FlexiPort® Blood Pressure CuffsDerby Teaching Hospitals NHS Foundation TrustStandardisation Case Study

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Derby Teaching Hospitals NHS Foundation Trust is highly rated. Staff motivation and morale are high and patient outcomes excellent. The Trust is busy too, with 1,100 beds and over one million patients cared for each year.

With the need for staff to work as efficiently and effectively as possible, the Trust has turned to innovative technological solutions to help staff carry out routine observations quicker. Not only has this saved the Trust money, most importantly, it has released nursing time back to caring for patients.

Reducing the Pressure at Derby Teaching HospitalsWith Flexiport: The Only True Standardisation Solution

A better way of doing things?Before deciding to standardise blood pressure cuffs, the benefits had to be clearly understood.

c Was there a way of procuring BP cuffs so that just one manufacturer could be used throughout the hospital?

c Would this end cuff confusion and save time with simpler, quicker connections?

c Could it provide the full range of sizes to suit all patients, whatever their shape or size?

c Would care improve as a result?

More than that, would there be assurance of a dedicated supplier partnership, providing an on-site presence for the product installation, training, internal communications and technical support?Last but not least, could the new system be installed without interrupting the smooth running of the wards?

THE ROYAL DERBY IS THE SECOND BIGGEST SINGLE SITE HOSPITAL IN ENGLAND

Blood pressure monitoring was a case in point. A routine task that should be completed in seconds was often taking far longer. With a range of BP machines, cuffs and different connectors, staff could lose precious minutes trying to find the right match. Some machines were under-used as a result; some not at all. Boxes of incorrectly ordered cuffs built up on the wards.

From procurement to clinical engineering, different staff were coming to the same conclusion: there had to be a better way of doing things. The question was, how?

The Trust needed more than just a blood pressure cuff supplier. It needed a partner offering not just cost effective products but the expertise and technical know-how to make standardisation a success.

Their search took them to Welch Allyn and its unique FlexiPort cuff system, an unrivalled, holistic solution, quick to attach to patients and easy to use for the caregiver. It offers the most comprehensive range of cuff options available on the market, backed by dedicated on-site representatives.

‘It’s not just about the cost.’ Stephanie McCarthy, Clinical Procurement Nurse

‘I had no idea of a solution, but it just couldn’t go on.’

Rebecca Pipes, Sister MAU

A routine task that should be completed in seconds was often taking far longer.

‘It could take five or ten minutes to find a machine.’

Vanessa Middleton, Senior Sister Ward 402

A TOTAL APPROACHThere had to be more benefits than just cost saving. The new cuffs had to exceed everyone’s expectations, including patients. And that meant selecting a supplier capable of offering a holistic solution.

‘We have a holistic perspective.’

Stephanie McCarthy

REDUCING THE COSTCost effectiveness was integral to the project, with seven per cent the minimum savings target.

‘We needed a return of at least seven per cent.’

Stephanie McCarthy

STANDARDISATIONDerby Teaching Hospitals had already success-fully standardised other core products such as gloves. Blood pressure cuffs were an obvious candidate for a similar process – but only if similar efficiencies and clinical benefits could be achieved.

‘We needed a generic system to fit every blood pressure machine.’

Stephanie McCarthy

PATIENT SAFETYAny new blood pressure measurement system had to enhance patient safety. Using an incorrectly sized cuff can affect accuracy by up to 30mmhg1, so easy access to a range of cuff sizes which fit any machine was essential.

‘Patients have to come first.’ Rebecca Pipes

TIME SAVINGOn a busy ward, with hundreds of blood pres-sure measurements taken every day, attaching tubes and finding the right cuffs all took time. An alternative system was needed to release the time back to caring for patients.

DEFINING THE OBJECTIVES

THE HOLISTIC CHOICE: THE WELCH ALLYN FLEXIPORT SYSTEM

With a combination of unique features, the Welch Allyn FlexiPort system was an obvious choice for Derby Teaching Hospitals, to help meet all of their objectives.

