Great%20Expectations%20turning%20dreams%20into%20reality

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Great Expectationsturning dreams into reality

• Adrienne Johnston
• Project Leader, Care Pathways
• Ulster Community Hospitals Trust
• 028 90484511 x3245
• adrienne.johnston_at_ucht.n-i.nhs.uk

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Trust Profile

• Merger Community Acute Trust.
• Services include- primary, secondary and
  community care
• Community services -pop. 140,000
• Acute services -pop. 260,000
• 2 community hospitals 40 beds total
• 1 acute hospital 600 beds
• 5500 staff (3304 WTE)

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What is a Care Pathways?
An integrated Care Pathway determines locally
agreed, multidisciplinary practice based on
guidelines and evidence where available, for a
specific patient/client group. It forms all or
part of the clinical record, documents the care
given and facilitates the evaluation of outcomes
for continuous quality improvement. National
Pathway Association 1998
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• A patients experience of an episode of care is
  sometimes likened to a journey. But the patient
  as traveller may feel more like an intrepid
  explorer continually coming up against the
  unknown rather than a modern traveller whose
  journey has been planned with a travel agent....
• Planned journeys carry less risk than unplanned
  ones, and knowledge of the journeys steps and
  stages reduces anxiety and fear. Our patients
  should expect at least the same amount of
  planning for and information about their health
  care as they get from travel agents.
• Layton et al 1998

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Pathways electronic notes
Pathways
Electronic notes

• Whole note
• Multi-professional
• Accessible by all
• Evidence based
• Structure format
• Stored centrally

• Whole note
• Multi-professional
• Access on need to know basis
• Evidence based - built in alerts
• Structure format
• Accessible all locations

• Treatment plans
• Future plans
• Demographic details
• Past histories
• Examinations
• Results
• Referrals

• Treatment plans
• Future plans
• Demographic details
• Past histories
• Examinations
• Results
• Referrals

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• A mess computerised is a computerised mess
• Draft RCP record keepingstandards
  inpatientsRoyal College Phys. 2003

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• The right information at the right time is nine
  tenths of any battle
• Napoleon Bonaparte

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Cancer patient
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What staff want

• Access specific information

• Access to ALL information

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What staff want

• Access specific information
• Access to ALL information

• Aware of patient understanding wishes

• Access to evidence

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What staff want

• Access specific information
• Access to ALL information
• Aware of patient understanding wishes
• Access to evidence

• Alert to risks

• Use professional judgement

• Access for review audit

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• Since computers entered office systems, paper
  utilization has increased six-fold

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• Identify goal

• Agree ALL information required

• Agree who needs access when

• Policies procedures off shelves

• Develop ONE system no mix match

• Computerise

• Review information improve care

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