In June 2021, Julia Antcliffe, Sheffield Children’s Lead Nurse for Digital Technology, and the Digital Clinical team, led a major project to spearhead the use of CareFlow Connect, a secure and mobile clinical communications and collaboration system designed to facilitate faster and safer care co-ordination for clinical teams within a hospital and across a care community.

The Challenges

With the need to ensure user adoption across nurses, doctors, allied health professionals and specialist staff such as occupational therapists, dieticians and physiotherapists, Julia was responsible for coordinating an implementation programme with the support of System C. The implementation required extensive communication, engagement, and training.

A key contributor to the success of the implementation was detailed preparation. The Trust took the time to understand the mistakes other Trusts had made before the system went live. Levels of clinical engagement across staff groups were also extremely high. Julia explains:

"We engaged extensively with leaders across the Trust, including ward managers, gaining their buy-in to the value of using Connect and the improved handovers, referrals and communication that would be achieved as a result."

People can often be averse to using new systems, although CareFlow Connect proved very easy and intuitive to use from the start. The app was also carefully tested before rollout, and the Trust developed an excellent understanding of how the app would work best for their varied user groups. In addition, the Trust rolled out hundreds of new mobile devices to ensure staff can easily access the system.

The Implementation

Over an initial six-week period, CareFlow Connect was deployed in two wards per week. Ward managers, superusers, clinical educators and champions all contributed to a structured roll-out. They were all quick to get staff trained and using the system, generating excellent feedback on the training and support offered. All pre go-live training was conducted remotely through Microsoft Teams due to the pandemic and staff had access to training materials, including short videos and a full recording of a training session via QR codes. Julia says:

"It was great to access training materials during a night shift. Scanning a QR code to watch a video was effortless and this helped us feel prepared for our go live date."

Another vital element of the successful deployment was the multi-media communications campaign used to launch and raise the profile of CareFlow Connect, which helped internal and external audiences, including patients and parents to understand the digital journey Sheffield Children’s were embarking upon, which explained why they were likely to see more nurses on wards using iPads! This included branding tailored to the overall Digital Journey campaign (which includes CareFlow Connect), an animated video to introduce the system, stickers with QR codes leading to more information, intranet information including an advertising banner on the home page and weekly internal emails that explained what was happening and why throughout the duration of the implementation project.

The ‘faces’ of the campaign were Digital Theo and his digital dog, as well as a team of robotic dogs led by Barney (see right), who is named after System C's project manager Barnaby Franklin.

Dr Caroline Kerrison, Consultant and CCIO at Sheffield Children's NHS Foundation Trust, summed up the campaign by stating:

"Our pack of robodogs will help see us safely through our digital journey. Thanks System C for helping healthcare make a connection, communicate safely and bring joy to children while we’re at it."

Julia concludes:

"Overall, the support from System C and the Trust’s internal team has been fantastic."

The Benefits

With over 1000 users and over 3500 patients with handovers completed to date, CareFlow Connect continues to grow in popularity and contribute to better communication and collaboration. In addition to the wards, 25 specialty teams are using the app for handovers, tasks, and referrals, to suit their working processes for activities that range from complex discharge handover to medication review. The Trust’s overall objective is to make the adoption of CareFlow Connect mandatory in the future.

Early benefits have been that nurses and doctors can update handover information in real-time, rather than waiting until the end of a busy shift, which often relies on memory and hand-written notes. Information is accessible and nurses particularly like seeing handover notes from doctors. They weren’t used to seeing medical handovers from doctors before, but now there is an expectation to see them every time when treating a patient. Another advantage of electronic handover is that SBAR has been adopted by all teams. CareFlow Connect’s handover feature incorporates Situation, Background, Assessment, Recommendation (SBAR); a popular technique in healthcare used to facilitate and prompt appropriate patient handover.

Julia said, "Before the implementation of CareFlow Connect, clinical teams used different formats, so it’s great to see handovers recorded in a standard way."

The Infection Control team have sent tasks to other teams when MRSA swabs are due and have noted an increase in the number of patients receiving swabs within the target period.

Insight information available via the app reports on user activity. This is also crucial for the Trust, as it’s helping to embed the correct processes and ensure maximum adoption.

Excellent User Feedback

• Transparency of information across all professionals for handovers means less duplication and no confusion about the plan of care.
• If details differ between handovers, we can clarify the plan before mistakes happen.
• CareFlow Connect has helped improve communication on Ward 1 as everyone has access to up to date information on patient details, history and the plan of care, as well as which patients are on the ward and who is caring for them.
• When new patients are admitted, the whole team have access to the referral information before they arrive.
• CareFlow Connect is easy to update and use, makes handover quicker and is useful when information is needed quickly, as it’s not usually necessary to find medical notes.

Mass user adoption can be a challenging feat, but the buzz created by CareFlow Connect has made all staff groups very interested in using the app. Julia says:

"The secret to the success of implementing CareFlow Connect at Sheffield Children’s was ensuring user adoption amongst nurses first. Starting with nursing handovers meant we had a large number of nurses confidently using the app before rolling it out to doctors and speciality teams. Nurses have been able to support doctors and the wider speciality team on their journey, making the transition from a paper handover sheet to an electronic system much easier.

Implementing CareFlow Connect has given users an enthusiasm for digital technology and they’re now asking, ‘what’s next?’ The roll out will continue into 2022 and the digital clinical team continue to be visible, supporting staff on their digital journey."

Next Steps

The system has facilitated faster and safer patient handovers, referrals, and overall communication, significantly improving the efficiency and quality of care provided.

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