Digital solution saving time, increasing efficiency and reducing waiting list backlog

By adding an MPage for prioritisation to its Oracle Cerner EPR, clinicians working at two hospitals now see real-time patient lists

A digital solution to remove a cumbersome, time-consuming manual process for validating elective surgery waiting lists is paying dividends at the hospitals where it has been introduced.

By adding an MPage for prioritisation to its Oracle Cerner EPR, clinicians working at two hospitals run by the Calderdale and Huddersfield NHS Foundation Trust (CHFT) now see real-time patient lists – which is speeding up the waiting list validation process, reducing a post-COVID backlog by increasing efficiency and preventing the creation of unnecessary appointments.

Previously, lists were compiled in spreadsheets and sent in bulk for validation and prioritisation every 3-4 weeks. This process created common issues for the hospitals’ validation team, including poor/slow response rates and replies sent on Microsoft Word which then had to be copied to the spreadsheet, creating a risk of mistakes and wasting time.

Adding the Prioritisation MPage to the EPR saved 91 hours of clinicians’ time in one calendar month alone, whilst also preventing 5,000 unnecessary appointments.

The new process is the result of a collaboration between CHFT and a project team from The Health Informatics Service (THIS) - which is hosted by the trust - and representatives from St Vincent’s Health and Public Sector Consulting, which markets itself as a specialist in patient-centred healthcare solutions.

Rationale behind streamlined process

The rationale behind the project was an NHS mandate to provide each patient waiting for elective treatment with a P (priority) number between 2 and 4.

This added impetus to an existing desire to create a streamlined prioritisation and validation process using a digital solution that had already been mooted by THIS and CHFT for the trust’s two hospitals, Huddersfield Royal Infirmary, Huddersfield, and Calderdale Royal Hospital, Halifax, both West Yorkshire.

The project’s aims were to: provide real-time availability of information via a single source of truth; reduce administrative time for clinicians and the validation team; provide clearer visibility of patients’ changing circumstances to aid the prioritisation process; and increase efficiency to reduce waiting list backlogs.

The trust’s validation team, which processes an average of 1,800 patients a week, now records straight into the EPR. Anyone in the process can add comments, and clinicians have the ability to open the page and view it. The responses are live and actioned.

Neil Staniforth, THIS’s director of digital ops and delivery, says: “The fact that MPage writes directly into the patient’s notes during validation makes the process a one-stop shop, easy and convenient. The result is increased staff satisfaction from a workload perspective among clinicians, and the validation team is pleased with the clarity it provides.

“We think the new process is the best we’ve ever had. The ultimate testimony to the success of this project, is that we know if we said we were going to take the new process away, clinicians would fight us, rather than help us pack it up!” Kirstie Blackham, a member of CHFT’s validation team, says: “We receive validations as soon as the consultant does them and any queries can be sent straight back. This is in comparison to the days and, at times, weeks it could take to send things back and forth via email. The whole process is a lot smoother; all the information is clear and easy to access. Even at this early stage, I feel like this will only speed up as people become more comfortable using it.”

Listing the advantages

While the time reduction in spreadsheet creation and reconciliation allows more time for validation and review, the time saving for clinicians has halved from 10 minutes per patient to five. For example, in November 2022, 1,097 patients were prioritised, producing a time saving of approximately 91 hours for clinicians. In the same month, 5,524 pathways were closed, freeing up approximately 5,000 appointments that could be offered to other patients.

Neil Staniforth: “The benefits of this are twofold: it clears a backlog and if the appointments had not been cancelled, the patients concerned would have ultimately been booked for an appointment that was not necessary.”

Other advantages identified from the project include: a measurable end-to-end process – full audit trails are now available on EPR and CHFT’s Knowledge Portal Plus (KP+), identifying where each patient is in the process; improved reporting – although limited reporting is currently available via KP+, MPage enables more varied opportunities; improved clinical governance – all validation and clinical review information is available within the EPR instead of a spreadsheet; and reduction in general managers’ time to filter and distribute data. Previously, GMs were required to filter lists by consultant and distribute to the relevant ones. Data now lands directly into worklists, removing GM involvement.

Get in touch with THIS

As well as working within its host trust, THIS provides digital and IT services to health and care providers across the UK in primary, secondary and third sectors, such as NHS health trusts, GPs, laboratories, hospices and not-for-profit healthcare organisations. L

If you are interested in working with THIS, get in touch with us below.