Homerton University Hospital in East London is set to roll out an electronic check-in service in its Emergency Department that combines eTriage by eConsult Health with Cerner’s Millennium electronic patient record (EPR) system.
The implementation will strengthen the hospital’s ability to meet its government-set target of assessing walk-in patients within 15 minutes. By accelerating the process of prioritising and triaging patients in urgent care (UC) centres and emergency departments (EDs), the solution will also significantly reduce waiting times and enhance patient safety.
eTriage – an electronic check-in service that uses algorithm-based questions about symptoms and medical history – quickly identifies the sickest patients and categorises walk-ins into five different priority categories (P1 – P5). The end-to-end system integrates eTriage with the hospital’s workflow and Cerner’s clinical software and will process 350 walk-in patients per day, with a projected average completion time of 5.4 minutes (based on data from over 250,000 patient journeys in A&E departments using eTriage).
Speeding up time-to-assessment has a range of benefits for the hospital, its clinical and administrative staff and its patients which are listed below.
- Improving patient safety: eTriage ensures that patients requiring urgent medical attention are immediately identified and flagged within the hospital’s EPR system. This is particularly important for patients presenting at A&E with symptoms of a heart attack or sepsis for whom the ‘golden hour’ can be the difference between life and death.
- Freeing up clinical time: Face-to-face triage is a time-consuming process that requires an assessment nurse to take a history, obtain a set of vitals, and potentially conduct a urine dip or ECG. By accelerating this process, eTriage enables nurses to focus on communicating with people in the waiting room, as well as diagnosing and treating patients inside the hospital.
- Quick Covid-19 screening: All self-assessments start with a series of questions designed to identify potential Covid-19 cases. Patients presenting with symptoms consistent with the virus are flagged and directed to a ‘red zone’ inside the hospital before entering the main waiting room, protecting staff and patients.
Jean Lyon, Senior Nurse in the hospital’s Emergency Department said: “Homerton has a long history of successfully driving innovation to improve patient experience, and we have been working closely with eConsult and Cerner for the last six months to create this first-of-its-kind solution. We believe this new approach to assessing walk-in patients will have a really positive effect on our ability to treat patients and further improve their experience inside A&E. It will also futureproof the hospital for the next wave of government targets focused on time to assessment, time to recognition of deteriorating patients and total time in the emergency department. ”
The eTriage system will be the main pathway for UC/ED patients to check in on arrival at the hospital, with care navigators on hand to assist patients with using the platform. In advance of their triage, the system collects ECDS data from the patient. During triage, all questions are written in plain English and require a reading age of seven years old. The user interface is powered by touch and uses visual cues such as body maps and simple graphics to make it as easy and intuitive as possible for patients to describe their symptoms.
A recent study conducted by eConsult revealed that nearly two thirds (64 per cent) of UK patients who visited A&E in the last 12 months would feel confident or somewhat confident using an electronic self-check-in system to speed up the triage process, with just 12 per cent against the idea. However, for individuals who are uncomfortable with – or unable to use – the eTriage tool, an in-person check-in with a member of the reception team will still be available as an alternative.
Mark Harmon, Practising A&E Doctor and Chief Strategy Officer at eConsult comments: “There is currently unprecedented pressure on A&E departments who have been hit with a wave of post-lockdown walk-ins and have faced one of the busiest and toughest winters on record. Against this backdrop, we are proud to partner with the team at Homerton and our friends at Cerner to deliver a solution that will help support clinicians, hospital staff and patients through this challenging period and beyond.”
In addition to accelerating time-to-assessment, Homerton anticipates that allowing patients to input their own demographic information will improve data integrity and accuracy and reduce transcription errors by third parties. Once the patient has submitted their self-assessment through the eTriage system, the information is seamlessly integrated into the Cerner Millennium ERP system and is flagged and colour-coded in order of clinical acuity.
In addition to this latest deployment at the Homerton in collaboration with Cerner, eTriage is currently available in nine Emergency Departments & Urgent Treatment Centres including the Emergency Departments in St Richard’s Hospital in Chichester and Worthing Hospital in Worthing, and Queen Mary’s Hospital, Sidcup Urgent Treatment Centre, and Whitstable Medical Centre.
eConsult Health Limited provides the UK’s leading digital triage system in the NHS covering both primary and secondary care including:
- eConsult – An award-winning online consultation platform for primary care
- eTriage – A platform for NHS Emergency Departments and Urgent Treatment Centres designed to automatically check-in and prioritise patients upon arrival
- eSpecialist – A newly developed solution for outpatient care to ensure clinicians have the right information to be able to diagnose, manage and treat patients at the earliest point
All of eConsult Health’s platforms are developed by NHS clinicians and overseen by the company’s unique Clinical Governance Board to enable safe and effective triage and ensure patients receive the right healthcare at the right time by the right clinician.
Homerton Healthcare NHS Foundation Trust provides general health services at hospitals and in the community with staff working out of 75 different sites in the City of London and the London Borough of Hackney. Our primary site, Homerton University Hospital, has almost 440 beds spread across 11 wards, a 10-bed intensive care unit and maternity, paediatric and neonatal wards. In addition, the Trust manages services at St Leonard’s Hospital, Shoreditch and Mary Seacole Nursing Home.
The hospital has been rated as Outstanding by the Care Quality Commission. Its Emergency Department is also rated Outstanding and has consistently been one of the best performing EDs in the country for several years.
We have earned a reputation for the quality of training offered and are recognised as one of the top recruiters to high-quality research studies in the UK with particular interest in neonatal, sexual health and respiratory medicine. We are also recognised as innovators in embracing methods and systems that promise better and safer patient care.
We now employ over 4,500 staff, some born at the hospital and many living nearby. A number have followed their parents into work here or are working alongside siblings. All share a common belief that they belong to something of great value. A large proportion of our staff are members of the BAME communities. We also have a sizeable number of staff from the EU.
As seen in…
- Digital Health: Homerton Hospital signs eTriage deal to tackle wait times in A&E
- Building Better Healthcare: Homerton A&E signs eTriage deal to reduce waiting times
- Hackney Gazette: Homerton Hospital signs e-Triage deal for new digital check-in system