West Hertfordshire
Teaching Hospitals
NHS Trust
Text with Dynamic Background
HARNESSING DIGITAL
TECHNOLOGY TO MANAGE
ELECTIVE SURGICAL
BACKLOG

With high numbers of patients presenting to A&E with deteriorating disease while on waiting lists, this surgical department approached Open Medical to co-produce the digital transformation and streamlining of their elective surgical pathways

West Hertfordshire Hospitals NHS Trust provides acute healthcare services across 3 Trust sites

Adopting a user-centred design methodology, our team implemented a digital transformation project alongside West Hertfordshire Hospitals NHS Trust, customised specifically to the needs of the department. A seamless digital solution was required, incorporating both referral pathways and encapsulating the full patient journey: from injury to rehab. Pathpoint eTrauma is now revolutionising how the team manages its acute admissions and virtual fracture clinic.

St Albans City HospitalPrimary elective care centre Watford General HospitalTrust’s acute emergency services Hemel Hempstead HospitalUrgent treatment centre

Patients requiring elective surgical procedures require a coordinated multidisciplinary intervention through specialist teams, including surgical and anaesthetic teams, preoperative assessment (POA) teams and speciality nurses.

Multiple stakeholders

With so many stakeholders involved across multiple specialties, an end-to-end pathway approach is paramount.

Seamless communication

Facilitating efficient real-time communication to effectively manage workflows and necessary clinical interventions, ensuring all patients are appropriately prepared for their operation at pace and scale.

1 million
Patients visit the Trust each year
70,000
Outpatient appointments
640
Beds across all sites
15
Operating theatres across all sites
GENERAL SURGERY Lower Gastrointestinal/Colorectal, Breast, Upper Gastrointestinal, Vascular CLINICAL TEAM SUPPORT Preoperative Assessment, Admissions, Theatres ORTHOPAEDIC SURGERY GYNAECOLOGY UROLOGY ANAESTHETICDEPARTMENT PAIN SURGERY PHARMACY DEPARTMENT HEAD & NECK SURGERY Oral and Maxillofacialsurgery Ophthalmology,Ear, Nose and Throat SPECIALTIES SERVED BY SURGICARE
GENERAL SURGERY Lower Gastrointestinal/Colorectal, Breast, Upper Gastrointestinal, Vascular CLINICAL TEAM SUPPORT Preoperative Assessment, Admissions,Theatres ORTHOPAEDIC SURGERY GYNAECOLOGY ANAESTHETICDEPARTMENT PAIN SURGERY PHARMACY DEPARTMENT HEAD & NECK SURGERY Oral and Maxillofacial surgery Ophthalmology,Ear, Nose and Throat SPECIALTIES SERVEDBY SURGICARE UROLOGY

We were using paper before and the emergence of Covid-19 really expedited our need to go digital - there was a massive drive nationally to do this, and the Trust was also very keen to use this opportunity to shift towards a paper-light approach.

The team was adaptable, supportive, willing to engage. The system is user friendly and is cloud-based. The training was personally tailored to The Trust’s needs and more importantly was one-to-one. Open Medical has exceeded my overall expectations. The team were fantastic and has continued to support the Trust fully through the transition phase.

Isabel Hlomani

Lead Preoperative Assessment Nurse – West Hertfordshire Teaching Hospitals NHS Trust

