Nursing Led Implementation

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Paper is failure.

Audit results from King’s Early Warning Track and Trigger paper charts (POTTS) showed:

●80% POTTS charts completed fully●91% Associated EWS scored●90% EWS calculated correctly●49% Escalated + responded correctly to EWS

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Paper is failure.

Audit results from King's; January – June 2012:

55 separate SUIs● Failure to do obs - 25%● Incorrect EWS calculation - 16% ● Failure to recognise deterioration - 29%● Failure to follow protocol - 31%● Failure to respond appropriately - 49%

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

From this...

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

To this...

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Nursing Leadership

Engagement: Chair of the Trust Patient Deterioration Committee also IT geek!

Evidence: POTTS audit consistently showed inadequate calculation of scores and poor escalation

Engineering: Build it ourselves

Education: Iterate and learn

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Nursing Implementation

● Piloted on two wards● Ward sisters engaged and provided feedback

to improve system● Nurses LOVED IT!!!!● Adopted by Trust IT Dept and team set up for

implementation● Nursing Led Training and Roll-out … Senior PM

was a Nurse

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Trust Wide Deployment

95,000 observations a month

● Failure to do observations - 0%● Incorrect EWS calculation - 0% ● Failure to recognise deterioration - 2%● Failure to follow protocol – 3%● Appropriate escalation response – 98.7%

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Engage nurses from the start!

Nurses know the reality of practice and what is “doable”

Make systems easy, friendly, playful!

Deploy systems that make a tangible and real difference to Patient Safety (not just managers....)

Some learnings...

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

We can do better...

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Meaningful Dialogue

Nurses and Developers working together

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

This is a process

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

This is not a process

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

Localised NEWS as Process

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

@code4health

Come and see Tactix4NHS England Open Source Pavilion

Tactix4 at BCS HC2014 19/03/14

Rob Dyke, rob@tactix4.com@robdykedotcom @tactix4

THE END