For the final webinar of HTN Now: January, we were joined by Saj Kahrod, Assistant Director of Blueprinting from the NHS England Blueprinting Team, along with Sarah Atkins (Scan4Safety Nursing & Product Specialist) and Rachael Ellis (Director) from Hull University Teaching Hospitals NHS Trust (HUTH).
Saj, Sarah and Rachael kindly joined us for an overview of the blueprinting programme, achievements from the past year and discussion on the blueprinting library, in addition to sharing a blueprint from HUTH on how to implement Radio Frequency Identification (FRID) and Real Time Locating System (RTLS) from planning to performance.
The blueprinting programme
“Blueprinting is a national programme working in the transformation directorate,” said Saj. “We work with NHS organisations and trusts. We’re looking to expand out to primary care as well.”
Saj shared some context to begin the discussion: “Blueprinting is about structured collection of knowledge assets, but also associated methodology. It covers a range of digital initiatives which allow organisations to share a step-by-step guide that is tailored for NHS organisations to suit local needs, and work around the digital components as part of digital transformation.
“We’re part of a support offer working to support frontline digitisation. A wider benefit of blueprinting is about accelerating the delivery of technology transformation to enable confident decision-making, share good practice and ideas, and try to reduce the number of risks, mistakes and lessons learned from other organisations and trusts.”
Saj touched upon the different levels of blueprints available, including a full blueprint which outlines the full detail of the project supported by relevant artefacts, tells the full story of the digital solution and provides an in-depth look at processes, successes and challenges). Another option is the ‘blueprint on a page’ (BPOAP), which provides key insights and benefits and outlines the main activities and journey. A technical annex, meanwhile, is a more detailed guide in implementing technical solutions and roll-out.
Blueprinting in 2022
Next, Saj shared some of the key achievements from the past year.
“We’ve been working with a number of global digital exemplars and trusts to develop great blueprints,” she said.
Facts and figure include 18 blueprint reviewers; working with 62 new trusts; 201 blueprints published to date; 2,453 downloads of blueprints and supporting documents; and 796 new joiners to the platform.
Engagement and education is another key focus, with ‘blueprint of the month’ sessions held to raise awareness, addresses at national and regional events, and training workshops provided.
The top five blueprints in terms of views, as of December 2022, shows the breadth of work happening in the team; they focus on inpatient care coordination for bed management from Bedfordshire Hospitals NHS Foundation Trust; how to implement RFID and RTLS from HUTH (more information to come on that, from Sarah and Rachael); A&E patient flow management from Bedfordshire; guidance for nursing on what good looks like from NHS England Transformation Directorate; and a digitised paediatric appendectomy pathway from Alder Hey Children’s NHS Foundation Trust.
From 06:38 on the video below, Saj showed examples from the National Blueprinting Library.
“The library can be found under the Blueprinting FutureNHS Collaboration platform,” she said. “All you need to do is log into that, and we can provide you with access.”
In the platform, Saj explained, there are blueprints relating to a number of topics including kiosks, clinical noting, e-observation, integration, single sign-on and robotic process automation.
“We’re looking to increase this, particularly focusing on developing blueprints around artificial intelligence, remote monitoring, virtual wards and video conferencing,” she added. “That portfolio is increasing as we speak.”
Saj emphasised that the Central Blueprinting Team are here to help any organisations wanting to create blueprints. She encouraged anyone who is interested to sign up for the FutureNHS platform by emailing [email protected] with their request, and added some contact details for specific individuals on the presentation at 07:29.
How to implement RFID and RTLS from planning to performing: a blueprint
At this point, Sarah and Rachael took over the discussion to share their experience in developing this blueprint for HUTH.
“RFID technology is commonly used in retail and supermarkets to track and trace any products from warehouse to shop floor. It works by radio waves ‘seeing’ labels which identify where products actually are, with antenna and readers in the ceiling which can track whether the item has passed beneath them. We wanted to see how we could make this work for us in a hospital setting,” Sarah explained.
