Back in Manchester a week later for BCS Health 2014 I participated in the stream 'Fit for practice – exploring the nursing experience of the usability of clinical systems' facilitated by the Royal College of Nurses and Chaired by Dr Susan Hamer of The National Institute for Health Research. Here I discussed the implementation of a clinical system and how the success of this project was rooted in the nursing-led implementation.

1. Nursing Led Implementation

2. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Paper is failure.
Audit results from King’s Early Warning Track and
Trigger paper charts (POTTS) showed:
●80% POTTS charts completed fully
●91% Associated EWS scored
●90% EWS calculated correctly
●49% Escalated + responded correctly to EWS

3. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Paper is failure.
Audit results from King's; January – June 2012:
55 separate SUIs
● Failure to do obs - 25%
● Incorrect EWS calculation - 16%
● Failure to recognise deterioration - 29%
● Failure to follow protocol - 31%
● Failure to respond appropriately - 49%

4. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
From this...

5. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
To this...

6. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Nursing Leadership
Engagement: Chair of the Trust Patient Deterioration
Committee also IT geek!
Evidence: POTTS audit consistently showed
inadequate calculation of scores and poor escalation
Engineering: Build it ourselves
Education: Iterate and learn

7. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Nursing Implementation
● Piloted on two wards
● Ward sisters engaged and provided feedback
to improve system
● Nurses LOVED IT!!!!
● Adopted by Trust IT Dept and team set up for
implementation
● Nursing Led Training and Roll-out … Senior PM
was a Nurse

8. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Trust Wide Deployment
95,000 observations a month
● Failure to do observations - 0%
● Incorrect EWS calculation - 0%
● Failure to recognise deterioration - 2%
● Failure to follow protocol – 3%
● Appropriate escalation response – 98.7%

9. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Engage nurses from the start!
Nurses know the reality of practice and what is “doable”
Make systems easy, friendly, playful!
Deploy systems that make a tangible and real
difference to Patient Safety (not just managers....)
Some learnings...

10. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
We can do better...

11. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Meaningful Dialogue
Nurses and Developers working together

12. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
This is a process

13. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
This is not a process

14. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
Localised NEWS as Process

15. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
@code4health
Come and see Tactix4
NHS England Open Source Pavilion

16. Tactix4 at BCS HC2014
19/03/14
Rob Dyke, rob@tactix4.com
@robdykedotcom @tactix4
THE END