The benefits of using NHSmail at Stanfield Nursing Home include:
- registered nurse (RN) clinical time saving - 10 hours a week
- quicker receipt of accurate information
- an improved audit trail
- increased patient safety
Stanfield Nursing Home looks after 41 residents with higher needs aged 60+ who require nursing, specialist dementia and rest of life care. Delivering this care is a team of staff, including a nominated GP for the care home, registered nurses and other qualified staff.
Previously RNs had to spend a considerable amount of time each day ringing the GP surgery and an average of two hours a day was spent on the phone, connecting to the nominated GP for the home. Given the demand facing GP practices, making this connection took some time. When they finally did get through, GP admin staff took and transcribed messages for the GP. Unfortunately, not all the messages were accurately recorded, taken or translated which often meant that the GP had to ring back, which all took clinical time away from the RN's core purpose.
Previously there was limited access to up-to-date medical notes and test results, which made it difficult to provide a sufficient update to the loved ones of patients/clients. Often, prescriptions arrived at the care home with no clear indication of why they arrived, while engagement with the local older person's mental health (OPMH) team involved making multiple phone calls, to understand a patient's/client's care plan.
Stanfield Nursing Home requested, and was allocated, three NHSmail accounts which are used by the nursing office. The local clinical commissioning group (CCG) provides local administration support for these accounts.
With NHSmail, all emails go into the nursing office which means that RNs no longer need to make phone calls to the GP, to get updates and chase information. With direct communication now possible between the nursing staff and nominated GP, this allows speedier and safer transmission of medical updates and consultation notes.
The use of NHSmail has saved 10 hours a week of RN clinical time, which in turn has been re-invested back into the core activity of patient care. This also provides a more efficient process, ensuring that all relevant documents are emailed to the GP on the Sunday, adequately preparing the GP for their Monday morning visit. In so doing, both the nursing staff and the GP have good quality information, which is up-to-date and consistent at the start of the week.
For example, in a recent case, a resident attended an appointment with the neurologist who immediately transmitted results via NHSmail to the nursing office. Previously the RN would have had to make multiple phone calls to follow up and understand results.
Blood results and urine results are now received directly via NHSmail to the nursing office and pharmacies are now able to send an email advising what medication is to be or has been dispensed, what has been done and what further action is required. This ensures that all prescriptions received at Stanfield Nursing Home are adequately accounted for. In addition, with NHSmail, it's now possible for the tri-party or GP, care home nursing team and OPMH team to review a case using the same information and care plan.
Where discussions have occurred between a community psychiatric nurse (CPN) and a GP, the nursing office is now able to immediately pick up and understand what the plan is and who is responsible for managing delivery of the care plan.
Written communication significantly reduces the potential for misunderstanding/misinterpretation, increasing patient safety.
With the length of stay in hospitals getting shorter and shorter, families are increasingly anxious to immediately understand the health condition of their loved ones. Using NHSmail allows Stanfield Nursing Home to get more involved in health conversations and provide informed updates to families.
Stanfield Nursing Home can now communicate more efficiently with the continuing health care (CHC) team, who routinely use NHSmail. The home estimates that NHSmail saves significant time for other health professionals as well as the CHC team.
More work is needed to assure and encourage more GP practices to communicate with Stanfield Nursing Home using NHSmail, as some practices are still resistant.
There are also significant opportunities to explore better ways of sharing discharge and admissions information with Stanfield Nursing Home, through NHSmail. This is particularly the case when someone goes into hospital with pneumonia then a short time later returns back to the care home with no advance notice. In such a case, having advance notice of discharge would help towards the speedy development of a care plan. NHSmail clearly offers much potential!