eWard

Doctor holding stethoscope

eWARD assists in the management of care provided to hospital in-patients, including electronic medicines management and automated production of Immediate Discharge Documents and Nursing Transfer Documents.

eWARD can be linked to SCI Store to obtain patient demographics, and discharge documents can be sent electronically to GPs via SCI Gateway.


Testimonial

Checklist with boxes ticked

“We have worked closely with The Solution Works to implement and extend eWARD to meet the evolving needs of NHS Forth Valley. The Solution Works are responsive and their flexible collaborative approach enables us to achieve our goals, and the software is good quality and user-friendly.” Liam Coughlan, eHealth Project Manager, NHS Forth Valley

Awards

First Place

eWARD is at the centre of a revised pharmacy workflow at NHS Forth Valley, enabling increased efficiency and effectiveness of the Pharmacy team to such an extent that NHS Forth Valley has received recognition for its achievements in innovation and patient safety by winning the coveted Patient Safety Initiative of the Year award for 2009 at The Pharmas Awards, which recognise excellence in UK pharmacy.

NHS Forth Valley also won the Hospital Pharmacy Team of the Year and Innovation and Change in Pharmacy Practice awards in The Scottish Pharmacist Awards 2010.

History

The Solution Works has enjoyed a long working relationship, first with Falkirk and District Royal Infirmary (since 1994) and then with NHS Forth Valley.

TSW developed the well-regarded Delta system (for automating the production of Immediate Discharge Letters and Nursing Transfer Documents), which was implemented in FDRI in 1994 and used until 2006 when it was replaced by eWARD. TSW was also involved in the ongoing development of FDRI's MatSys maternity system, which was in use at FDRI from 1992 until 2001, when it was replaced by the new Maternity System.

eWARD was developed by The Solution Works in consultation with NHS Forth Valley as a replacement for Delta using more modern tools and technologies. The Maternity System was also developed by The Solution Works (using the same tools and technologies as eWARD) in collaboration with NHS Forth Valley and NHS Scotland and shares many core modules with eWARD. Maternity is Crown Copyright in Scotland and is available free to all NHS hospitals in Scotland.

Implementation Goals and Objectives

NHS Forth Valley implemented eWARD in 2006 with the primary goal of improving patient care and safety, via the following objectives:

  • Reducing the risk of medication-related errors
  • Providing a clear and accurate Immediate Discharge Letter

The Solution Works worked closely with the eHealth Programme Office, Pharmacy Department, Medical and Administrative staff from NHS Forth Valley to configure and extend the functionality of eWARD to enable these objectives to be achieved.

A group of doctors. The primary doctor is holding a clipboard

Project

A doctor handing over a prescription

In 2006 NHS Forth Valley implemented eWARD in Falkirk and District Royal Infirmary (replacing Delta) and Stirling Royal Infirmary (where no similar computer system was available previously).

As part of the implementation, working practices were standardised across the hospitals, and NHS Forth Valley was closely involved in the development of new pharmacy and discharge workflow functionality for eWARD, including integration with SCI Gateway to enable electronic transmission of discharge documents to GPs.

eWARD provides flexible support for NHS Forth Valley's working practices, enabling staff to work efficiently and effectively, focusing on patient care and is well-regarded by the large user base in NHS Forth Valley.


Sample Screenshots

  • Bed Management Bed Management Functionality
  • Prescription Signature Capture Prescription Signature Capture
  • Episode Summary Episode Summary
  • Episode Discharge Summary Episode Discharge Summary
  • Discharge Document Properties Discharge Document Properties
  • Discharge Document Discharge Document
  • Discharge Summary Preview Discharge Summary Preview
  • Pending Prescriptions Pending Prescriptions
  • Pending Prescriptions Pending Prescriptions
(All data shown is fictitious)
Benefits
Benefit Description
Pharmaceutical Care Plans
Improved patient safety

eWARD enables a pharmaceutical care plan to be created for a patient episode, recording risk factors, past medical history and active problems, and enables (with the patient’s consent) sharing of this information electronically with community pharmacists, improving patient safety and care.

