A recent conversation about the potential benefits to be gained within Acute Services in the NHS through the adoption of just one of the features of 2Go No Code Mobile, has given me a reason to consider what the larger impact might be upon the NHS, its workforce and patients if fuller use could be made of such as solution as 2Go No Code Mobile.
I’m sure that we will uncover further benefits over time as the use of 2Go No Code Mobile within healthcare gets more widely accepted but for now I’d like to focus on 4 key areas:
- Time savings
- Cost Savings
- Beneficial impact upon patient safety
- Beneficial impact upon staff safety
Each one of these is, in its own right, an important factor but taken as a whole, there is significant potential for major benefits to accrue through the use of this approach.
Let’s consider Time:
An emergency doctor, Dr Adam Radford, working at the Royal University Hospital of Bath has looked at how 2Go No Code Mobile’s ability to enable him to use the voice recognition facility with a mobile device to enable him to dictate notes directly into patient records systems.
To him, this offers the prospect of saving between 10 and 15 minutes every time he needs to record a Finished Consultant Episode (FCE) for a patient. Whilst this may not seem a great time saving, in practice this could allow Dr Radford and his 7,500+ emergency doctor peers working within the NHS to treat some 26% more patients in A&E and, as a result ensure better performance against the target of dealing with 95% of patients within 4 hours.
This could result in close to 300 extra patients a day being treated in A&E across the NHS Acute Services alone and nearly 400 extra patients a day being treated if the same savings can be identified in Day Case, Elective Inpatient, Non-elective Inpatient and Outpatient services.
One other aspect of time which can be saved through the deployment of 2Go No Code Mobile technology is the reduction in time staff spend each day walking to and from the ward desktop in order to enter or review information about the patients within their care.
A study has shown that staff walk on average 3.6 miles a day and, in one extreme case, up to 11 miles a day! This equates to an hour a day spent walking and if we assume that 10% of this time is spent walking to and from the ward computer then this effort and time can be reduced.
Finally, let’s consider the time taken to arrive at a current impression of the state of a patient’s health. Currently there are multiple opportunities for a single patient to be in contact with NHS services and each “discipline” tends to have their own discrete systems but often holding similar information e.g. a Trusted Assessment.
The next doctor to consider the patient currently has to spend time wading through multiple logins etc. to try to form “a holistic view” of the patient’s current state, sometimes with missing content . Through the use of Multiple Concurrent Views, 2Go No Code Mobile can provide an immediate cross-discipline view of the Trusted Assessments in order of most recent interaction. This might save up to a further 15 minutes of doctor’s time in dealing with each FCE.
Now let’s turn to Cost:
The financial impact of saving 10 – 15 minutes per FCE could result in significant savings to NHS Trusts as even just within Acute Services and assuming only 1 FCE per patient per annum this would amount to £22 million or £110 million over the initial 5 year life of the 2Go No Code Mobile solution.
Grossed up across the other areas of the NHS (Day Cases, Elective Inpatients ….) the figures are even more impressive at nearly £300 million a year or £1.5 billion over 5 years
Again, with the saving of say 6 minutes per day per nurse estimated from the walking study and taking into account the number of nurses in the NHS (311,380) and the average salary (£34,000), this could equate to a saving of over £500,000 a year or £2.5 million over 5 years.
As shown above, a saving of as little as 10 minutes per FCE could result in savings of nearly £300 million a year and the assumed saving of 15 minutes in preparing for “a holistic view” of a patient via 2Go No Code Mobile’s Multiple Concurrent View approach could add a further £450 million a year to this total!
Such discussions however fail to address a couple of equally important areas so let’s first address the beneficial impact upon Patient Safety:
Although apocryphal, the oft quoted comment about doctor’s handwriting being undecipherable does however, raise important considerations of patient safety. If the next doctor to review your notes is unable to decipher the handwriting of the previous practitioner, or worse, mistakes entries in the notes, this can lead to significant risk of mistakes in patient care and/or medication.
Clearly any process which converts such a hand-written approach to note taking to one which is recorded digitally will substantially reduce the likelihood of mistaken reading, but this is reliant upon the skill and speed of the typing ability of the doctor entering the notes.
This is where 2Go No Code Mobile’s voice recognition based data capture comes into it’s own as it enables the doctor to dictate notes directly into the patient record, review on screen and amend where necessary.
One other impact of the implementation of 2Go No Code Mobile in Acute Services is the rate at which doctors can move on to treating the next patient, estimated to be 10 -15 minutes faster than at present. This increase in efficiency should have a beneficial impact on waiting times and it is estimated could reduce an average 4 hour target time to around 3 hours 11 minutes. This means that patients can be treated more quickly and either discharged or admittedly more rapidly.
Overall, the use of mobile working technology will also improve patient safety as it will enable doctors and nurses to review case notes in a more timely fashion without having to wait for the last person to see the patient walking back to the ward computer (and sometimes queuing!) to enter the notes – they can be captured at the bedside.
Finally, there should be a very positive impact upon Staff safety:
This results from the requirement of staff to wear full Personal Protective Equipment (PPE) as part of the Standard Infection Control Procedures (SICPs) and has obviously been brought sharply into focus by the Covid-19 pandemic.
What may be new to people, is that there is a body of opinion that there is an increased risk to staff of contracting Covid-19 at the time of removing PPE as this may be carrying the virus at the time and with, on average, up to 4 changes in PPE per shift taking place, any reduction in the need to remove PPE also reduces the risk!
Eliminating the need to remove gloves in order to type also brings another benefit in that before staff can don a new set of gloves, it is necessary for them to wash their hands thoroughly again, all leading to taking longer to complete the same number of tasks.
The voice recognition based data capture facility within 2Go No Code Mobile can be accessed directly via the mobile device in use by the practitioner and does not require them to, for example, remove gloves in order to type.
Typing also raises another problem with accessing keyboards etc. at present which is that, with some equipment in communal use, there is a need to “deep clean” after every use and another potential risk area of infection if this is either missed or not conducted correctly. Personal mobile devices can be relatively easily swabbed clean on a regular basis.
The reduction in walking time created through remote working should also benefit staff leaving them less tired at the end of a shift and lead to better staff health and morale.
 Source: Key Facts & Figures about the NHS – The Kings Fund 8 November 2019
 Source: Nursing Times – 11 January 2016
 Source: Key Facts & Figures about the NHS – The Kings Fund 8 November 2019
 Source: Nurses.co.uk website
You can also find more on our 2Go in Healthcare page.