Background

Serving North Derbyshire's population and beyond, Chesterfield Royal Hospital NHS Foundation Trust provides a full range of acute services - plus 24-hour accident and emergency care. The hospital has around 550 beds and a budget of £160 million (2007/2008). More than 3,000 staff are employed by the Trust.

Situation

The Trust used a variety of methods to capture patient activity and clinical workload in Therapy Services, which employs just over 120 staff. Understandably, this meant that comparison between services and teams was difficult and it also led to inconsistent working practices.

The Trust’s PAS (Patient Administration System) was used for scheduling outpatient appointments and as such it provided basic activity, access and waiting time data but it was inappropriate for day to day clinical use.

It was concluded that the service required a robust system that would reliably provide:

• Accurate, consistent and detailed activity data
• “Live” waiting time data
• A clear picture of clinical workload
• Time and costs associated with each intervention
• Aetiology information to inform service planning and redesign
• Detailed clinical information to support clinical care planning and pathway development for clinical interventions
• Intelligence to refine reference costs and tariffs for HRGs
• A clear picture of cross directorate shared activity or therapy shared activity
• Sufficient flexibility to adapt to innovative clinical practice or new evidence based service delivery
• Facilitate clinical task management for individual patients
• Provide consistency of information and comparable data
• Ongoing monitoring and adaptation to national and local service targets

Outcome

The implementation of Therapy Manager has delivered considerable changes to the provision of Therapy Services within the Trust. They now have accurate information to drive change in workforce utilisation (both clinicians and administrative staff), improved scheduling, a greatly enhanced understanding of clinical activity and informed forward planning.

It has also allowed the Trust to incorporate PROMS (patient reported outcome measures) into day to day clinical activities.

Therapy Manager has also enabled the Trust to gain standardisation and consistency across all specialties within Therapy Services.

“We are very happy with how the implementation of Therapy Manager has gone. The ease of use of the system and the untiring support and professionalism of Pathway’s staff has contributed hugely to it’s successful implementation and use across all clinical areas.
As a management tool having accessible real time information on clinical capacity and activity is superb. As the system becomes more deeply embedded into everyday practice we are looking forward to Phase Two of the project.”

Michaela Wright, Head of Speech & Language Therapy

“We are delighted with the rollout of Therapy Manager across our full range of Therapy Services. This has been a huge step forwards for the teams, moving to working with fully electronic patient records, and has transformed the availability of performance data.  

The support from Pathway through this challenging process has been excellent.  We now have clear visibility of activity and are well positioned to undertake service improvement based on accurate, timely data to continue moving our services forwards for our patients.”

Stuart Ellis, Head of Innovation & General Manager - Central Services