? We have every reason to be vigilant about this. Recent experience with large computerisation schemes (The National Programme, the Post Office, the Criminal Justice System) shows us that automating large scale complex processes is very difficult, and takes time and rigorous testing. It is therefore very important to look very hard at any automation that supports pathways of care, and which might direct treatments, drugs and courses of action.”
How MAXIMS can support safety-critical processes
A Safety-First Product
A trusted technology partner that understands the nuances of UK healthcare can be a valuable asset in helping maintain patient safety pathways. IMS MAXIMS has been built with a UK focus and safety in mind, every step of the way. At a high level, the key aspects of the company and system are:
An EPR solution that has been developed hand in hand with UK clinicians for over 25 years – this ensures a true understanding of clinical context and workflow
A modular, highly configurable system – this allows deploying organisations the flexibility to tailor the system to their specific workflows and focus on the most critical areas of deployment first
True web application and Open APIs – these support flexible use across all care settings and to better leverage existing system investments which can be integrated
Full compliance with the Minimum Digital Foundation specification
HIMSS Level 5 capable
As mentioned above, IMS MAXIMS fully adheres to the DCB0129 standard involving such activities as:
Maintaining the key appropriate safety documentation (Clinical Risk Management Plan, Hazard Log and Clinical Safety Case Report)
Ensuring any incidents are prioritised, managed and captured in a timely manner
Assisting deploying organisations with their supporting DCB0160 documentation
Real-life Safety Successes
No matter how technically sound a system has been built, the key is replacing or augmenting existing clinical workflows with more robust, safety-focused, digital ones. The example below shows just one instance (patient observations) of how MAXIMS can be used to promote better workflows and further instil a safety culture in the deploying organisation.
Background
Wye Valley NHS Trust’s patient observations were recorded on a standard paper NEWS2 chart with the NEWS2 score calculated by the observation taker. A key driver within the Trust was to have a system that improves the communication and documentation of patient data, with a clear audit framework for tasks, notifications and interventions.
The Solution
The MAXIMS eOBS module was well-placed to deliver on all the above. The eOBS module provides real-time notifications of deteriorating patients based on their latest NEWS2 scores and allows full visibility of patient tasks and reminders. Any clinical data input is directly entered into the EPR system and is available for all users at the point of submission. The speed of onboarding end-users onto the system allowed quick and effective utility of the system – most users’ training was delivered in under half an hour – and the solution was able to be scaled quickly, with over 400 users now using the system seamlessly.
From a benefits and safety perspective, there has been a noted step change in how things are measured, recorded and expedited. MAXIMS eOBS is now the repository for all patient observations and allows users to notify others, expedite tasks and increase the number of observations taken with the same resource. Observations can be seen from any location which allows for faster multi-disciplinary decision making for time-sensitive patients and audit and research is much more effective and efficient. Clinical errors from calculating scores have been eliminated and automated escalation allows a much quicker review for potentially deteriorating patients.
From a safety perspective, this is just one of many use cases in which IMS MAXIMS can support patient safety at scale. Working with a trusted partner such as IMS MAXIMS can ensure safety is built in from the start and can manage even the most safety-critical pathways in healthcare.