Challenges and Solutions

Existing Electronic Patient Record systemdoes not provide triage or risk stratification Pathpoint can filter granular informations forspecific cohorts: Risk/Cancer/Priority/Wait/Surgical needs Inefficient legacy processes of Paper forms,spreadsheets, & emails to coordinate patient care Sync team workflows with automaticallyupdated digital waiting lists acrossdepartments Difficulty in tracking patients along theirentire elective care surgical pathway Digital theatre board to track POA status orany specific surgical requirements Keeping track with procedures that were beingfurther delayed or cancelled Surgical scheduling tools including short notice,pre screening on POA additions to maximisetheatre utilisation Inefficient governed means of recordingpatients’ Covid-19 surgical risk assessment Automatic Covid risk assessment andintegrated harm review assessment 1 2 3 4 5
Existing Electronic Patient Record systemdoes not provide triage or risk stratification Inefficient legacy processes of Paper forms,spreadsheets, & emails to coordinate patient care Difficulty in tracking patients along theirentire elective care surgical pathway Keeping track with procedures that were beingfurther delayed or cancelled Inefficient governed means of recordingpatients’ Covid-19 surgical risk assessment 1 2 3 4 5 Pathpoint can filter granular informations forspecific cohorts: Risk/Cancer/Priority/Wait/Surgical needs Sync team workflows with automaticallyupdated digital waiting lists acrossdepartments Digital theatre board to track POA status orany specific surgical requirements Surgical scheduling tools including short notice,pre screening on POA additions to maximisetheatre utilisation Automatic Covid risk assessment andintegrated harm review assessment

Our Process

REQUIREMENTS GATHERING Trust project team and Open Medical spent time with allspecialities and stakeholders involved in the project, whichwas critical given the complexity of the elective surgical pathway. CO-DESIGN WITH STAKEHOLDERS The pre-implementation consultation phase provided the Trust with anopportunity to fully engage with Open Medical about the overall requirementsof the solution needed and inform about the challenges with the current paperbased processes. SOLUTION IMPLEMENTATION The solution was implemented in October 2020.Pathpoint Surgicare was customised to the needsof the Trust, and provided a fully integrated clinicalworkflow allowing clinicians across the teams toprovide the best patient care in a sustainable manner.
REQUIREMENTS GATHERING Trust project team and Open Medical spent time with all specialities andstakeholders involved in the project, which was critical given the complexityof the elective surgical pathway. CO-DESIGN WITH STAKEHOLDERS The pre-implementation consultation phase provided the Trust with anopportunity to fully engage with Open Medical about the overall requirementsof the solution needed and inform about the challenges with the current paperbased processes. SOLUTION IMPLEMENTATION The solution was implemented in October 2020. Pathpoint Surgicare wascustomised to the needs of the Trust, and provided a fully integrated clinicalworkflow allowing clinicians across the teams to provide the best patientcare in a sustainable manner.

What is Pathpoint Surgicare?

Highly-intuitive end-to-end digital solution for elective care

1
Improved care and team coordination with customisable digital workflows for every speciality
2
Effective theatre scheduling with real-time overview of states, cancellations and surgical capacity with total theatre time estimation
3
Better quality service with seamless anaesthetic escalation pathways, allowing communication between the pre-assessment team
4
High level visibility on the performance of the department with filters and custom codes

Surgicare outcomes

The adoption of Pathpoint SurgiCare at the Trust, has enabled clinical, administrative and management teams to have a full bird’s eye view of the entire digital elective surgical care pathways, from decision to operate to post-operative discharge.

This has helped the Trust in reducing the surgical backlog, and will continue to provide a sustainable system on which to implement future surgical quality improvement projects.

1
TRANSFORM
Digitally transformed surgical workflows of 11 specialties
2
STREAMLINE
Streamlined preoperative assessments across multiple interlinked POA departments
3
COMMUNICATE
Communicated real-time POA status & outcomes to admissions & theatres departments respectively
4
ESCALATE
Effectively escalated to patients requiring clinical anaesthetic assessment prior to surgery
5
VISUALISE
Pathways are connected between departments across the entire patient journey, improving visibility
6
ASSESS
Appropriately risk assessed surgical patients for Covid-19 related complications
7
CONNECT
Ensured documentation is available for all stakeholders to review
8
REDUCE RISK
Conducted clinical harm reviews of delayed patients to ensure they were not coming to harm

Pathpoint has shown rapid scalability serving clinical workflow at multiple NHS care settings:

150+

NHS Sites

3m

Patients

25,000

Daily active clinicians

With the ultimate goal of improving quality of care, Pathpoint helps organisations standardise care, streamline processes to enhance efficiency, leverage data-driven insights, and foster a collaborative excellence among healthcare providers, all seamlessly

ALIGNING WITH GIRFT PRINCIPLES.