Lincolnshire is one of England's most sparsely populated counties, with 751,200 people spread across its 5,921 square km. It is predominantly rural with no motorways, which creates fundamental difficulties in the provision of healthcare services, underlining the need for cross-organisational workflows that improve collaboration and coordination.
United Lincolnshire Hospitals NHS Trust (ULH) has two main trauma units, which receive between 1,200 and 1,500 referrals per month from seven virtual fracture clinics (VFCs) dispersed throughout Lincolnshire.
ULH used to receive referrals through various ungoverned and non-standardised means, including phone calls, emails, and faxes. Trauma lists were manually managed using legacy processes like whiteboards and paper, and they lacked time-references, patient status, or tags. This led to difficulties tracking patients along their pathways and made processing referral information, and gathering and analysing data highly time intensive. The major contributors to their challenges were the fractured communication and minimal visibility across sites. It exacerbated challenges in case-load management and impacted their trauma workflow efficiency.
A transformative digital solution
To address these challenges, ULH planned to harmonise and streamline their orthopaedic trauma processes across the region to improve data quality, security, and collection, and boost regional collaboration and visibility. They achieved their progressive vision with the help of Open Medical’s digital solution PathpointⓇ eTrauma, a cloud-based, end-to-end platform designed to optimise cross-organisation trauma coordination.
Open Medical employed a collaborative approach to ensure the solution was tailored to the specific clinical workflows; Mr. Kulandaivel Sakthivel, Consultant Orthopaedic Surgeon and Divisional Clinical Director at ULH, and Mr. Thomas Cheung, Clinical Director for Urgent and Emergency Care (UEC) at Lincolnshire Community Health Services (LCHS) both played a pivotal role ensuring eTrauma effectively addressed the challenges that they sought to overcome.
“I have worked at different LCHS sites, each had its own legacy referral pathways to Fracture Clinic. eTrauma provided consistency across all sites as well as improved accountability and governance of the referral process. This is the cornerstone to developing a beautiful collaboration between UTCs and the T&O team. The data from eTrauma will be invaluable to streamlining the process and providing evidenced feedback to both the Orthopaedic Consultants and UTC ACPs.” Mr. Thomas Cheung, Clinical Director UEC at LCHS.
Optimised referral management
VFCs can submit referrals via eTrauma's centralised interface, which offers referral templates with mandatory fields and integrates with the Patient Admission System (PAS). This allows clinicians to access essential clinical information on a single system, streamlining referral management. With eTrauma, ULH actioned 99.7% of over 33,700 referrals within the mandated 72 hours. In addition, with an average referral assessment time of 10.7 hours, the trust was able to maintain the same admissions rate despite an increase in referrals.
The platform displays an automated trauma board with a list of scheduled, unscheduled, and pending patients and provides real-time oversight of the trauma department. The patient status is highlighted with tags so that clinical teams can readily monitor and prioritise patients throughout their care pathways. These functionalities, coupled with optimised referral management, helped the trust preserve efficient referral to theatre times, with a median of 1 day for inpatients and 3 days for outpatients.
eTrauma captures SNOMED CT coded clinical data at the point of entry which can be viewed on the system's dashboard. The platform captures high-quality data, which in turn gives the trust granular care metrics they can use meaningfully, such as for future service planning.
eTrauma is cloud-based and user access is regulated; multidisciplinary teams have access to relevant information whenever and wherever they need it. eTrauma provides visibility of the end-to-end patient journey between geographically dispersed sites and sub-specialty teams, significantly enhancing collaboration and resource allocation.