The James Cook University Hospital (JCUH) is part of the South Tees Hospitals NHS Foundation Trust, which is located in Middlesbrough in the North-east of England. This is a tertiary neonatal unit without any surgical facilities, with approximately five thousand deliveries and five hundred admissions.

The JCUH upgraded from BadgerNet Clinical Summary to BadgerNet Neonatal EPR in January 2023. Recently, we invited Prakash Loganathan, a consultant working at the JCUH to talk about the trust’s experiences in implementing BadgerNet Neonatal EPR system on our webinar, ‘Upgrading to Neonatal EPR - how to build your business case.'

Preparation

Prior to implementation of the BadgerNet Neonatal EPR, JCUH conducted a detailed survey among the unit’s nursing and medical staff. Prakash’s team had been comfortable with BadgerNet Clinical Summary since 2008 and had concerns on why they should change now. Initially the team thought of all the negatives surrounding a potential upgrade:

• Typing patient information into digital platforms can be time consuming.
• Understanding the system takes time and resources.
• Hardware could be a problem due to internet issues and firmware updates.

Staff at JCUH had various meetings with other neonatal units, including Dundee and Liverpool, who have used BadgerNet Neonatal EPR for several years. This collaboration between trusts allowed the team to determine areas they should work on and what problems they could potentially face during implementation. These invaluable experiences and accounts allowed JCUH to navigate their way through the process of upgrading to the Neonatal EPR with ease.

Implementation

The team at JCUH went through vigorous preparation in order to be ready to implement BadgerNet Neonatal EPR. Initially, they mapped out how the EPR would be used within the unit and the benefits of upgrading from the clinical summary system.

Prakash and his group decided to upgrade their systems in a phased manner giving time to put the proper preparations and infrastructure in place before go-live. For example, an additional consideration the team at the JCUH had to investigate was hardware,  and asked a variety of different questions including “How many computers and iPads do we need? Do we have enough physical space? Do we have enough Wi-Fi connectivity?” In order to counter these worries, Prakash and the procurement team involved their IT unit and biomedical engineering team in every single consultation.

In the very beginning, the teams started to realise that they needed to delegate the work, for example, the procedure checklist, the central line, umbilical line, intubation, were all developed by their nurse practitioners. Upgrading to BadgerNet EPR gave the team the opportunity to customise the EPR to match their unit’s procedures and policies. This allowed the unit to become paper light, as all charting functions were now accessible on the iPads.

To help support trusts who are undergoing procurement for hardware, the BadgerNet EPR team are on stand-by. The team regularly arranges demonstrations to show the functionalities and differences between clinical summary and BadgerNet EPR whilst also answering any further questions. 

Training

To facilitate proper training and implementation, the team’s digital lead nurse underwent a one full-day learning exercise to understand the system. This was to ensure a seamless transition and to put in place proper training for other staff members. The team also identified key individuals they called ‘alpha people.’ These individuals were involved in informal teaching and supporting others during implementation. Members of the team needed to be informed every step of the way so, to uphold this, the JCUH send regular emails every month, have a WhatsApp group and opted to regularly update the team in all the directory and consultant meetings. 

Prakash and his team were also mindful of the other stakeholders such as ophthalmology, physiotherapy, dieticians and audiology to make sure that they understood what their needs with regards to education and training were.

To further support with training, the BadgerNet team at System C gave JCUH access to a test system, where they created dummy babies to help simulate everyday admissions and procedures as well as discharges. In addition to this, the team at JCUH created numerous e-learning videos which were made available on the internet for easy access. They developed practical videos simulating admission, day-to-day ward rounds, procedures, parents’ communication, and discharge. To make deployment of the EPR more accessible to the team. JCUH put rules in place which made it mandatory that all the trainees were required to watch all the e-learning videos.

Staff at JCUH also developed in-depth user guides which were then made accessible online This allowed staff both quick access as well as reminders on the timeline of the Neonatal EPR upgrade process. Staff at JCUH also conducted many face-to-face training sessions for both medical and nursing staff.

“We prepared ourselves for a rough journey but also we got a lot of support from the BadgerNet EPR team.” Prakash Loganathan, Neonatal Consultant South Tees Hospitals NHS Foundation Trust.

Post Go-Live Support

For the first few days post go-live, staff at the JCUH made an informal rota with a ‘Badger Super User’ to be available on most of the shifts, including weekends and nights to help the team if they had any questions or something went wrong. For the first three months after implementation, they also kept a diary called Badger Diary so people could provide their feedback and suggestions. This gave the team an opportunity to address any concerns by providing extra training, or to issue a ticket with the BadgerNet support team at System C. Prakash and his team made regular use of System C’s ‘Service desk’. System C also provides a common platform for Trusts, in the form of the BadgerNet EPR forum, which allows users to communicate together as a team.

Staff at the JCUH also paved the way by introducing ‘Badger Bytes’ after implementation – a monthly digest of top tips and learning points as well as an update on any additional features that are being introduced, so staff are kept up to date.

“We are constantly viewing and updating the new changes by BadgerNet. For example, recently in the last six months we have been using something called E-referral, that means we do not do any paper referrals anymore both within the hospital and also outside the hospital.” Prakash Loganathan, Neonatal Consultant at South Tees Hospitals NHS Foundation Trust.

“Going paperless was a massive change for our unit, and at the time was an area of anxiety for some members of staff. However, the benefits of going electronic have been huge. It is now much easier to follow a baby’s Neonatal journey, especially when they have been to different hospitals that also use EPR.” Ellee Bailes, Digital Nurse at South Tees Hospitals NHS Foundation Trust.

User Testimonials

“Specialist reviews are much clearer to view, and plans can be followed with much more ease as everything can be seen under the relevant speciality. From a nursing point of view, monitoring and keeping up to date with any safeguarding concerns is much easier as conversations are documented in one place, meaning you have a very clear understanding of any issues that are going on. BadgerNet also generates a safeguarding ‘yellow’ flag to help identify babies with safeguarding concerns." Ellee Bailes, Digital Nurse at South Tees Hospitals NHS Foundation Trust.

Prakash and his team at the JCUH highlighted some key benefits of adopting the full BadgerNet EPR during our latest webinar.

• “We can clearly read and understand what's the doctor's documentation and nurse's documentation.”
• Alert System – “When you open BadgerNet EPR, on the top right-hand side you can see when the baby was admitted, what is the weight of the baby as well as the yellow and red flags alert system.”
• “There's a default alert system created by BadgerNet, but it is also extremely customisable.”
• “There is something called smart search, if you search a specific term, for example, I want to know did the baby receive optimal cord clamping. So, I put cord clamping where I can find the details and I can do the input.”
• “BadgerNet EPR makes care more efficient as we can prep all the parents’ communication applicable for their baby. We can develop a PDF document if need be.”

Next Steps

The successful journey of South Tees Hospitals NHS Foundation Trust in upgrading to the BadgerNet Neonatal EPR system highlights the importance of thorough preparation, collaboration and phased implementation. It serves as a valuable example for other healthcare institutions aiming to modernise their systems and improve patient outcomes.

To delve deeper into the Trust’s experiences, we invite you to watch our on-demand webinar. Additionally, you can explore more about our Electronic Patient Record (EPR) system and its benefits. If you have any questions or need further information, please don’t hesitate to contact us today. We’re here to help.