Prescription Workflow
Reduced prescription waiting times

The prescription workflow functionality provided by eWARD has enabled NHS Forth Valley to reduce waiting times for discharge prescriptions by 50%, with 90% of prescriptions ready in under two hours of the request.

Bed Management
Encourages real-time patient tracking

eWARD provides an intuitive user interface (designed to support SMART Boards and other interactive displays, including drag-and-drop) encouraging real-time update of patient movements and enabling management of ward capacity on a day-to-day basis.

Improved occupancy rates

eWARD enables monitoring of ward occupancy across the whole hospital (across multiple hospitals, if required), enabling vacant beds to be located quickly and providing information on ward capacity and status (e.g. ward is empty, ward has vacancies, ward is full), as well as details of vacant, reserved, and occupied beds, and patients that have not been allocated a bed.

Nursing Handover
Reduced clinical risk

Formalisation and standardisation of the process to handover patient care from one nursing shift to the next using eWARD supports Information Governance best practice and reduces clinical risk through the elimination of duplication and transcription of patient demographics and other clinical information during nursing handover.

Hospital at Night
Improved inter-shift and intra-shift communication

eWARD enables staff to request that specific tasks be performed at specific times, e.g. "take blood sample at midnight", "change bandage in the morning", and for other staff to perform those tasks and record when the tasks have been completed. Monitoring support indicates which tasks are outstanding, due or complete, enabling appropriate prioritisation.

Improved patient care

eWARD supports the handover of patient care from the day staff to the Hospital at Night Team, enabling day staff to notify the Hospital at Night Team of patients who will require attention during the night, and for the Hospital at Night team to provide feedback to the day staff on those patients.

Improved patient safety

eWARD enables night ward staff to alert the Hospital at Night Team to patients who take ill during the night and require attention from the Hospital at Night Team, and also provides a mechanism to notify the day staff of this. An automated scoring mechanism, based on patient assessments such as blood pressure and heart rate recommends a timescale for the patient requiring attention to be seen by the Hospital at Night Team.

Immediate Discharge Letter (IDL)
Improved IDL quality

GPs in Forth Valley have been impressed by the improvements in the quality, clarity, and consistency that the new Immediate Discharge Letter (IDL) generated by eWARD provides compared with the previous manually-produced discharge letters.

Faster transfer of IDLs to GPs

IDLs are now being sent electronically from eWARD via SCI Gateway to all GP practices in NHS Forth Valley from most wards in Stirling Royal Infirmary and Falkirk and District Royal Infirmary. This means practices receive them in a matter of hours, well within the government target of 24 hours. The system has been described as "brilliant and very easy to use".

Reduced administration

Stopped drugs and the reasons why they were stopped are shown clearly on the discharge letters generated by eWARD. Along with other improvements in the IDL this has resulted in significantly fewer queries from GPs regarding the content of discharge letters, saving secretaries time tracking down case notes and/or consultants to clarify issues.

Barcode Scanning
Minimal data entry

eWARD allows users to create a new episode movement quickly by scanning the CHI number barcode on the patient's wristband, automatically receiving the patient into the local ward.

General
Improved availability of patient data

eWARD provides secure remote access to patients' notes and episode details, enabling pharmacists to access information without having to physically be on the ward, for example.

Improved collaboration

eWARD supports a systematic approach to patient care, integrating the work of medical, nursing and paramedical staff, enabling more effective and efficient collaboration, saving time and improving patient care.

Improved traceability

eWARD's comprehensive audit trail provides automatic auditing of viewing and modification of data, improving traceability.

Current and Possible Future Developments

NHS Forth Valley continues to work closely with The Solution Works on the expansion of eWARD, including:

  • Integration with Electronic Document Management
  • Bed History (for infection control)