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Reducing cardiac arrests and critical care length of stay at Manchester University NHS Foundation Trust

With Alcidion’s Miya solution, the Manchester University NHS Foundation Trust has been able to halve cardiac arrests, reduce risk of mortality for out of hours admissions and reduce critical care length of stay. The data collected from several thousands of observations every day is also helping the Trust see how different wards respond to patient needs and identify ways to improve.
  • 50%
    reduction
    in cardiac arrests
  • 90%
    compliance
    in VTE re-assessment within three weeks
  • 29%
    reduction
    in length of stay

Our client

The Manchester University NHS Foundation Trust (MFT) was formed on 1st October 2017 following the merger of Central Manchester University Hospitals NHS Foundation Trust (CMFT) and University Hospital of South Manchester NHS Foundation Trust (UHSM). MFT is the largest Trust in the United Kingdom (UK) with an annual turnover of approximately £1.7 billion and is also one of the biggest local employers with around 20,000 staff employed across the organisation.

MFT currently consists of 11 hospitals, in addition to delivering community and secondary care across Manchester and Trafford, and specialist services to patients from Greater Manchester (GM), the North West and the rest of the UK. MFT will also welcome an additional hospital, North Manchester General Hospital, into the Trust in the 2019/20 period which will enable them to deliver a ‘Single Hospital Service’ for the population of Manchester.

MFT hosts and is a statutory partner of the community organisation Manchester Local Care Organisation (MLCO). The organisation employs around 3,000 team members and provides community and mental health services plus primary care and social care across the Trust. There are five community services that run under the MLCO.

The challenge

MFT is passionate about patient safety and it knew that providing better care for deteriorating patients was central to this.

The Trust recognised that staff sometimes lacked confidence in dealing with sick patients and that difficulties were encountered in passing information to senior colleagues when patients were in urgent need of escalation.

MFT is a teaching Trust, with new staff coming through on a regular basis. This means that new members of the team need to get up to speed quickly on the protocols used to care for the sickest patients. The Trust had implemented early warning scores (EWS) to identify deteriorating patients in many areas, but there were occasions when the policy did not achieve 100% compliance.

The Trust also wanted to take an approach that could work across all hospitals, which meant that information needed to be available to healthcare professionals across the patient pathway.

The solution

MFT became an early adopter of electronic observations with the Alcidion Miya solution. Alcidion worked with the Trust’s informatics team to apply ‘track and trigger’ technology across all its wards.

By working closely with clinical and informatics staff, Alcidion designed assessments and configured the system to meet local needs and priorities. This, together with a concerted effort to promote the benefits of the technology, helped the Trust to fully embed the system for all in-patient areas across 55 wards, in both adult and children’s Manchester hospitals.

For the development of the assessments, Alcidion worked closely with ward staff and the Trust’s specialist teams. Meetings and workshops were conducted to understand the needs of the clinicians and patients and to determine how they might want to adapt the system to meet their individual requirements. This helped encourage them to get on board with using technology as part of the care process.

“We combined the technology with acute care education to engage all staff, encouraging colleagues to follow established protocols. We also worked with informatics staff to show the difference they can make at the frontline of patient care, through patient stories that illustrate how technology can make a real difference to individual patients.”

– Richard Cox, Matron for the Acute Care Team, Manchester University NHS Foundation Trust

Informatics staff also carried out integration work to ensure that the patient observation process continued seamlessly across MFT sites and a single attendance and patient record was maintained. This benefits the patient, as all their sets of observations are maintained for the duration of their care with the Trust.

“We have worked closely with Alcidion to support our clinical processes using technology. This did not come without its challenges. However, by working together with the company and our dedicated staff, we have developed the system to ensure that we can meet all their needs and ensure safer patient care.”

– Sarah Ingleby, Lead Nurse for the Acute Care Team, Manchester University NHS Foundation Trust

The result

At MFT sites, the Alcidion solution flags patients at risk of deteriorating and automatically alerts medical staff.

“Our approach has delivered clinical benefits such as more rapid clinical attendance for patients most in need, which has helped alongside other acute care initiatives to achieve a 50% reduction in cardiac arrests. We have improved the accuracy of observations, reduced the risk of mortality for out of hours admissions and reduced critical care length of stay.”

– Richard Cox, Matron for the Acute Care Team, Manchester University NHS Foundation Trust

The Trust has also seen dramatic improvements in VTE re-assessment, with 90% compliance within three weeks of the implementation of the assessment.

When MFT reviewed mortality over the seven-day week, they found no difference between weekdays and weekends and attributed this to the solution’s ability to pull nurses and doctors to patients’ bedsides when needed.

Data is also collected from several thousands of observations every day, which helps MFT see how different wards are responding to patient needs and identify how it may improve. There is even healthy competition between wards in making sure that patients get the best care possible.

“The software, and the approach to care it helps deliver, are becoming much more integrated with our clinical systems and practice. We can now see nurses of all technical abilities use technology to realise benefits for their patients. It is something that I am proud to be working on, as it makes such a huge difference to the care we can deliver to our patients.”

– Richard Cox, Matron for the Acute Care Team, Manchester University NHS Foundation Trust

TOGETHER CARE MATTERS
  • Everyone Matters
  • Working Together
  • Dignity and Care
  • Open and Honest
  • Hospitals: 11
  • Beds: 2,500
  • Average inpatient stay: 4.67 days
  • A&E attendances: 410,912
  • Clinic attendances: 3,256
  • Inpatient (non-elective): 134,653
  • Inpatient (elective): 31,932
  • Day cases: 137,913
  • Outpatients: 1,725,000
  • Staff (clinical and non-clinical): 21,945
  • 50% reduction in cardiac arrests
  • 90% compliance in VTE re-assessment within three weeks
  • 29% reduction in length of stay

Customer Success Stories