Shift Organiser (#2885)

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Innovation 'Elevator Pitch':
An app designed by a Midwife, with the aim to help healthcare professionals manage their tasks and workload whilst on duty.
Overview of Innovation:
The idea stemmed from working on the wards during the 12 hour busy shifts. At handover, you are informed of all the tasks required for your patients and the only way of knowing what needs doing is by memory or writing things down on scrap peices of paper. During the 12 hour shifts, I found it easy to forget all the tasks as call bells would be ringing and many questions asked by patients. The fear of forgetting led to my idea, Shift Organiser. It is an app designed to act as an alarm system stating what is due and at what time. For example, bed 2 is due antibiotics @ 14.00.

The app provides a clear and systematic digital way of all that needs doing during the healthcare workers shift, anything overdue (if they are too busy) will appear in one column and everything complete in another.

My aim here and being a healthcare professional myself is to try and help healthcare workers such as nurses and midwives manage their heavy workload. With the growth and inovation in digital health I have come across new ideas and concepts with the aim to help the public and patients. Whilst I am all for this, I thought I would try to do something for the healthcare workers themselves. I also have the aim of keeping it simple. I have had first hand experince on the wards with being introduced to new 'tech - heavy' ways of working, which some nurses have found hard to use. The whole purpose of Shift Organiser is to be simple, quick and helpful.

I am now seeking any advice in the world of digital health which can further develop the use of my app. I am very open and appreicative of any ways in which help can be offered.



Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
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Innovation 'Elevator Pitch':
LASSO utilises disruptive 'Uber style' technology to introduce a unique approach in nurse recruitment. It enables the immediate supply of higher quality, temporary nurses to the healthcare market at half the current cost. 
Overview of Innovation:
LASSO is an innovative technology solution aimed at addressing the crisis in healthcare recruitment. A unique, mobile-centric platform has been created to allow healthcare workers the ability to directly interface with hospital providers through a simple, user-friendly, free smartphone app. This eradicates the need for third party agencies and gives workers full control back in terms of managing their own lives, at their own convenience. The same technology can also be utilised to manage hospital temporary staffing 'banks,' without the need for employed bank administrators and managers.
 
This disruptive technology enables immediate supply of higher quality, temporary staff to the healthcare market at significantly reduced cost. Currently, £3.6 billion is spent on NHS agency staffing pa with this spend recognised as one of the most significant causes of deteriorating hospital finances. Unfortunately, this spend sits alongside a noticeable decline in the quality of temporary staff, traditional recruitment agencies knowingly making excessive margins, aging IT platforms resulting in inefficiency and declining productivity, and antiquated, manual paper-based processes operated by teams of administrators.
 
LASSO utilises ‘Uber’ and ‘TripAdvisor’ style technology to eradicate unnecessary manual intervention. Its unique and dynamic system and simplicity of process are offered for instantly seeking/booking temporary work and immediately receiving feedback/rating on the service provided. This responsive approach not only increases productivity and removes un-necessary waste,  but it also  delivers millions of pounds of savings to healthcare organisations. LASSO’s pledge is to re-invest a proportion of any profit back into training and education to increase and incentivise its future partnership. LASSO believes its approach and value proposition will not only drive up quality but also support the retention of UK trained nurses, Allied Health Professionals (AHPs) and doctors.
 
With an annual 28% increase in NHS agency nursing spend and NHS organisations now fined for agency overspending, Introducing such a unique product with significant customer/user value proposition into a sector that has experienced little disruption in 15 years, will result in rapid time to value. 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption
Benefit to NHS:
Economic- LASSO will provide significant direct and indirect savings to NHS providers. In terms of direct savings, LASSO recruitment fees will be at most 50% of the current fees charged by the traditional recruitment agencies with an instant realisation of benefits as the savings are shift related.  Initial projections highlight this equates to millions per annum (pa) for most Trusts.. More efficient automation will result in indirect savings through increased productivity with the release of workforce time and the introduction of a paperless framework.
 
• Social- one of LASSO’s major aims is to instantly improve its partners' quality of life and give back direct control of working life. Staff are empowered and able to immediately post when and where they wish to work rather than wait for third party intervention. Equally, providers have the opportunity to post shifts immediately and choose who fills the shift in a more responsive way informed by staff rating. Receiving feedback through the rating system, makes staff feel valued and appreciated at work and provides motivation to 'be the best.'
 
