How long does the intervention take?
During the project phase, we recorded the time taken to complete the QTD intervention including completing the care plans, conducting the discharge counselling session and the follow-up phone call. The stats show that the time varied between 45 minutes and an hour and a half. These times are no longer recorded, but as the team have become more accustomed to the intervention, it is no longer a discrete episode, but rather a structure to their interaction with patients. It is simply part of the job.
Are there cost implications with regard to staffing resource and the cost of the electronic patient record?
No additional staff have been employed by the Major Trauma team to continue the QTD initiative. There is an annual cost to pay for the licence of the PKB access.
Will my team generate more and more post-discharge enquiries via the electronic portal- is this sustainable?
The ‘e-messages’ would generally have come to the team in the form of telephone enquiries prior to QTD. Responding to the messages is less time-consuming and more robust in terms of the clinical governance whilst avoiding duplication of documentation.
Will the older patients engage with the website?
We don’t have figures reflecting the demographic of the patients engaging actively with their electronic record, but anecdotally, the team report that our older patients tend to be more actively interacting through this medium. Certainly one of my most active correspondents has been a gentleman in his 70’s.
Will there be issues with information and clinical governance?
We encountered no opposition when exploring this with our IG, IT or legal teams in NBT. The electronic patient-held record (including Patients Know Best specifically), is becoming increasingly widely used in the UK and internationally. PKB were happy to address any concerns with regard to these more technical issues.
Is there a requirement for my institution’s IT department to be involved?
In the case study we provided, the answer was ‘no’. However if we had wanted to integrate the electronic patient record with Trust systems which would have significant benefit, then clearly this would require IM&T cooperation.
Do patients use the record?
Yes! Below are some figures which show a very positive uptake from the patients who receive the QTD intervention:
Jan-Dec 2017
- 868 patients registered on PKB by MTPs
- 222 actually offered access and given full ‘Quality trauma discharge’
- Lowest number of patients logging in (each month) is 24 (c11%)
- Highest number of patients logging in (each month) is 54 (c24%)
- Most months at least 40 patients logging in at least once (c18%)
- 1036 messages have been sent since 1st January via PKB
- 51 files added since 1st Jan
- 128 symptoms added since 1 Jan