Summary
We were commissioned Review the current EPaCCS system in use by two ICBs with a look to Refreshing the processes and functionality in use to ensure access to information about dying patients was available to those who needed it most. The result was a suite of resources within the clinical system (SystmOne) that would easily identify those patients receiving palliative care and provide the clinical staff with quick access to priority information to support decision making and patient care.
New processes were introduced to speed up access to this information and to increase the coordination of patient care across multiple care settings. Multiple stakeholders were engaged to facilitate representation across the entire patient care pathway and care was taken to ensure all services were able to request changes that were pertinent to them.Clinical resources included data entry templates, letter templates, protocols, reports and views.
Aims/Objectives
-Be able to highlight identified cohorts of patients based on agreed clinical or administrative markers.
-Allow the recording of clinical information using SNOMED coding by both the patient and the system users.
-Allow or facilitate the sharing of agreed data to other Health care providers
-Have the functionality to print care planning information for both the patient and system users.
-Have the ability to highlight priority information.
-Have the ability to control information visibility on a single-entry basis.
What did we do?
-Workshops with the Hospices, ICBs, Hospitals, Community teams, Councils, Care Homes and Ambulance Service.
-Created resources to support the identification of suitable patients, registration triggers, identification of EPaCCS specific key information, update the EPaCCS resources within the clinical system, Advance Care Planning (ACP) recording and RESPECT form recording, prognosis response tool and KPI reports.
-Fully reviewed the existing community unit and provided support to update processes to include the most recent functionality.
-Delivered training sessions to Stakeholders.
-Created bespoke training guides.
-Created bespoke training videos and integrated them into the clinical resources
What was the context / background?
The existing resources and processes used by the EPaCCS service had been in place for several years and stakeholders felt they were either not able to easily find the resources/information they required or did not have access at all. The ICBs correctly identified the need to ensure that the care for dying patients should be as smooth as possible and a review and refresh of the current system/processes would work towards this goal.
How was it organised and who was involved?
We worked with with the Hospices, ICBs, Hospitals, Community teams, Councils, Care Homes and Ambulance Service.Workshops were held face to face across multiple sites and on multiple days. Online meetings were also held with stakeholders who were unable to attend the face-to-face meetingsCCG leads were happy to co-ordinate and chase where necessaryICB lead contributed to strategic discussions and provided guidance regarding the development of the new system.
What resources did you need?
Clinical System Access (SystmOne)
MS TeamsInformation Dashboards, Excel, Power BIStaff engagement
NHS Digital publications & wider papers
SCCI1580 Requirements documentation.
Benefits?
Increase registers for QoF patients and end of life patientsIncrease in prognosis recording and awareness.
Register baseline for palliative patientsEasily identify Palliative, EoL, prognosis patients.
Allows the clinician to access and review key information quickly.
Standardised tool for access and entering information improving data quality.
Response needs tool allows clinicians the ability to assess the needs of the patient, via an agreed protocol, against a set criterion to increase standardisation when it comes to prognosis management.
ACP captures the wishes of the patient in one process, this information is then readily available to all organisations and patients in one place.
Standardising the approach and improving data quality allows for more quality and detailed reporting.
Capturing detailed information at the point of death allows the service to improve reporting and measure the quality.
Easier standardised process for patients to become known to the EPaCCS service.