Easy to fit, use and remove, FlexiPort cuffs have a one-handed snap on, snap off connection and can be attached to patients in seconds - quicker and simpler than any other system.

A simple conversion in minutes is all it takes for FlexiPort cuffs to work with any blood pressure device, regardless of make or model.

Quicker and simpler than any other system.

Patient comfort is significantly improved with the rotatable port and can be swiftly moved aside during surgery, making access far easier for theatre staff.

With one of the widest range of sizes available on the market, including five for adults, the Welch Allyn cuffs

A cross-functional team was assembled to evaluate the cuff options available. Following agreement on the price per unit and purchasing route via the NHS Supply Chain, the decision to go with Welch Allyn was made at the end of 2014.

prioritise BP accuracy by using the correct sized cuff.

In addition to reusable cuffs, there are also disposable and single-patient use equivalents.

Spending on cuffs is anticipated to go

down by 75%.

STAGE ONE: THE TRIAL February 2015A robust trial that tested the new system to the limit was essential. As one of the busiest wards in the hospital with a daily turnover of more than 50 patients, the MAU (Medical Assessment Unit) was the logical trial location.

Conversion of the MAU’s ten blood pressure devices averaged just a minute apiece – around 25 per cent faster than anticipated.

‘We had a phased introduction programme that worked very well.’

Stephanie McCarthy

STAGE TWO: REVIEWING THE TRIAL February - March 2015Reviewed a month later, the trial generated universally positive feedback, with praise for the speedy, disruption-free conversion of each device – and the instant improvement it had made. ‘It saves a load of hassle and a load of time,’ commented Clint Cooper, Charge Nurse MAU.

STAGE THREE: HOSPITAL-WIDE ROLL OUT April – May 2015In April and May, more than 2,000 blood pressure devices were equipped with the FlexiPort fitting and cuffs by Clinical Engineering and Welch Allyn together.

‘Areas that fed into each other were changed at the same time.’

Iain Watt, Senior Theatre Practitioner and Anaesthetic Equipment Coordinator

Welch Allyn had an on-site presence throughout and was fully involved in supporting internal communications, from intranet updates and posters to seamless training for senior staff, so everyone was clear about how the FlexiPort connector worked.

For the technicians, the biggest reaction was … silence. And that’s ‘a good thing,’ confirms Jeff Pilbin. ‘It was very straightforward.’

‘All credit to Welch Allyn. They’ve done a lot of work behind the scenes.’

Stephanie McCarthy

FROM IDEA TO INSTALLATION: THE CHANGEOVER TIMELINETHE HOLISTIC CHOICE: THE WELCH ALLYN FLEXIPORT SYSTEM

GETTING BACK THOSE LOST MINUTES

‘You’ve always got the right-size cuff so you’re saving

yourself maybe five minutes each time.’

Rebecca Pipes

Ward staff are in no doubt that the new, FlexiPort system is adding precious time to the working day, releasing time to care for patients.

Theatre staff, too, are seeing similar added efficiencies. ‘So far since the changeover, the box for “can’t find equipment” hasn’t been ticked,’ says Iain Watt.

A BETTER EXPERIENCE FOR PATIENTS

Healthcare Assistants can take routine obser-vations quicker and more accurately – making blood pressure trends easier to monitor over time.

‘HCAs now do the observations within minutes,

so they’re not disturbing patients.’

Karen Hooley, Housekeeper Ward 402

It makes for all-round improvements, agrees Russel Turner. ‘Patients get their blood pressure taken when they need to, accurately, because we’re using the correct products.’

THE ROUTE TO SUCCESS DETAILED PLANNING

c Trial first in demanding environment c Full roll-out based on hospital geography to convert maximum devices in the shortest possible time c Phased changeover to reduce cuff wastage c Flexible approach

COLLABORATION c Small, expert team combining clinical and technical experience c Total supplier commitment – Welch Allyn on site through the entire conversion process

COMMUNICATIONS AND TRAINING c All hospital staff kept in the picture, supported by Welch Allyn, with posters, intranet and

screensaver updates c Top down training from Welch Allyn, with senior nurses training other ward staff

THE RIGHT CUFF FOR EVERY DEVICEOf staff questioned by Welch Allyn2 about their reaction to the cuffs, 100 per cent agreed it had made their working lives easier. Nine out of ten found the new cuffs easy to fit on patients.