She described how they went out to tender and eventually partnered with a company who have been implementing RFID in hospitals since 2020.
“We have antenna and readers in the ceilings of the hospitals on both sites, Castle Hill and Hull Royal,” Sarah continued. “Most are located in walkways, inside storerooms, in and out of entrances to departments and anywhere where there is high footfall and these cover every patient entrance and exit.”
The project wasn’t just about keeping track of stock, she noted. “We wanted to label our medical devices and assets too,” Sarah said. She described how RFID tags can be attached to medical devices or assets, such as beds; the labels identify the exact device or asset, including serial codes, unique identifiers, brand names and so on. “As the bed moves around the hospital and passes under a reader, the information is sent to our system.”
An issue with inventory can be the fact that people have different names for the same devices, Sarah pointed out. The labels help with this as there is the option to include the nickname the device might go by in the RFID tag, making it easier for a colleague to locate it.
Sarah provided an idea of the project’s scope by noting the items currently covered by RFID in the trust: hand-held portable electrical appliances (approximately 72,000); bed frames (approximately 3,500); mattresses (approximately 2,000); mobility aids (approximately 600); bedside assets (approximately 9,000), sterile tray sets (approximately 14,5000).
Phase two of the project will see patient belongings included in this list.
In terms of need for RFID, Sarah provided a number of reasons. Assets need to be tracked down for patient use, often urgently; if something is in the incorrect place it can cause future problems so this needs rectifying; there is a need to quarantine assets sometimes in a timely manner; maintenance dates must be adhered to for assets requiring servicing or maintaining; and there is a need to create an up-to-date equipment library.
Next, Sarah shared a video to share more information on the project from different roles within the trust; go to 13:37 on the video below to view it.
In terms of benefits of RFID, Sarah said: “We see improved quality of care for patients – when we need assets for urgent patient care, we can find it easily. There’s a reduction or an avoidance of capital investment; if we can find everything, we don’t need to replace it. It also reduces or avoids loan equipment expenses, because if we know what we have, we don’t need to hire extra assets in.”
Other benefits include lowering operational expenses as there is less need to cancel procedures due to issues with asset availability; avoiding lost, overdue, incorrect or excessive rental equipment charges as the team have better clarity on when items are due back with the supplier; and reducing or eliminating unproductive clinical and medical engineering time, with less need to search for assets in the wrong place.
Rachael joined in the discussion at this point to emphasise how the project has saved the trust time and money.
“We did a time and motion study to work out how much time we were saving,” she said. “When we stood on a theatre corridor for four hours, 11 colleagues spent three hours and 47 minutes between them looking for assets. Now we know that we can find an asset within four minutes of looking because the readers at key points direct us to the location in real time.”
They expect to release official figures on this in the coming months, Rachael said, adding that “we are expecting those figures [on savings] to be quite phenomenal. Our target was to save 80 percent of time and I think we will achieve that. It’s been a massive improvement.”
On becoming a global digital exemplar (GDE), Rachael noted: “It was a great deal of hard work, but I’m hoping that other people can benefit from it. Our learnings are embedded throughout the document – if you are even considering RFID, you can download our blueprint along with the artefacts that you find useful, such as pieces of evidence, videos, plans, templates and so on.”
The blueprint contains a project overview; information on how ROI is calculated; the scope of the project; key decisions made and the reasons behind them; technical prerequisites; pre-implementation considerations; planning and preparations to consider; post-implementation considerations; baselining activities; and key learnings.
On collaboration, Rachael added: “The central blueprinting team supported us massively in putting this together and it was kindly read by Stuart McMillan at the West Yorkshire Association of Acute Trusts. For us, it was great to have a peer read it, understand it and confirm that it is helpful.”
The team took questions from this point, available to watch from 32:19.
Many thanks to Saj, Sarah and Rachael for joining us.