• Educational - LASSO believes, with a 20% reduction in applications for nurse training, investment in future partners is critical. Once financially stable, LASSO will therefore invest in the training and education of new and existing staff. This investment will be in the form of free extra placements/courses and costs are built in.
 
• Political– recognising the NHS is 'publicly' managing the largest deficit it has ever faced, there is now a strong political imperative to reduce spending. Agency staffing cost accounts for one of the largest contributors to this deficit with most trusts spending millions pa. This scenario is compounded by the fact that the quality of temporary staffing is falling resulting in the potential for patient safety to be compromised and for trusts to face reputational and regulatory pressure. With no market transformation  or alternative approach, trusts are struggling to comply with the new targets. LASSO will address this.
 
• Environmental - transforming the recruitment and placement approach from a traditional administrator-led, paper-based process to one delivered through innovative technology offers real, tangible benefit that can be instantly realised. A paperless system removes any waste associated with documentation and waste disposal.
Initial Review Rating
2.60 (1 ratings)
Benefit to WM population:
The LASSO project aims to commence its implementation in the West Midlands region as the first roll out area. Projections across the West Midlands region calculate the potential NHS saving to be around £10m pa. LASSO has already partnered with Worcester Hospitals NHS Trust to act as the pilot Trust. It will therefore be Worcester that work directly with the LASSO team to refine the project and make it individual for their nurses and ‘shift bookers.’ They currently spend £7.7m pa on agency nursing fees of which £1.2m is recruitment agency costs. LASSO will therefore save the hospital up to £600k pa on agency spend.
 
Worcester currently have a contract for their ‘bank staff’ with NHS Professionals (NHSP). This contract is due to expire, and as the service provided is of poor quality (less than 28% of shifts filled) and expensive, the Trust have  also agreed to work with LASSO to develop a bank product. They will serve notice on the NHSP contract and once the LASSO bank product is developed they intend to purchase bank nurses from LASSO, which will not only provide savings but offer a significantly higher quality of service. Once both LASSO products are embedded in Worcester, they will be rolled out across the West Midlands and then other regions nationally.
Current and planned activity: 
Engagement with the NHS can be challenging, based on the complexity of the organisations and the political agenda. This challenge has been simplified with several of the LASSO leadership team are already known to the NHS and well regarded. As such LASSO has already undertaken engagement with a number of NHS organisations including NHS Trusts and NHS Improvement. St Bartholomew’s Hospital (a LASSO partner) worked with the development team to help scope and create the LASSO prototype, through a number of user workshops. Nurses and ‘shift bookers’ engaged to describe the challenges they faced, inform the team of the flows associated with existing process and then redesigned these flows and the associated requirement to inform the prototype design. LASSO has shared its aspirations and work directly with NHS Improvement to get their full ‘buy-in’ to the programme and the team have now commenced engagement with a number of West Midlands Trusts to prepare for the first regional roll-out. 
What is the intellectual property status of your innovation?:
As the technology itself is not new, Intellectual Property does not apply in this instance. The innovation comes from the use of this technology to transform temporary nurse recruitment. LASSO has protected this innovation with robust Non-Disclosure Agreements (NDAs) being agreed with all organisations prior to formal engagement.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
3
Regional Scalability:
The Business Case and associated Implementation Plan propose the roll-out of the product across the West Midlands over a 24 month period. This allows for lessons learnt to be understood and embedded for every new site, to ensure the technology is highly responsive to users, potential future partners and other commercial opportunities. Positive conversations have already commenced with Trusts who are due to be targeted after the pilot site.
 
Measures:
LASSO will provide direct and indirect savings for NHS organisations with an 'increased volume/reduced cost' model seeing providers paying a baseline cost which is 50% lower than the current commercial rate and as the volume of LASSO shifts posted and filled increases, so the costs of buying LASSO shifts fall. This saving, along with fill rates and speed of shift fill will be monitored and reported on a monthly basis to all Trust Boards as part of the project.
 
The Trip Advisor App embedded within LASSO provides the opportunity to instantly measure and feedback on the quality of the temporary workforce being utilised. This unique system offers both nurses and providers the opportunity to rate each other and provide feedback - something both parties expressly requested in the workshops. This information will be utilised by LASSO and the organisations to monitor and check quality and inform required changes as necessary.
 
In line with all healthcare providers, LASSO will ensure all regulatory and compliance standards and requirements are met, with the use of technology being utilised to simplify this protracted process and also ensure that all appropriate checks are undertaken and recorded electronically for reference. 
 
