Use of a Software Platform to Improve Patient Safety in Handover and Escalation of Care

Project summary

Background

Emphasis on healthcare quality and patient safety has increased significantly in recent years. In part this has been a consequence of concerning findings picked up through high impact, well-publicized reports into the current state of affairs both nationally and internationally.

Work has been conducted looking at safety gaps that exist within the patient pathway; including between primary and secondary care and daily clinical handover between hospital teams. There is a critical transition point occurring with regularity that needs further scrutiny: Escalation of Care (EoC). Escalation represents part of the entire handover process and is one of the multiple deficiencies that exist within clinical handover at the present time.

The introduction of several electronic and technological improvements in the way health systems work (known as eHealth) has incentivized those in the healthcare industry to invest in this area. This research project will use eHealth and a systems approach to escalation to improve the quality and safety of escalation within clinical handover.

Aims

1. To define a systems approach to EoC which will identify the levels of escalation
2. To establish the problems within handover that occur at each level across the patient pathway from patient through to consultant/critical care
3. To assess the ability of technology to improve these issues including current structures such as EWS and H@N
4. To develop new software with the aim of improving EoC practice
5. To test the safety, efficacy and cost-effectiveness of the new software.

Outputs

• Escalation of care and failure to rescue: a multicenter, multiprofessional qualitative study.Surgery. 2014.
  
• Effectiveness of interventions to improve patient handover in surgery: A systematic review.Surgery. 2015.
  
• Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams. Am J Surg. 2015.
  
• Escalation of care in surgery: a systematic risk assessment to prevent avoidable harm in hospitalized patients. Ann Surg. 2015.
  
• Raising the Alarm: A Cross-Sectional Study Exploring the Factors Affecting Patients' Willingness to Escalate Care on Surgical Wards.World J Surg. 2015. 
  
• The uses of smartphones and tablet devices in surgery: A systematic review of the literature.Surgery. 2015.
  
• Requirements of a new communication technology for handover and the escalation of patient care: a multi-stakeholder analysis. J Eval Clin Pract. 2014.
  
• The Imperial Clarify, Design and Evaluate (CDE) approach to mHealth development. BMJ Innovations. 2015.
  

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