Oldham's Integrated Discharge Team

Digitalising Discharge To Assess

Briefly describe the initiative/ project/service; please include your aims and objectives

Collaboration of teamwork between Unity Partnership (wholly owned company of Oldham Council) IT and Business Change Department, Airelogic, Oldham Cares and Oldham Council, to digitalise the Discharge to Assess process within Oldham Hospital.

– Digitalise a paper based timely business critical process
– Improve integrated ways of working across the health and care sector
– Improve quality of service by increasing interoperability
– Overcome a current business problem
– Create technical capability within Oldham which could be reused
– Integrated approach to discovery, design, and delivery
– Utilising Unity Partnership’s existing technical infrastructure as a core function

– Lead the way in digitalisation of business critical problems (in the absence of an Acute EPR).
– Digitalise the discharge to assess process to reduce significant waste in the current process
– Digitalise first – Integrate second
– Create an MVP which could be reused to enable an interoperable MDT approach within Oldham
– Create digital capability which could be shared regionally
– Connect organisations through digital infrastructure

– Increase integrated ways of working for MDT teams from different organisations
– Increase the most up to date information being collected for patients and preventing rework and duplication for other teams
– Reduce re-admissions and increase quality of the service provided

What are the key achievements?

This was a first of type in Oldham, utilising the Azure infrastructure and enabling teams to work collaboratively on the same referral. This was one of the first of type for digitising the D2A process, which was accelerated as a covid response but mainly exists as a paper form. Utilises new technology for multiple organisations. Oldham Hospital (Part of Northern Care Alliance) now submit 99% of discharge to assess referrals digitally to the discharge hub, ensuring that the most up to date, information is available to help support and progress a safe discharge from hospital. The information is thorough, legible, and structured with the ability to be passed on to other care providers which may be involved in the discharge or reablement of that patient.

Technical capability has been utilised in the following way:
– Digital form hosted by Unity Partnership (Digitalisation)
– Linking of the Azure Active directories (integration) to allow NCA staff to access the form via a secure single sign.
– Unity’s Azure environment linked via secure API to the NCA Patient Administration System (integration), providing a patient search function, using the hospital number and DOB.
– Ability to view and edit forms completed by other care professionals. Ability to view forms submitted in last 30 days. Design which can be reused to create joint care plans.
– The form will open in an overlay screen and where demographic information is pre-populated from the PAS system. The clinician is then able to complete the form, submit or save for another clinician to complete. Form is designed to open on any device, iPhone 5 (size) or above.
– Navigate between sections using the navigation pane. It is possible to navigate even where the mandatory fields are not completed within a section.
– Green tick and red cross icons in the navigation pane show complete and incomplete sections.

Additional fields added to support the discharge – temporary address, frailty score, covid vaccination status. Oldham now have a robust digital process which is proving invaluable for patient care and the transfer of information to all care provisions. The frailty score and covid vaccination status has been added to the data collection and the form using structured logic to enable a good user experience. Feedback from teams has been extremely positive and the benefit of the functionally is recognised across the system. Other areas where digitalisation is needed are keen to engage and adopt a similar approach.

How innovative is your initiative?

This initiative has not just seen the integration of technology but also put to test an integrated way of working. Teams from across multiple services and organisations have come together as a team to progress this and really drive this forward. This has been designed to be hosted by the local authority but be used by hospital staff, linking the two technical infrastructures. Azure has been used to link active directories enabling a way to legitimise users to access systems across
organisations. This system has given staff the ability to work in a true digital MDT approach.

What are the key learning points?

– Dedicated project manager from each organisation
– Identifying delivery team in all organisations early
– Revisit how we bring the patients view into the design earlier
– Working with external clients has enabled us to upskill internal staff
– Learning throughout the process on new technologies
– Agile approach has allowed for flexibility and delivery without the blockers of a multiple approval process and made decisions process quicker
– Engagement with clinical team has been key and a dedicated lead in the team has been a vital factor in the uptake and success.