Within the individual nurse profile sits a full training and education profile which will need to be reviewed and updated to support ongoing LASSO compliance/registration. This information is then stored in the form of an electronic 'training' passport which nurses can share with Trusts and other organisations. This information can also be utilised to assist in training and development programmes. Once a 'swell' of nurses are registered on the LASSO system, LASSO has agreed to share regional and national workforce information to support workforce planning and education programmes.
Adoption target:
There is a proposed detailed phased roll-out plan of all the West Midlands Trusts highlighted with the Business Case. This has been designed to ensure early adoption within less complex organisations followed by an ability to scale up at pace and market the opportunity to numerous customers, once the implementation model is proven.
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Innovation 'Elevator Pitch':
MedsMinder is designed to help people improve their medications taking with behaviour change principles so that they can fully benefit from the medications their doctors prescribe for them. Reducing wastage, facilitated by pharmacists and SBRI

 
Overview of Innovation:
MedsMinder is designed to help people improve their medications taking so that they can fully benefit from the medications their doctors prescribe for them. The NHS works hard to help people improve their health, yet much of the drugs budget is wasted, and people’s health deteriorates when people forget to take their medicines correctly, and we want to help patients and the NHS to improve.
medsminder is being developed by ADI in Saltaire, Bradford, under the SBRI-Healthcare programme funded by NHS England. Its purpose is to develop effective ways to help people improve their adherence to prescribed medication, which will both improve their health and help the NHS avoid waste.
It builds on the behaviour change work of Dr Ian Kellar, Associate Professor of the School of Psychology at the University of Leeds. For more information, contact Dr Kellar ati.kellar@leeds.ac.uk.
The programme is being facilitated by Prescribing Support Services (PSS)
Secure integration into clinical systems  and pathways. Allows trusted two-way flow of information between patients and professionals such as pharmacists and clinicians, that can be relied and acted upon.  Data on adherence, per medication dose, is available to clinicians/pharmacists via the clinical portal. Clinicians can message users individually or as a group.
 Much more impact on long-term patient engagement and  adherence than “free”, timer-based apps. The psychological basis is founded upon Behaviour Change principles supplied and guided by Prof Ian Kellar, University of Leeds: Essentially this aims to involve the user in creating and maintaining a routine that supports his/her personal lifestyle. 
Specifically:
  • Planning - the user decides when to schedule medication doses not based on clock time, but on routine event cues, such as meals or other daily activities. 
  • Logging - this is self-monitoring of medication taking, which is known to report actual adherence far more accurately than retrospective self-reporting.
  • Routine awareness - the app knows when and where you actually take doses, and adapts and learns what normal behaviour is over time, thereby allowing more appropriate reminders and prompts.
  • Multi-language support 
  • Digital ordering of repeat prescriptions.  ( which is flagged to clinicians and pharmacists). 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Wellness and prevention of illness / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
Estimation only as under evaluation:
  1. Summary of  financialsnd your estimate of ROI for the CCG
    • Estimated ROI for CCG :
      • Meds Companion users show improved  average adherence >15% vs baseline, across a range of medications ( Ian Kellar).. Translates into  different benefits and savings for the CCG eg improved control of type II diabetes using monotherapy and concomitant reduction in more expensive dual/triple therapy. (see example). Estimate minimum £250,000 in-year cash savings to Bradford CCGs with 50% takeup of the Meds Companion service, as well as longer-term improvement in outcomes from better adherence.
      • Meds Companion users have increased and convenient engagement with the repeat prescription ordering process, synchronising this with actual logged consumption, thereby reducing oversupply and enabling instant switchoff of unwanted repeat ordering.   Estimate minimum £50,000 in-year cash savings to Bradford CCGs from unwanted or premature repeats based on 50% usage of Meds Companion
=> estimated total in-year savings of £300k.
Online Discussion Rating
6.00 (1 ratings)
Initial Review Rating
3.80 (2 ratings)
Benefit to WM population:
There a great need for prescription waste reduction across all CCGs, the AF Programmes of care with new drugs is also key.
With regards to AF, adherence 
Current and planned activity: 
We are keen to work with any CCG, NHS Trust which is looking to reduce wastage, has an AF or Diabetes programme that needs some adherence tools for patients or has programmes which suite the MedsMinder app.
What is the intellectual property status of your innovation?:
ADI own the IP
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
2
