Lewisham & Greenwich Trust

Clinical Change Requests – Documentation, Correspondence & Emergency Medicene 

OVERVIEW

Lewisham & Greenwich NHS Trust had a backlog of approx. 20 high priority change requests, which had be completed within a 3 month deadline. In addition, there was an urgent requirement to develop a solution for current issues around documenting Deep Vein Thrombosis (DVT) in their EHR system. Previously DVT was not being documented within the timeframes as part a mandatory NHS requirement. As a result, this had significant cost implications for the trust with DVT’s not being recorded in time.

CHALLENGE

Requirement for a large number of change request to go-live within a short time period. This included; requirements gathering, design, consulting, development in non-live environment, testing/sign off & implementation into live system. Some of which were complex configuration changes across several Oracle Cerner solutions. There was a key dependency for trust counterparts to provide further information on queries, perform testing and complete operational readiness tasks (i.e new training materials, user acceptance testing & trust communications.

“SIX FIGURE QUARTERLY COSTS REDUCED COMPLETLEY TO ‘ZERO’ FROM OF NEW DEEP VEIN THROMBOSIS (DVT)  SOLUTION”

PROBLEM IDENTITY

To implement many change requests within a short timeframe, it was essential have requirements defined, documented and signed off by the trust. Scope changes in requirements, would often have an impact on delivery timescales.

Clinical and financial impact for not documenting Deep Vein Thrombosis (DVT) correctly and within specific timeframes.

Countess of Chester Hospital
BENEFITS & OUTCOME
Sample reports outputs identified and resolved,
  • Trust penalties for insufficient DVT submission reduced from six figures to zero in the first quarter from go-live
  • 90%of change requests were implemented into the live system within the agreed deadline
  • Remaining change requests were on hold due to external dependencies and implemented soon after as part of an agreed work off plan
  • Minimal interruption to live service during the implementation of each change request
  • Consulting expertise for recommended best practice design approach
  • Robust change control process adopted and monitoring solutions (post-go-live)
  • Excellent communication between e-Health and trust change teams throughout this project

Example deliverables as part of this cohort of change requests:

  • Excellent communication between e-Health and trust change teams throughout this project
  • Clinical note templates for Maternity patients (Antenatal & Postnatel)
  • Powerforms for documenting mortality
  • PAS clinic build, appointments and letter templates for new cardiology diagnostics requirements
  • Order catalogue and communication requirements for Radiology and Pathology inegrated system
  • Auto discharge ops job configration

 

SOLUTION

Assessment to review priority, impact, risk and expected development time for each specification. Implementation approach developed and documented into a comprehensive project plan.

Majority change requests were completed on time within the specified deadline. A work off plan was defined and agreed for outstanding items on previously on hold with the trust.

Custom clinical development solution implemented to vastly improve Deep Vein Thrombosis (DVT) recordings in the trust EHR system., which had a direct impact on patient care. Significant costs within the region of six figures were reduced completely to zero from the first quarter from go-live of this implementation. 

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