THHS is passionate about improving the health and lives of the North Queensland community. THHS sees on average 336 people in the emergency departments, 1,913 people through the specialist outpatient clinics and more than 40 people in the operating theatres daily.
THHS was looking for a solution to help digitise and automate medical task management and streamline communication processes within the Hospital.
THHS were experiencing challenges related to doctor workload, particularly with junior doctors working overnight. The manual process of task management was a significant contributing factor to this challenge, with doctors and nurses having no visibility into:
- levels of workload
- the status of requests
- prioritising tasks
- viewing the history of communication
These bottlenecks meant that the Health Service was experiencing issues with doctor fatigue attributed, in part, to manual task management processes with doctors at Townsville Hospital taking in excess of 100 phone calls per shift.
There was no paging system for medical tasks within THHS prior to the implementation of Smartpage. Traditional medical pagers were used solely as a medical emergency alert system. All regular medical tasks were manually called through a DECT phone carried by a doctor. In the after-hours space, each doctor would typically cover multiple medical or surgical wards simultaneously.
|Alcidion’s Smartpage solution was ideally suited to assist in these circumstances. Smartpage was specifically created to solve this particular problem of clinical task management, with comprehensive, structured Identify, Situation, Background, Assessment and Recommendation (ISBAR) messaging, instant delivery of messages with read receipts, two-way WhatsApp type messaging between users, task sharing between clinicians, after-hours oversight with the ability for clinical coordinators to triage and intervene, as well as much more.|
Smartpage has been designed to facilitate fast and effective clinical communication and task management between doctors and nurses, with clear visibility of workloads, support for efficient collaboration and easy task prioritisation.
Alcidion worked closely with the THHS team, and even though the COVID pandemic impacted the project with changes in the project team and staff, we were able to progress the Smartpage implementation. There was considerable testing undertaken by THHS and a significant number of mobile phones were deployed to support the usage of Smartpage.
Smartpage initially went live in an Acute Mental Health ward during business hours. This was later expanded to the Medical and Surgical wards after-hours. Since Smartpage Clinical was implemented, THHS staff have sent over 42,400 pages with 100% of them delivered for just over 10,100 patients. Smartpage has recently been implemented in the Emergency department short term treatment area, the Paediatric ward and the Intensive Care Unit 24/7 with more areas enquiring about its use due to demonstrated effectiveness. Each team has integrated its use based on their unit’s unique challenges. Use cases are currently being explored in radiology, pharmacy, and allied health workflows.
An example of innovative use is the introduction of Smartpage for medication charting requests in the ICU. Even though ICU medical staff and nursing staff often work in proximity, it was identified that medications were often commenced during an emergency situation that required electronic charting after stabilisation. Nursing staff were left with the task of constantly reminding doctors to chart the medications. Smartpage provided a convenient solution as an electronic means of recording this task, without the need to disrupt critical work and reducing patient risks. It also reduces duplication of requests as both pharmacists and nurses have a global view of all jobs requested.
Figure 1: Number of pages sent and type of requests over a six-month period
Figure 2: Type of requests sent by each ward over a six-month period
The success of the Smartpage Clinical implementation has led to the solution’s expansion into other wards. The clinical communication process has streamlined workflows, task management and improved clinical engagement and service delivery to customers.
Following the implementation, the team at THHS contacted Alcidion for an overview of the data charts now available to them and the ability to use and view the key statistics relating to clinical paging and tasks, across ward/s and across an organisation to improve their processes.
Smartpage data can be utilised to improve workflow efficiency by:
- Highlighting areas of heavy work burden and ‘peak time’ for workforce planning
- Allows investigation into causes of delay to job completion
- Common job requests and their predictability
As Townsville University Hospital continues to expand, so will its workforce challenges. The current hospital expansion project includes a further 143 extra inpatient beds with new surgical theatres by 2026. THHS will continue to look for innovative applications of Smartpage within their ever-evolving complex healthcare system to improve efficiency and to provide the best patient care for North Queensland residents.
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The key statistics for THHS are outlined below:
- Area covered: Extending west to Richmond and Hughenden, north to Cardwell, south to Home Hill and east to Magnetic and Palm Islands in North Queensland.
- 19 hospitals and community health campuses and two residential aged care facilities
- Population: almost 250,000 people
- North Queensland’s only tertiary hospital, which supports a referral catchment of almost 700,000 people.
- Healthcare staff: 5,583
- Beds: 785
- Admissions: 97,840 per year
- ED attendances: 98,476 per year (~280 per day)
- Ambulatory/outpatient services: 389,296 per year
- Visibility of after-hours workload and details regarding the type of tasks required
- Improvement in workflows
- Can be used in incident analyses to explore workloads and delays
- Reduced task interruption relates to better efficiency and safer patient care
- Improved communication
- Less time spent by nurses trying to get hold of the doctor by phone
- Less calls for the same task