Streamlining patient record storage and retrieval
Previously, East Sussex Healthcare NHS Trust kept patient records in seven separate libraries to support its four hospitals: Uckfield, Bexhill, Eastbourne District General and the Conquest Hospital in Hastings.
When patient documents were requested by hospital departments, staff simply placed orders by telephoning the Medical Records Department, often two weeks before planned appointments. The Medical Records team would locate the files and send them via hospital courier to be housed in the relevant hospital library until needed.
Records were stored alpha-numerically, and each hospital had its own filing system, with an additional system introduced by the Trust to identify the thousands of patients who had been registered twice.
It became increasingly difficult to store and find records. Shelf space was becoming more limited as the number of patient records increased and piles of records on the floor became common.
This made retrieval even more difficult and when records couldn’t be located, medical records staff would often have to continue searching in their own time. Furthermore, an inadequate paper trail, with the transfer of documents recorded via a Patient Administration System (PAS), made it difficult to track the bulk movement records between different sites.
If a record couldn’t be found, a temporary record had to be created, generating additional paperwork that also needed to be tracked,
for which the PAS offered limited functionality. As the number of patients grew, so too did the number of documents in both new and existing records – in some cases, by 10 extra pages for each appointment. The additional space and time required to store and retrieve these soon meant that temporary records became the norm.
“The process was not fit for purpose,” said Nick Sheppard, Systems Configuration Analyst at East Sussex Healthcare NHS Trust. “The situation became so serious that, at one point, appointments were being rescheduled so that the relevant records could be found, resulting in a significant backlog. We needed a way to streamline storage, improve audit trails, and reduce the number of temporary records being created.”
Tracking patient records throughout their journey
The Trust rolled out iFIT, Idox’s hospital inventory and records management solution. With its ability to track numerous media types, the Trust has been able to introduce day forward packs which ensures that physicians are provided with every single record relating to a patient.
Using radio-frequency identification (RFID) technology, iFIT enables Medical Records staff and couriers to physically scan each day forward pack’s tag or barcode with handheld scanners as it reaches or leaves a department, creating an active and accurate audit trail. At the same time, passive RFID scanners located throughout each site record the packs’ journey through the hospital.
Prior to implementing iFIT, the Trust undertook a deep audit of every record it had on file, consigning anything relating to a patient that had not been seen for 12 or more years to deep storage. Idox assisted the Trust in migrating details from the incumbent PAS system to the new recording method. Then, every time a medical record was returned to a library, it was given a barcode and RFID tag relating to the respective patient’s NHS number, and stored on a dedicated new row. Crucially, as the documents were now digitally trackable, they did not have to be returned to the same place they were retrieved from. At first, only 10% of overall library space was dedicated to the new filing system, but this grew quickly as more records were returned and tagged.
Compatible with the Trust’s electronic documentation system (EDMS), Kainos Evolve, the implementation of iFIT helped enable the digitisation of patient records, in collaboration with document scanning service provider, Hugh Symons. “Digitising patient records was an important evolutionary step in optimising our record-keeping,” continued Sheppard. “iFIT’s compatibility was a great help in setting up our EDMS, it enables us to automate document migration to Hugh Symons. I’m not sure how the Medical Records team would have coped without it, it wouldn’t have been a smooth transition at all. Overall, its implementation finally enabled us to clean up and organise our libraries, create a more transparent, real-time audit trail, as well as start producing patient day forward packs.”
Greater efficiency, reliability, and access to patient records
The implementation of iFIT has dramatically improved the efficiency and reliability of the Trust’s record storage and retrieval. Since streamlining its record-keeping processes, for example, the Trust has markedly reduced the amount of space it needs to store patient records. More recently, it centralised its four libraries to a single offsite facility.
It’s also been of great relief to the Medical Records team. Without the pressure of having to manually search for a record to compile day forward packs – the number of temporary records has fallen significantly, from 6.6% of records prior to iFIT, to around 0.6% today, which beats the Trust’s Key Performance Indicator (KPI) target.
Perhaps most importantly, patients are no longer having their appointments rescheduled as a result of clinicians being unable to view their records. In fact, the ease of access means more patients are being seen than ever before.
“It’s becoming increasingly important for all areas of the NHS to bring patient care records together into a regional shared record system, allowing healthcare providers to access and update a single basic health and care record,” said Sheppard. “With patient records from every one of the Trust’s departments now on the EDMS, iFIT has allowed us to take a significant step toward this goal.”
“It’s been a huge help during the pandemic too. Our previous record management processes would have made social distancing very difficult. Now, there’s no need for anyone to visit many different sites to locate records and one-way systems have been much easier to implement.”
About East Sussex Healthcare NHS Trust
Providing acute hospital and community health services for 525,000 people living in East Sussex and surrounding areas, East Sussex Healthcare NHS Trust employs over 6,000 staff and has an annual turnover exceeding £380m.