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How Worcestershire Acute Hospitals NHS Trust achieved rapid benefits realisation through its fast implementation of Sunrise EPR

The trust, which was categorised as "Group 0" under the frontline digitisation programme, has embarked on its digital transformation journey through the implementation of Altera Digital Health's Sunrise electronic patient record (EPR) system in March 2023. Now live across all 56 inpatient wards, the ambitious project saw the trust quickly accelerate its digital maturity, developing a highly configured system that is bespoke to the trust's needs, without needing national funding.

Prior to implementation, clinical teams spent a considerable amount of time completing unnecessary, admin-heavy processes, such as paper observation notes. This resulted in clinicians spending much of their time handwriting manual forms, away from patients. There was also significant duplication of data in multiple places that was not only time consuming but also added risk.

Recognising this, the decision was made to implement Altera Digital Health's Sunrise EPR system. This was based on its interoperability with other systems, the speed of implementation and benefits realisation, support available from the Altera team and the high levels of configurability of the technology.

workflow
Streamlined clinical workflows
telehealth
Improved visibility of patient data and risk assessments improving safety
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Time released back to clinicians
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More than 27,000 documents created per day on Sunrise

Clinically led digital transformation

The trust opted for a phased approach to the EPR implementation, which ensured the system was developed in line with clinical needs and caused minimal disruption to staff whilst delivering rapid benefits. Initially working from an EPR blueprint provided by Altera, the EPR team then localised this blueprint to suit the trust's specific needs.

The Worcestershire EPR team decided to begin the rollout with a three-ward pilot. Having tried and tested the approach, the trust was then able to quickly and successfully roll out the solution to all 56 inpatient wards. Throughout implementation, the trust proactively engaged clinicians, with clinical champions on each ward. This aided the smooth rollout and made sure patient safety was a top priority.

Taking a clinically driven approach also enabled the trust to configure the system to meet specific needs. For example, a "countdown clock" was introduced on the ward tracking board to remind staff when the next set of patient observations was due. This provided staff members with better visibility of their patients' needs, and supported more timely decision-making, improving patient safety.

Stuart Cooper, EPR Programme Director at the trust, said, "The ability to configure the EPR meant the team could hit the ground running with a system that fit their clinical needs and resulted in a smooth digital transition for users."

"The deployment was led by a multidisciplinary EPR team, made up of technical, clinical and operational staff, to ensure the solution was reflective of the trust's specific needs. We have quickly been able to improve the baseline of our digital maturity, with minimal disruption to patient care. The project enabled us to learn along the way to make the transition as smooth as possible, as for many staff this is their first time working digitally."

Stuart Cooper

EPR Programme Director at Worcester Acute Hospitals

Robust training

The trust developed a robust training programme. This was a key component to the success of the project, ensuring staff members were fully equipped for the go-live. Users were provided with a range of training methods, such as user guides, a dedicated website, short video training guides, online support and 24/7 floor walkers throughout the go-live.

A command centre was set up for five-and-a-half-weeks during the pilot golives to ensure the implementation ran smoothly. Set up as a hub in Worcester Royal Hospital, this empowered staff to openly ask questions, familiarise with the new system and ensure it was clinically driven throughout the project.

Before, during and after implementation, the team also received ongoing support from Altera Digital Health.

Stuart Cooper said, "We have worked collaboratively with Altera, developing their blueprint and localising it to meet our requirements. This flexibility meant we were able to build a solution that benefits patients right from go-live. These benefits included improved workflows from a system built to suit the needs of clinicians, released time back to patients and enhanced patient safety."

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Instant improvements to clinical workflows

The highly configured system has made major improvements to clinical workflows and patient safety. Clinicians can use tracking boards for better visibility of patients, and they also enable clinicians to prioritise patients by clinical need.

Matthew Little Chief Nursing Information Officer at the trust, said, "Clinicians can now see every patient's NEWS score in a dashboard, which helps ensure more effective decisions can be made more quickly. Configuring the system to enable this has improved patient experience, but also prioritised clinical needs at the same time."Worcestershire Acute Hospitals NHS Trust

Previously handwritten notes are now electronically inputted, eliminating the risk of illegible entries, saving time that was spent rewriting or interpreting notes. These notes can also be viewed by any clinician from any location, meaning on-call doctors can make more informed decisions more quickly.

Matthew Little continued, "Clinical time is precious, so being able to release time to care is really benefitting patients, improving the standards of care they are receiving. The system is enabling documentation to be completed more quickly and to a higher standard."

Reducing paper processes

It is also saving vast amounts of time that was spent rewriting or interpreting notes. Currently, more than 27,000 documents are created in Sunrise per day, significantly reducing the administrative burden on clinicians, who previously would have filled these out on paper.

Improved patient safety

The EPR is also helping increase safety for patient records as lost observations are less likely to occur and clinical teams can locate patient notes instantaneously. Records can be viewed by any clinician, resulting in safer care and improved clinical processes.

Looking to the future

Having quickly and successfully completed the first phase of its digital transformation journey, the trust is now looking forward to continuing its digital journey and increasing the functionality of its EPR. Given the high configurability of the system, the trust intends to continue making enhancements to the existing functionality, so it continues to meet the needs of the trust and its patients. In the next 12 months, as part of the second phase, the trust plans to go live with electronic prescribing and medicines administration (ePMA) as well as activate Sunrise EPR in its emergency departments.

Dr Anna Bayes, International Medical Director, Altera Digital Health, said, "The team at Worcestershire has demonstrated immense dedication to this major project go-live. Sunrise users are already benefitting from enhanced multidisciplinary communication, visibility of patient observations and serial assessments as well as reduced gaps in care. This is just the first step in Worcestershire's digital transformation, and we look forward to building on this momentum for even further benefits to be harnessed."

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