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Develop a digital perioperative patient portal

Supporting patients on planned care pathways through further development of a digital patient portal where patients can track their appointments, see waiting times, receive optimisation/prehab advice/support and submit information.

Read comments 17
  • Winning idea
  • 2022

Meet the team

Also:

  • Rob Armstrong, Associate Director of Operations
  • Richard Moyes, General Manager for Outpatients
  • Helen Odedra, Matron for Surgical Pre-Assessment

What is the challenge your project is going to address and how does it connect to the theme?

Patients struggle to communicate with secondary care providers when waiting for care, we want to remove that struggle.  Working alongside partner organisations during the pandemic we have listened to patients about what matters to them and how to improve their care.  Patients have asked for information that is accurate, trusted, delivered by staff, and that is person centred.  We need to transform the way we communicate with our patients to share information with them in a way that meets their needs.

The portal would enable patients to understand where they are on a waiting list, receive personalised perioperative advice as well as change appointments, submit clinical information e.g. medication history and see written information in their choice of language.  To overcome digital exclusivity the portal can be set to enable a patient to receive information in writing, or through telephone updates and all in a language chosen by the patient.

What does your project aim to achieve?

1) Improve effective and joined-up communication between care providers and patients about waiting times and appointments

2) Improve accessibility of information through enabling patients to advise of their  contact needs, set language preferences for letters and translator needs and where a telephone/digital appointment may or may not be feasible.

3) Proactively provide patients with information about what they can do to ‘wait well’ e.g reminders to complete pre-operative exercises, support and signposting to be more active/live a healthier lifestyle in preparation for surgery etc.

4) Enable patients on surgical pathways to submit clinical information e.g. medication history and preoperative screening questionnaires to enable patients to be triaged to either a telephone, or face to face appointment.  Where the triage identifies a high risk/complex patient the face to face appointment can be booked on a day/time when anaesthetists and geriatrician colleagues are available to support shared decision making, right patient in the right clinic!

How will the project be delivered?

Through developing our patient portal to deliver personalised perioperative optimisation and suport shared decision making.  The portal is currently in testing in one specialty to enable patients to manage their appointments and that, where in use has so far shown a reduction in DNA rates.  The portal has the ability to enable two way communication, and to empower patients to submit information e.g PROMs and pre-assessment checklists but this has not yet been tested.

Patient focus group have already taken place to design and co-develop our Shape Up 4 Surgery campaign and these would need to be replicated to support co-design of the patient portal as a tool through which the campaign could be delivered in a personalised, patient centred way.

How is your project going to share learning?

Perioperative medicine, personalised care and improving communication across pathways are key as we attempt to build back better and move towards living with covid.  The number of patients on planned care waiting lists is larger now than it has ever been and using a digital means to support patients whilst they are waiting is something that would be of interest to many who are trying to tackle the elective backlog.  This work has the potential to support all patients and providers of planned care as well as reducing the burden on  primary care colleagues who are trying to navigate waiting lists to inform their patients.

This work, and its outcomes would be shared nationally through conferences, improvement events, Proud2bOps meetings and through ICS networks to help support others find ways to build back better.

How you can contribute

  • Has anyone in the Q community done something similar before and is happy to share their learning?
  • Does anybody in the Q community have te the ability to support patient focus groups? We would be looking for an independent individual not from the host organisation to encourage open conversation with patients to help explore their experiences of using the portal.
  • Once the portal has been co-designed with patients and staff there is a need to have a critical friend.
  • We would be looking to network with Q members to share the project, gain feedback, identify what is good and potential problems. There are many organisations trying to tackle the elective backlog and there is a need to share ideas and promote each others work to improve care for all.

Plan timeline

4 Apr 2022 Run patient focus groups
4 Apr 2022 Run staff focus groups
4 Jul 2022 Build preoperative Patient Portal
10 Oct 2022 Test Patient Portal in single specialty
31 Oct 2022 Analysis of patient interaction with portal
9 Jan 2023 Review test and launch on single site
10 Jan 2023 Ongoing analysis of patient interactions with the portal
13 Mar 2023 Review and launch across all sites

Comments

  1. Great idea. The system may help to prioritise patients on the waiting list after a period of time has lapsed as well as provide information/guidance to patients while they are waiting (and feeling anxious and frustrated).

  2. Great project Sophie and a something we are always looking at and exploring ideas. Keen to see how this develops and happy to connect and share learning and ideas

    1. Great to hear from you Chris, hope you're keeping well.  Yes definitely keen to connect as this will likely impact patients across the WY region so would be great to collaborate.

