How Great Ormond Street Hospital is leading the way on using bedside technology


Great Ormond Street Hospital (GOSH) has been heralded as an example to follow for nurses using mobile devices to electronically observe patients. Find out more about what they're doing.

GOSH have introduced a pioneering technology system, which uses mobile devices to electronically observe patients' vital signs.

Great Ormond Street Hospital nurse using bedside technology

Led by a GOSH Clinical Site Practitioner and nurse, Sarah Newcombe (pictured), the system tracks any deterioration in a patient's health and sends automatic alerts to relevant clinical teams.

It gives clinicians Trust-wide visibility of all their patients and their vital signs, no matter where they are in the hospital. This allows them to respond rapidly if patients become unwell, and ensures that nothing can be missed when making decisions about a patient's care. 

Sarah is responsible for monitoring patients across the Trust who become unwell during their stay. It was in this capacity that she identified the need for a digital clinical communication tool that members of the Inpatient Clinical Care Team could use to review their patients' health.  

The system has made it easier to identify the sickest patients prior to rounds, particularly during out of hours, when there are often 350 patients to look after. 

Clinical information is now accessible in real time on mobile devices, allowing clinicians to make decisions to best prioritise their patients care. 

Caron Swinscoe, Clinical Lead for Nursing at NHS Digital, said:

"Good clinical care is all about information and communication. 

"Bedside technology gives clinical staff crucial information about patients in the palm of their hand which is accurate, up-to-date and shared by the whole team. Used effectively, it can ensure that changes in patients' conditions are noted in real time and help to ensure early recognition and quick action, vital in the care of sick patients.

"There is emerging evidence that mobile technology helps doctors and nurses to spend more time on wards, visible to other staff, patients and visitors. More time to spend with their patients is the greatest gift that technology can give to a clinician.

"Engaging clinicians in decisions about new technology is crucial. Our experience is that investing in e-technology to assist clinicians is just the beginning. By ensuring that developments are clinically driven and clinically led the potential benefits for patients and clinicians are huge."

Sarah Newcombe, Clinical Site Practitioner at Great Ormond Street Hospital, said:

"Our nurses and clinicians needed to know, in real time, where the sickest patients on our wards were, in order to respond quickly to prioritise care for those who needed it most. 

"The benefits we've seen following the implementation of this new system are brilliant. It has really helped us to improve the visibility of our patients and the response times of clinicians. It has also saved thousands of nursing hours per year, and has delivered more than 50,000 Children's Early Warning Score alerts per year.

"One of the biggest benefits is that nurses no longer need to leave the bedsides of sick children to call for extra help. If the e-observations tool detects an unusually high score on a patient's vital signs observations, the mobile device automatically instructs the nurse to stay with the patient, and sends an alert to senior staff.

"We can then use the device as a tool to communicate, and send patient allocated texts, to check whether the need for a review by a senior clinician is urgent.

"This isn't a replacement for the knowledge and skills that our fantastic nurses have, as interpreting the observations the system gives us is still down to clinicians, but it is a safer way to ensure we're monitoring our patients to the best of our ability."
Following successful pilot, Sarah and her team spent six months rolling this system out. It's now used in all ward areas across the Trust, with the exception of intensive care, for the past three years.

Sarah continued:

"Our patients, and their families, are supportive of the system- they regard it as an innovative, modern and, safer way of working.

"This has also proven to a more effective way of interacting with our patients, who are children growing up in the digital age. We are finding that talking them through their observations is much more effective and engaging than a traditional chart would be."

The team has now developed a new 'paediatric early warning system', which is quicker, more sensitive, and more reliable at identifying the sickest patients and those who show deterioration. 

The system has led to an increase in unplanned admissions to the hospital's intensive care unit - a sure sign that nurses are now more quickly identifying patients in need of urgent care.

Sarah, who won a "Digital Leadership Award" from NHS Digital earlier this year, now shares learning with other NHS Trusts through user forums and site visits.