University Hospitals Birmingham NHS Foundation Trust

University Hospitals Birmingham NHS Foundation Trust (UHB) are a long-time partner of The Access Group. The Trust runs four hospitals, three diagnostic clinics, and a chest clinic for respiratory medicine.

UHB have been using our legacy Oceano ED application as their emergency department software solution for some time, but with their valuable clinical feedback and our own software improvements, we are now moving them onto our reimagined solution – Access ED.

In this case study we will explore testimony from Dean Croft, IT Project Manager at University Hospitals Birmingham, to learn how the four hospitals have been getting on with Oceano previously and what inspired our collaboration to overhaul Oceano with the new Access ED solution.

Who is University Hospitals Birmingham?

University Hospitals Birmingham NHS Foundation Trust is one of the largest Foundation Trusts in England, with more than 24,000 members of staff treating more than 2.6 million people over the course of a year across their sites.

Their sites include the largest hospital in the city, the Queen Elizabeth Hospital Birmingham (QE), as well as Heartlands Hospital in Bordesley Green, Good Hope Hospital in Sutton Coldfield, and Solihull Hospital.

University Hospitals Birmingham has emergency departments at the first three, as well as a Major Trauma Centre at the QE and a minor injuries unit at Solihull.

The Challenge

We interviewed Dean Croft – IT Project Manager at University Hospitals Birmingham – on our stand at this year’s Digital Health Rewired expo at Birmingham’s NEC.

Dean’s view, in combination with clinician feedback, was that while UHB liked the Oceano ED solution, there were areas of improvement available. Feedback from users suggested design elements looked dated or could be clearer, to help with at-a-glance engagement in the highly stressful emergency departments. There were also reports of latency issues within the solution, which risked delays – especially on older computers.

From a technical standpoint, University Hospitals Birmingham also wanted a change to their discharge screen and the injury intent fields, to help record violent admission information better. Their figures suggested that only 4-5% of patients had their Emergency Care Injury Intent identified by healthcare professionals.

The Solution

They asked, we delivered. The reimagined Access ED software is built in collaboration with NHS clinicians for NHS workflows, meaning:

Real-time visibility of every patient.
A range of display changes to help with visuals, including colour schemes, a blue light theme, a high contrast theme, and various fonts including dyslexia-friendly options.
Improved software speeds.
A new and improved discharge screen to encourage better recording of injury intent – notably violent admission information as per UHB’s feedback.

Dean explained: “[The changes] write into the same database as our existing ED system at the moment as we transition users across. We will be taking the old one off them shortly, but we are still in the middle of the rollout, so all of our clinical teams are now using Access ED.

“We still need to roll out to our reception and admin users. We've got that planned over the next four or five weeks. Then the idea is that everyone will be using Access ED. No one needs to worry about Oceano. Everyone should see the improvements in workflow, performance, look, feel.”

Outcomes

Off the back of the Access ED rollout across University Hospitals Birmingham NHS Foundation Trust’s four sites, feedback has been positive. Small initial requests were made about adjusting the amount of white on-screen, due to the potentially harsh visuals when working long shifts into the night, but Access rolled out tweaks within a week on top of the initial accessibility options.

Dean went on to say that “I think we had coverage of something like four or five percent for our injury intent fields. As of the end of last week, that's now gone up to around 25% and there's clearly like an upward trend in that. We expect that to continue going upwards, so I think that's a real measurable data quality improvement that we've had since we implemented Access ED, which has only been over the last month or so. So yeah, really positive to get that improvement already.”

Steve Wightman - General Healthcare Manager at The Access Group, said: “The partnership with UHB has been absolutely pivotal because their clinicians have worked with us to make sure that the application does absolutely everything that they want to do.

“It's been so transformational. Clinicians are actually fighting to get on to the new system when we were trying to do a slow start with it, with only a small number of clinicians, and they really pushed hard to move it out, and they've ended up rolling out to all four hospitals in less than a month.”

Croft added: “It has genuinely been a really positive experience… I think the way that Access Group have been able to deal with AI-aided development just means it's really turbo-charged everything. When we have an issue or we have a request for a feature enhancement, we're feeding it back to your guys [Access] and then you're turning it round in, I mean, sometimes 24 hours, and we're getting it through the test system, getting those things raised into life. And it's just… it's been a really exciting way of working.

The Extended emergency medicine ambulatory care (EEMAC) operating principles are “core operating principles that should underpin extended emergency medicine ambulatory care (EEMAC) activity”. These are new directives, as mentioned in our previous article on NHS Urgent and the Emergency Care Plan. For organisations like UHB, adherence to these new instructions is mandatory, so it’s important that their solution(s) acknowledge and accommodate these requirements. Thankfully, Access have already integrated these new rules into the Access ED solution.

“We're just in the process of rolling out functionality for emergency extended medicine ambulatory care or EEMAC. So that's something that I think was only published by the NHS last month. And The Access Group have turned around the software so quickly” said Dean. “So we're in a process where that has just gone from our test system into our live system. We're doing like an engagement session with one of our ED sites tomorrow to try and onboard them for that, which is quite exciting and something that we wouldn't have been able to do with the previous system."

What’s Next?

According to Dean, the Access ED rollout will serve as a foundation for more integrations with other systems used in their emergency departments, with The Access Group joining in on roadmap planning to help deliver further functionality enhancements.

Steve Wightman sung ED’s praises further: “Our new ED platform has been built using all our latest tooling. We've built the whole thing in less than three months and put it live in less than a month with Birmingham. The clinicians absolutely love it. And we want to do more of the same in the acute space with other applications, so we're now looking at sexual health, oncology, theatre management, maternity… I think we have a real opportunity to make a real difference to a lot of organisations.”