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
Measures:
What outcomes are you hoping to achieve and what are the measures that you will use to gauge the success of the innovation and how will these assessments be made? Please ensure that you have quality, safety, cost and people measures.
Adoption target:
What are the targets for adoption across the WM and what are the minimum viability levels?
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Innovation 'Elevator Pitch':
Clinical CARPS improves patient care outcomes & staff experience through effective management, distribution & prioritisation of work
#Clear, consistent, flexible task allocation
#Real-time workload understanding
#Data for analysis & improvements
Overview of Innovation:
Clinical CARPS (C-CARPS) is a simple to use clinical task management system. Users have been delighted with the speed of implementation & the ability to fine tune the system to their needs
The system improves patient care outcomes & the experience of clinical staff in a very cost effective manner by saving time, optimising the deployment of staff resources & identifying areas for improvement. 
C-CARPS has been implemented with great success by the Hospital at Night team at The Alfred Hospital, Melbourne with our co-developer partners, InControl Australia. Alfred Health have cited many achievements facilitated or directly enabled by the system:
  • improved performance against patient care targets e.g. 8% increase in emergency patients admitted within 4 hours
  • increased overall productivity
  • improved staff attitude towards the overnight shift
Alfred Health won the “The Premier’s Award for Advancing Healthcare 2013”  & "The Metropolitan Health Workforce Initiative Award 2014" for their achievements, in which C-CARPS was instrumental.
C-CARPS replaces the existing method of task allocation, typically reliant on paging & phone calls between staff to clarify patient needs. In simple terms it is used as follows:
  • Nursing staff issue clinical task requests from ward PC’s or mobile devices
  • Team members carry a mobile device to track, manage & update allocated tasks
  • “Clinical Leads” have the ability to re-allocate work according to demand
  • Handovers are managed quickly & safely through the system
Task requests contain all the information required to immediately prioritise & complete the task. Geographic, nurse & patient identifiers provided by C-CARPS task requests optimise efficient task allocation, improve communication & help prevent errors
The ‘Clinical Lead’ can see all tasks in real time and redistribute them as appropriate. This allows free staff to ease the burden on others, preventing individuals from being overwhelmed & minimising delays. Clinical Leads now redistribute around 14% of the work on a nightly basis.
Data from C-CARPS is used to identify long trends & to understand the type of work carried out by specific staff at night. This has provided supporting evidence in cases of complaints or concerns from staff & enabled the implementation of organisational or procedural change to improve staff utilisation & patient care. In one instance, C-CARPS data was used to reduce the overnight drug chart re-writes average of 42 to 2.5
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
  • Saves nursing and clinical staff time by communicating task information in a clear, complete and standardised way, giving staff more time to focus on the tasks themselves and to progress patient care and professional development
  • Clear visibility of entire workload means that teams can respond dynamically in busy periods by re-allocating work to optimise use of valuable resources in real-time
  • A more responsive and even workload distribution ultimately results in fewer delays and reduced risk of clinical errors due to unmanageable workloads, stress levels or ‘burn-out’
  • Improved handover between shifts, saving time and reducing the likelihood of errors
  • Transparency of the system promotes a team ethic and a shared workload mentality
  • The centralised, time-stamped and easily accessible data will save time reporting on:
    •  Performance, creating new opportunities for performance analysis, promote continuous improvement of working practices and monitor any changes.
    • Resolve any complaints or disputes easily by reviewing real time data evidence.
Additional Information
Please watch the presentation “Data to Transform: Electronic Task Management in the After Hours” by Alfred Health’s Benjamin Warren (Redesigning Care Project Officer at Alfred Health) and Dr Kyle Brooks (Senior ICU Registrar and overnight Clinical Lead at The Alfred), available through the InControl Australia YouTube Channel:

https://youtu.be/NmHE0Jg4DXU

Please view the presentation slides, including graphs, from a presentation delivered by Andrew Stripp, Deputy Chief Executive & Chief Operating Officer of Alfred Health, at the 2014 Emergency Department Management Conference in Melbourne, Australia, which demonstrate the instrumental role Clinical CARPS has played in the success of Alfred Health’s ambitious and award winning “Timely Quality Care” initiative:
http://www.slideshare.net/informaoz/andrew-stripp-alfred-health

InControl Australia have produced a short demonstration video entitled “CARPS Clinical Task Management Overview”, showing the basics of task allocation and distribution between the controller PC software and an Android smart device:
https://youtu.be/3a9yaZ1z8L0