‘It’s an excellent system.’ Iain Watt

The same number rated the FlexiPort connection far easier to use and more comfortable for patients.

And had the Trust been wise to opt for a standardised system? More than ninety per cent of staff surveyed agreed it had.

COST SAVINGS THAT REALLY ADDED UPThe Trust’s consolidated purchasing power enabled Welch Allyn to provide the best solution at a very competitive price. Spending on cuffs is anticipated to go down by 75 per cent – enough to cover half a staff nurse’s salary each year. ‘This is way, way over our seven per cent savings target,’ says Stephanie McCarthy.

‘What’s it given me? Half a staff nurse.’

Stephanie McCarthy

A QUIETER LIFE FOR ENGINEERS

‘People comment that the system is much better.’

Russel Turner

Clinical Engineering anticipate that over the next three to six months, cuff-related queries will go down. ‘We’re very happy with the way it’s gone,’ says Tom Spicer.

THE WRAPAROUND BENEFITS

c One connector, one cuff and one system

c No more cuff and machine mismatches

c Helps improve blood pressure and trend accuracy

c Staff saving valuable minutes – releasing time to care

c Spending on cuffs anticipated to reduce by 75%

c 100% of staff surveyed agreed that Flexiport has made their working lives are easier

c Smooth, problem-free implementation

c No stock shortages or incorrect ordering

c Training is more accurate

c True partnership with the supplier (Welch Allyn)

THE KEY OUTCOMES

For many in the hospital, the logical next stage is greater use of single patient use cuffs to assist with patient flow. Currently, this is a ‘golden aspiration’, which will be implemented with the FlexiPort system when the time is right. For now, there’s universal praise for the way the Welch Allyn system has improved daily life for staff and patients.

Their advice to other Trusts thinking of doing the same thing? ‘Be brave and go for it.’

‘BE BRAVE AND DO IT!’: THE ADVICE TO OTHERS

DEVELOPING STAFF COMMUNICATIONS From posters to the screensaver reminders, Welch Allyn helped produce a range of internal communications materials to keep staff informed.

SHARING THE INSTALLATION PROCESSWelch Allyn ‘were involved in most stages of the conversion, physically going round with the engineers and helping to do the swap overs,’ says Russel Turner.

‘Everything promised has been delivered.’

Tom Spicer

WELCH ALLYN: A PARTNERSHIP FROM START TO FINISH

INVOLVEMENT IN STAFF TRAINING Welch Allyn helped to train senior ward staff with the new system, ensuring they were able to train other team members.

100% of staff surveyed agreed that Flexiport

had made their working lives easier

MANY THANKS TO ALL THE STAFF INVOLVED IN THE DERBY TEACHING HOSPITALS FLEXIPORT STANDARDISATION, PARTICULARLY:

c Mark Cannell, Clinical Specialist and Equipment Library Manager

c Russel Turner, Equipment Library Clinical Equipment Trainer

c Clint Cooper, Charge Nurse MAU

c Karen Hooley, Housekeeper Ward 402

c Stephanie McCarthy, Clinical Procurement Nurse

c Vanessa Middleton, Senior Sister Ward 402

c Jeff Pilbin, Technician Clinical Engineering

c Rebecca Pipes, Sister MAU

c Tom Spicer, Deputy Manager Clinical Engineering

c Iain Watt, Senior Theatre Practitioner and Anaesthetic Equipment Coordinator

References:

1. O’Brien, E. Measurement of Blood Pressure. Beevers, Lip, O’Brien: The ABCs of Hypertension. Blackwell Publishing, 2007.

2. Welch Allyn on-site questionnaire (15th May 2015)

© 2015 WELCH ALLYN MC12454