CareNow - Streamlining Clinical Workflows

Aim

Gold Coast Health (GCH) aims to transform the traditional clinical workflows through the lens of future focused, virtual, data-driven, and technologically advanced improvements. This project, ‘Streamlining clinical workflows to save clinicians time through CareNow,’ showcases how we aim to tackle the inefficiencies and time-consuming processes that burden clinicians. These inefficiencies not only detract from the direct patient care time, but also pose significant barriers to the swift and effective delivery of healthcare services. By implementing solutions such as the Clinical Photography application, and automated Patient Lists, we sought to address the critical challenge of manual, disjointed workflows that hinder the timely and accurate sharing of patient information. Our aim was to harness digital technology to create a seamless, integrated clinical workflow that not only optimises clinicians' time, but also enhances the quality of patient care. These initiatives are focused on solving the challenge of how to allocate clinician time more towards direct patient care and less towards administrative tasks. Through these future-focused improvements, we aim to ensure our services are more accessible, efficient, and responsive to the needs of the communities we serve, thereby solving the problem of maximising the efficiency of clinician time through technological innovation

Outcomes

Clinical Photography application

By uploading high-quality images of patient conditions on smartphones, and then directly into the patient’s ieMR, ensure rapid and accurate assessments for crucial for immediate care decisions. This initiative has resulted in several benefits:

• Enhancing clinical efficiency: By eliminating the need for manual documentation, printing, and storage, the application significantly reduces the administrative burden on clinicians, allowing them to allocate more time to direct patient care.
• Improving patient care: Immediate access to visual information facilitates quicker, more accurate assessments, enabling a swift multidisciplinary response crucial for effective patient management.

• Ensuring data security: Photos taken with the app are directly uploaded to the patient’s ieMR and are never stored on the clinician's device, adhering to patient confidentiality and privacy. This approach was adopted after a thorough evaluation of existing clinical workflows, identifying key areas where digital solutions could introduce efficiency and improve care delivery. The app's development was guided by clinician feedback and a detailed analysis of patient care processes, ensuring that the solution was both practical and beneficial to the end users.

  Patient Lists
  Building on the success of the Clinical Photography application, GCH has created the next CareNow workflow, Patient Lists, which pilots in the Neurology department in mid-March 2024. This digital tool can streamline how doctors manage their inpatient lists by automating the aggregation of patient data from various source systems, providing a comprehensive clinical snapshot of each inpatient.

Recognising the need for improvement, the adoption of this digital Patient List seeks to:

• Reduce manual tasks: The current manual process of compiling patient lists is cumbersome and error-prone, often requiring unpaid time from junior doctors. By automating the creation of a digital patient list, we alleviate this manual burden on junior doctors, freeing up their time for more valuable clinical tasks and reducing the risk of errors inherent in manual data entry.
• Provide an accurate clinical snapshot: The digital patient list provides an up-to-date, accurate clinical snapshot of each patient, enhancing the quality of care by ensuring all relevant patient information is easily accessible.
• Enhance workflow visibility: With this tool, the progress of patients through their inpatient journey can be tracked more efficiently, increasing the visibility of doctor workflows and improving the coordination of care.
• Facilitate collaboration and parallel tasking: By enabling multiple clinicians to access and update Patient Lists simultaneously, the application facilitates real-time collaboration, ensuring all team members are informed of the latest patient statuses and care plans. This parallel tasking capability not only streamlines workflows but also enhances the efficiency and effectiveness of patient rounds, allowing for a more coordinated and dynamic approach to patient management.

• The Patient Lists tool will leverage existing data within CareNow, reducing redundant data entry and ensuring that admission information is current and accurate. It’s also designed to evolve over time, progressively enriching its database with clinical data to ensure it becomes an increasingly valuable and comprehensive resource for patient care. By May 2024, GCH plans to have rolled this out beyond its pilot phase.

Why these solutions?
Our adoption of these digital solutions was driven by a clear recognition of the need to advance our healthcare delivery to meet the evolving requirements of our community. The Clinical Photography app and Patient Lists represent key steps in our journey towards a more integrated, efficient, and patient-centred health service. By prioritising the adoption of these digital tools, we not only streamline clinical workflows but also ensure our healthcare services are accessible, responsive, and secure.

Background

Gold Coast Health (GCH) is at the forefront of transforming clinical workflows through innovative digital solutions. As workforce shortages rise, it is critical to enable our staff with streamlined and accessible workflows to meet increasing demand for services.

Discussion

We have aimed to capture both quantitative and qualitative data that reflect the effectiveness, efficiency, and user satisfaction of these initiatives.

Clinical Photography app evaluation

• Efficiency and time savings: We measured the reduction in time required for clinicians to document, upload and access patient images. This involved comparing the time taken for images to become available within the patient’s ieMR before and after the application’s implementation.
• Usage statistics: There has been a significant increase in users of the tool from an initial five per week to on average 55-60 per week. There has also been an average 10-fold increase in number of images uploaded to the patients' ieMRs.
• Enhanced clinical care: The reduction in administrative tasks has enabled clinicians to significantly increase direct patient care.

Planned evaluation for the Patient Lists tool

• Time reduction: Analyse the time saved in generating and updating patient lists by comparing the time taken to prepare patient lists pre and post implementation, aiming to reduce the average handling time (AHT) for patient management.
• Accuracy and reliability: Assess differences in different locations

Lessons learnt

Regarding lessons learned from the Clinical Photography app deployment, a notable insight emerged regarding the balance between application timeout settings and authentication requirements. Clinicians preferred longer timeout periods to enhance usability during their busy workflows, allowing them more flexibility without the frequent need to re-authenticate. Conversely, our cybersecurity team advocated for shorter timeout durations as a security measure, and to protect sensitive patient data. To address these dual requirements, we introduced a secure PIN feature. This approach satisfied clinical needs for efficient access while adhering to cybersecurity measures, maintaining a balance between operational efficiency and data security.