 
Initial Review Rating
4.60 (1 ratings)
Benefit to WM population:
Clinical CARPS is a tool that enables safer, more efficient working practices and improved opportunities for performance analysis, facilitating the implementation of further improvements. This can reduce the costs associated with care delivery and dealing with errors and delays.
  • Saves nursing and clinical staff time
  • Allows staff to progress patient care and professional development
  • Provides clear visibility of entire workload to optimise use of valuable resources in real-time
  • A result of workload distribution  is fewer delays and reduced risk of clinical errors  by managing workloads and stress levels and avoiding ‘burn-out’
  • Reducing the likelihood of errors via Improved handover between shifts and saving time
  • Transparency of the system promotes a team ethic and a shared workload mentality
  • Time-stamped and easily accessible data reporting:
    •  new opportunities for performance analysis to promote continuous improvement of working practices whilst monitoring any changes.
    • Easily resolve any concerns, complaints or disputes by reviewing real time data evidence.
 
ROI
  • The potential exists for very high return on investment, depending on the relative efficiency of the hospital’s existing processes. A user of the original CARPS system cited recovering the original investment every four months! The non-clinical version of CARPS typically recovers initial investment within 18 months. We are awaiting analysis of data on installed versions of Clinical CARPS. We are expecting similar or even better results, due to potential cost savings within a clinical environment.

    Note: Our previous model is used successfully within 15 UK NHS trusts to mange non-clinical tasks
Current and planned activity: 
Currently ‘Clinical CARPS’, Clinical Task Management System is being used in Australia and seeking first adoption within the NHS in the UK. We are looking to NHS organisations within the West Midlands to discuss the possibility of adopting the clinical version on a trial-to-permanent basis.
 
We are seeking collaborations with West Midlands NHS trusts, clinical speciality services or an NHS region to experience our technology, understand the simplicity of installation and to witness the benefits that it can bring to managing the clinical workload, especially out of hours where resources may be limited or stretched and thus not immediately available unless the work flow is adjusted. 

Evaluation/Validation – We are seeking a trial centre to work with to gain additional evidence & validation of the benefits that our software delivers

We look forward to discussing with West Midlands Clinical Management teams how ‘Clinical CARPS’ can transform their task management processes.

.
What is the intellectual property status of your innovation?:
Clinical CARPS is the property of In Control Pty Ltd, co-developer partners of Purcell Radio Systems Ltd. Purcell Radio Systems Ltd have sole rights for the distibution of Clinical CARPS within the UK and Europe.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
3
Regional Scalability:

All of our solutions are highly scalable and an installation of CARPS software will typically lead to a future expansion of the system within that site or further installations at other sites within the region or company, usually by word of mouth promotion. Pricing for individual software licences will come down where larger systems are purchased within a single contract. Depending on the needs of the client we would expect to have a single installation up and running within 2 - 3 months.

Measures:

Quality: We expect Clinical CARPS to improve the quality of communication regarding clinical task allocation, for instance Clinical CARPS task requests can be configured for required minimum information to be mandatory. We would expect this to be measurable by a reduction in the amount of time spent on task allocation (phone calls, conversations, etc) and an increase in productivity in the undertaking of the clinical tasks themselves (delivering patient care). We would expect the enhanced analytical possibilities enabled by CARPS data capture to result in the identification of improved working processes, which should also be taken into account as measures of the system's success.
Safety: We expect patient care outcomes to improve based on the fact that Clinicians and nursing staff have more time available to deliver care as above and can re-allocate work according to demand, priority, availability and suitability. We expect to see measurable improvements against patient safety targets such as improved performance against the four hour admission target from emergencey and a reduction in errors and delays to patient care. As above, any improvements to patient safety made possible through CARPS enhanced data capture should also be counted.
Cost: Return on investment can be measured against increases in productivity on the front line and relating to time saved on performance analysis and the production of reports performed my clinical Management. We would expect complaints to be reduced and costs around the complaints process should also be factored in. A normal CARPS system would be expected to cover the cost of implementation within 18 months and we might cautiously expect even better results within the clinical environment, due to the increased value of the resources involved.
People: Feedback from users and stakeholders should give evidence of an improved attitude towards the way clinical tasks are managed compared with the preceeding system.

Adoption target:

Minimum viability would be the out-of hours clinical team at one hospital. After confirmation of the system's success, we would hope to expand use to 24/7 and to implement the system at other hospitals within the WM region.

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