Clinical CARPS – Clinical Task Management System with out-of-hours capabilities (#1866)

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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)
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Innovation 'Elevator Pitch':
Clinical CARPS improves patient care outcomes & staff experience through effective Handover management & 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 which aids safe handover and continuation of care. 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. Users have been delighted with the speed of implementation & the ability to fine tune the system to their operational needs
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:
  • Handovers are managed quickly & safely through the system
  • 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
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. 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: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
  • 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.
  • 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-allocatingwork 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’
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
Online Discussion Rating
4.00 (1 ratings)
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 handover, care delivery and dealing with errors and delays.
  • Saves nursing and clinical staff time
  • Reducing the likelihood of errors via Improved handover between shifts and saving 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’
  •  
  • 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
Regulatory Approvals:
Purcell has been an ISO 9001 accredited company since 1995, we are Safecontractor and Constructionline approved and are a member of the FCS.
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 two 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.
Investment sought:
We are looking for a hospital, Trust or region interested in implementing Clinical CARPS. As this would be a first for the NHS, we would be interested to know if funding might be available for an NHS hospital to make the initial investment on the basis of a formal evaluation of this innovation or "trial-to-permanent" basis.
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