The pace of digital transformation throughout the NHS is accelerating. Ways of working have been overhauled in response to the COVID-19 pandemic and new workflows are urgently required to address lengthening waiting lists. For stressed NHS staff the risk of burnout is now a major concern: 92% of trusts have concerns about staff wellbeing, stress and burnout following the pandemic.
It has never been more important to empower every individual with immediate access to trusted information at the point of care. Trusts are creating an ever-increasing volume of information that can transform patient care — from electronic patient records (EPRs) and Order-Comms to imaging and body maps. They are creating the foundation for new ways of collaboration and exploring innovations in the areas of artificial intelligence to improve patient outcomes.
Yet too often this investment is compromised by a failure to understand how best to present information at the point of care. Why invest in a state-of-the-art digital solution if staff can see only a tiny subset of the information on a small tablet or laptop? As Steve Belcher, Senior Account Manager at Ergotron explains, the quality of point of care computing can directly impact the way clinicians use information within clinical settings, supporting better patient outcomes and helping reduce clinician stress.
Digital maturity
The digital transformation progress made across the NHS over the past few years has been impressive. However, the digital maturity of organisations across the UK remains varied. While some Trusts have nearly eradicated paper and are providing clinicians with immediate access to detailed patient information at the point of care, others are still struggling with disjointed information, including paper records and charts.
As a result, clinicians still spend too much time walking to and from the bedside to workstations, then waiting for a workstation to become available. Research suggests more than 25% of a nurse’s time is spent walking the hospital floor. These delays can slow down patient treatment and even result in additional time spent in hospital. Such inefficiencies can also add to the risk of error, from ordering the incorrect tests to recording inaccurate information. They add pressures to an already overstretched NHS workforce.
What is really frustrating for clinicians is that the benefits offered by the significant investment in digital information resources over the past few years are too often compromised by the deployment of small computer displays that are ineffective at the point of care.
Undermining EPR value
In theory, the increasingly information rich and sophisticated EPRs should be transforming the point of care experience. Combining in-depth patient information, including imaging and test results, with workflow and evidence to support patient care decisions, EPRs are a hugely valuable clinical resource.
Yet these complex data resources can only empower clinicians if the information can be viewed and used effectively. How is information presented? Is it intuitive and available on one screen or are clinicians compelled to scroll? Is the screen resolution and size adequate to interpret images or collaborate with colleagues and interact with patients to support their engagement in their care plans?
As too many Trusts have discovered, the wrong device option at the point of care can add undue stress to a workforce already under immense pressure. Tablets, for example, not only offer an inadequate screen size for the breadth of information now held within the EPR, but also need constant charging, are routinely dropped and raise infection control concerns. Laptops also lack the screen size and resolution required to maximise the new depth of data resource, especially during ward rounds when multiple clinicians need to look at records, imaging, prescribing and notes simultaneously.
If the devices deployed at the point of care are not intuitive for clinical staff, they will not be used, rendering the investment in digitalisation worthless.
Supporting effective care
Frustrated by the size, resolution and battery constraints of laptops and tablets, digitally mature Trusts are increasingly refocusing investment towards larger, high resolution screens on powered carts to transform the experience at the point of care for both clinicians and patients. The ability to view and review images at the bedside or during a ward round is changing the way clinicians work. In addition to providing far quicker access to information and minimising the need to scroll, a larger screen makes it more intuitive for clinicians to follow key steps within a workflow.
Large screens support more effective clinician interactions during ward rounds, especially in acute surgical and medical wards where rounds include a diverse clinical team who need to view and review information simultaneously and manage workloads. Height adjustable, ergonomically designed carts ensure the technology can be used comfortably by multiple clinicians with different physical needs.
Access to a larger screen is also changing the patient interaction and encouraging patients to become more engaged in their own health information — a key strand in NHSX’s “What Good Looks Like” framework for measuring digital transformation. Unlike a laptop, which can become a barrier between patient and clinician, working together on a big screen allows patients to see, check and discuss the information. This approach also supports the Triangle of Care, which ensures the right distance between the provider, patient and technology to maximise comfort and the patient-clinician relationship.
Conclusion
The digital maturity of organisations across the UK remains hugely varied, and that is affecting the day-to-day experiences of both clinicians and patients. On one end, there is an ED clinician provided with a dual screen powered cart displaying both EPR and medical imaging, as well as highly visual information relating to waiting time against target deadlines and the patient’s stage within the care process. At the other end is an individual still wrestling with disjointed information, including paper records, trying to provide effective care. These are vastly different working environments that will have real implications for clinician stress, well-being and burnout.
The pressure to make change has never been greater. Clinicians need better access to resources, a chance to minimise delays, enhance collaboration and improve patient outcomes. The rapid evolution of EPR systems has provided far more detailed patient information but are clinicians able to use it effectively at the point of care?
To maximise the value of the investment in digital data resources, improve the day-to-day working environment for clinicians and support improvements to the patient pathways, all Trusts need to consider the right point of care computer and screen size to provide clinicians with rapid, reliable and timely access to systems and information.
