What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

Following two successful pilots, our proposal is to launch EDCK.IN (‘ED Check-In’) to support more efficient working, better patient experience and improved infection control in Emergency Departments. More than 400 patients attend our ED everyday – they need to know that ED is safe and open.

EDCK.IN is a website developed by St George’s Hospital Emergency Department (ED) and a software developer. It enables patients to complete a brief assessment questionnaire and shows them their current waiting time – all on their own smartphone.

The positive change EDCK.IN enables is better management of COVID-19 in the following ways:
– Reducing clinical administration workload enables faster flow
– COVID-screening questions can remotely direct patients to appropriate areas, protecting staff and other patients
– Smartphone use enables low-risk patients to wait in safe locations, even outside the immediate ED footprint; increasing virtual waiting room capacity reduces crowding and enables better social distancing.

What does your project aim to achieve?

Our project has three key aims:

SAFER Care for Everyone: remote screening and redirection of potentially infectious patients enables proactive infection control in ways we haven’t been able to do before. This concept can be applied to countless hospital departments for safer queuing and reduced time spent in crowded waiting areas.

FASTER Emergency Department Flow: auditing during pilots suggests EDCK.IN can reduce clerking time by around 8 minutes per patient. If just half our daily 400 attenders use EDCK.IN, this could save 26 hours of clinical time, improving flow and helping to decompress the waiting room.

BETTER Patient Experience: unclear waiting times cause patient anxiety which can lead to staff interruptions, dissatisfaction and even aggression. Empowering patients to track their waiting time and tell us – in their own words – why they are here, enables them to take an active role in their care, which is shown to improve experience.

How will the project be delivered?

Milestones met:

• Project approved by ED Senior Management and sponsored by Executive Director

• Implementation leads appointed (ED Consultant and Specialty Manager)

• Transformation project manager appointed to lead delivery following the Trust Improvement Methodology (PDSA)

• Software development company engaged

• Standard operating procedure approved by IT and Information Governance

• Data Protection Impact Assessment and Equality Impact Assessment complete

• Two successful pilot projects complete;  1,100 patients used EDCK.IN prototype

• User Acceptance Testing complete and improvement opportunities identified

• Key performance indicators and evaluation methods identified (daily patient usage, ED LoS, patient and staff experience surveys, Trust Patient Experience Group engaged)

Next steps are to:

• Source funding and complete the software developments

• Identify waiting room locations and install TV screens

• Deliver implementation plan (including stakeholder engagement and communication plan)

• Identify partner Trusts to be early adopters

• If funding allows, a sister product for outpatient departments will be developed concurrently.

How is your project going to share learning?

The software is being developed to share with other Trusts. Methods are sharing learning so far include:

– An EDCK.IN precursor project won the Health Innovation Network (HIN) 2019 Innovation Grant competition which funded the initial development

– EDCK.IN won the Trust Quality Improvement Dragons’ Den competition

– A paper has been accepted for an upcoming Royal College of Emergency Medicine digital innovation conference

-The project team presented at a HIN Urgent and Emergency Care learning event

Future Steps:

– The project team are approaching other Departments and Trusts to become early adopters

– A website is being built to share the concept and benefit of the check-in system

– The project team are working with the HIN and Trust Communications Department to draft a local media communications plan

– The project team are developing videos and demonstration resources to share with other Trusts and Departments to generate interest.