JOE DONNELLY – NHS TAYSIDE
EMPTAYDD
JANUARY 2002
256 DELAYED DISCHARGES IN TAYSIDE
RECORDED MANUALLY ACROSS HEALTH BOARD, 2 TRUSTS & 3 LOCAL AUTHORITY
AREAS
Initial Position
• Developed to resolve local issues relating to ISD
request to compile a validated, quarterly census of
delayed discharges
Lack of standardised recording methods
Lack of clarity relating to patient status
Difficulties in exchanging information securely
Difficulties in exchanging information quickly
Background
Background (cont.)
• Developed by NHS Tayside’s ICT department in
partnership with Information Services, Medical
Records, and Local Authority colleagues in Angus,
Dundee, and Perth & Kinross
• Provides secure access to a patient specific
delayed discharge database
• Enables live data recording and real-time reporting
Background (cont.)
• Builds upon local Community Health Index (CHI) database, a unique patient identifier used throughout local healthcare systems in Tayside and now a required data item in ISD quarterly census
• Has not replaced local social work referral protocols
• Requires an agreed information sharing protocol
Background (cont.)
Joint Information Sharing Protocol
● First of it’s kind in Scotland
● Agreed between each of the three Health & Social Care Partnerships across Tayside
● Allows sharing of patient data, and information reporting between and across local authorities and NHS
● Not strictly a legal document but a statement of guiding principle with some legal status
Central patient contact database
Reliable patient index based on CHI
Secure access for Local Authorities and NHS
Contact archiving and searching with flexible
query facilities
Comprehensive reporting facilities
Comprehensive user audit logging
Key System Features
Thin client, web based application (MS I.E. 6)
Oracle RDBMS (Version 8i)
Sun Microsystems Server (Solaris version 8)
LDAP (Lightweight Directory Access Protocol)
compliant
Operates over NHS Net
Full user and transaction audit logging
Full Back up and Recovery facilities
Key Technical Features
Ward UsersInput and amend health care data
Health Strategy/Delayed Discharge ManagerExtract info to inform strategic decisions Reporting at Chief Executive/Board level
Liaise with patients, carers, clinical and social care staff
Social Care UsersInput and amend social care data
System AdministratorEnsure data quality, report to Directorate level, census validation
and submission, and maintenance of system data tables
EMPTAYDDElectronic Management of Delayed
Discharge Patients
IM & TSystem Development, Implementation, Training
and Access
Organisational RelationshipsSystem User Group
PROCESS
Initially - operated centrally by Information Services - Weekly Turnaround Document created by system forwarded to ward, returned, and system updated as necessary
Now - ward users input/update live data which is then immediately viewable by Social Care
Social Care input/update live data which is then immediately viewable by Health Users
Data quality role for system administrator
WARD ROLLOUT
Began Summer 2004 - completed November 2004 (apart from small number of opt-outs e.g. A & E where DDs unlikely)
Named ward staff trained and given live access Paper systems withdrawn
Registration/reporting is now real time
Protocol to deal with occasions when ward staff unavailable to update
Regular audits by CHP DD Co-ordinators, Clinical Group Managers, Social Care managers
Jan 2002: Proposal to develop system
July 2002: System Q/A by Information Services
Aug 2002: Information Services “Live”
Dec 2002: Perth Social Work “Live”
Sep 2003: Angus Social Work “Live”
Nov 2003: Ward pilot by PRI based Community Liaison Team
Dec 2003: Dundee Social Work “Live”
Apr 2004: Ward Pilot PRI
Jun-Nov 2004: Ward User Roll Out
Aug 2006: NHS Fife version goes “live”
April 2007: Inaugural meeting of System User Group with Tayside & Fife membership
Jan 2007: NHS Ayrshire and Arran go “live”
January 2008: Agreement for national rollout
TIMELINE
Patient Search
Registration Screen
List of Delayed Discharges
Archive
Census Export
Export to EXCEL
Social Work Listing
Social Work Acceptance
Form
APRIL 2007 – NHS Tayside achieves nationally set targets - to reduce by 50%
those patients delayed in “short-stay” specialties, and those patients waiting more
than six weeks
ACHIEVED BY COLLABORATIVE WORKING BETWEEN NHS TAYSIDE AND TAYSIDE’S 3 LOCAL AUTHORITY AREAS
Current Position
EMPTAYDD IS NOW THE SOURCE OF ALL VALIDATED DELAYED DISCHARGE
INFORMATION IN TAYSIDE AND FIFE
WORKING TOWARDS ACHIEVING NATIONAL TARGETS OF ZERO PATIENTS DELAYED FOR MORE THAN 42 DAYS OR IN SHORT-STAY SPECIALTIES BY APRIL
2008
Current Position
EMPTAYDD becomes the national recording system for delayed discharges in Scotland
Seamless link to inpatient systems (TOPAS) for system users – to support bed management and
minimise delay in discharge
System users to benefit by availability of standardised, accurate, and timely data for local
and national reporting and analysis
Extend use of system to include patients with very complex needs – to support future strategic
planning
The Future Now
Further Information
Contact (Technical):- Ian Fenton
Head of Information & Communications
Technology
e-mail: [email protected]
phone: 01382 424452
Contact (Admin.):- Iain Dorricott
Information Team Manager (Infrastructure)
e-mail: [email protected]
phone: 01382 527809
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