  3. Guest

    Sanjay Sinha 1 month, 1 week ago

    Sounds really interesting. Periop backlog is one of the really challenges

    This has the potential of being implemented across the entire patient pathway

    consultation

    Diagnostic

    surgery

    follw-up

    All the very best

     

     

    1. Totally agree, this has the potential to support the entire pathway from contemplation of surgery to post-operative and getting patients back into society.  Many thanks for your comment and support.

  4. Hi Sophie & Team

    Really interesting project, would be interested to understand how you may interact with those with additional needs, enabling loved ones/carers to support.  Also whether you have any of your therapy team involved in the project to support with pre-admission well-being - optimizing self before admission, dismissing myths, clarify over prep, etc. This would be so helpful.

    Best of luck Joe

    1. Hi Joe

      Thanks for your comment. Our therapy teams have been critical to some of the preoperative preparation advice, we've built/designed some procedure specific preoperative exercises that our therapy teams have led and created some really helpful patient videos.  If you're interested this can be found on our website www.shapeup4surgery.co.uk

      We're also working to get pharmacy involvement so that we can provide preoperative medicine plans.  We're really lucky to have the support of our learning disabilities team, and patient experience team to try and ensure we can make this accessible to all but I'm sure as we go along we'll be learning lots!

  5. Is this a nation wide portal or will it be open for a single trust?

    1. Thanks for your question Thomas, this is a single organisation portal.  But reading the literature and other projects I think there are many organisations trying to do something similar, to create joined-up engagement and create a simpler pathway to accessing information and communicating with patients.  I wonder if in the future the NHS app might hold all organisations portal so patients only ever need one app.

  6. Have you explored digital pt held records more widely - many trusts have/are developing these and any pathway specific apps would need to be able to link with the wider EPR.

    1. Hi Rebecca, your project sounds really interesting and many thanks for getting in touch.  Longer term yes the aim would be that the portal would support patients through every step of their surgical journey, including rehabilitation post-operatively.  Some of our services already have apps that they have created to support patients with their post op exercises e.g. MSK and orthopaedics so initially we would hope to build this into the portal so that the portal becomes the single point of access for all information and appointment booking changes and support.  Then through the portal patients could launch the apps already created.  It's really important for us get the link with information already available right so we're not duplicating work but more importantly so that we don't create a digital burden for patients.  We want to make this a seamless experience no matter what you need from the portal.

      Using the portal for prompts is key too, at the minute ours is all around appointment bookings but being able to support patients with prompts about pre/post op plans is where would love to be.

    2. Hi Sophie - this sounds like a really worthwhile project. It's great that the portal links to electronic records, as Kate mentioned, this is key to joined up communication between care teams and patients.

      We are shortlisted for a similar project which has grown out of our Trust's recent transition to EPR. We have the Patient Portal up and running, with variable levels of patient engagement. Our project is focussed on increasing patient engagement with the portal and creating/installing automatic digital follow-up prompts. Initially we are planning to work with post-ICU patients, with a view to expanding to anaesthetic/surgical patients thereafter.

      It would be great to share your learning from your work on the engagement with the patient portal. Do you have any plans to expand the work to include the post-operative phase of care?

    3. Hi Kate, many thanks for your comment.  The organisation has introduced the ability for patients to view and change appointments using the patient portal, and also to request translators etc. as well as providing information about parking, COVID regulations in the hospitals, site maps and other useful information.  As yet the portal has not been used a means to provide information to patients about supporting them when waiting for surgery.  There are other apps available that do this and many are well received by patients.  The patient portal has the ability to do this and it would mean that all patients would have one access point for information from the organisation.  There would be no requirement to have different apps or different log ins for different teams/clinics/episodes of care, we could provide it all through the one portal.  As the portal send letters to patients, if a patient changes their language choice this information available to all teams who care for that patient, during any stage of their life meaning patients provide information once, in one place.  The portal links with our electronic records and IT system too rather than being held in a separate web space so staff can easily use the system.

  7. Great idea to support health at a population level and particularly in the context of the so called 'post' pandemic phase.

    1. Thanks for your comment Anna, I completely agree.  The ability to provide personalised care and advice to waiting patients is critical.  The organisation serves a large community, with a changing life expectancy of 10 years from north to south.  The portal for example will allow us to link patients to the resources and activities in their community rather than simply saying 'you can do this in Leeds' it's an opportunity to be patient centred with the advice we provide.

  8. Great that given the length of waiting times for some surgeries that advice on activities to help promote health can be given.

    1. Thanks Louise, trying to support patients whilst they are waiting has become so important.  If we can make that support and preop advice personal and relevant to an individuals surgery, and deliver it to patients using the communication channels they have chosen the potential for improvement and impact is so much greater.

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