Project Initiation Document

Transcription

1 NORTH OF SCOTLAND PLANNING GROUP Project Initiation Document Integrated bronchoscopy (endoscopy) documentation system using Endobase for Respiratory and Gastroenterology NoS networks Author: Dr RJ Brooker and Dr S Loganathan Date: 18 th November 2014 Version: 1.0 version NoSPG_Project_Initiation_Document_Integrated_Endoscopy docx

2 Contents 1. Document Control Background Key Aims and Objectives [Data audit, benchmark, how this will sit within service in Scotland) Project Scope (and any exclusions) Expected Outcomes Roles and responsibilities Outline Project Plan Project Budget Key Stakeholders and Types of Communication Risk Register Equality & Diversity Impact Assessment Guidelines for Completion of Project Initiation DocumentError! Bookmark not defined. 13. Glossary... Error! Bookmark not defined. version NoSPG_Project_Initiation_Document_Integrated_Endoscopy docx

3 Please refer to Section 13 Guidelines for Completion of the Project Initiation Document and Glossary, Section Document Control Key Personnel Title: Integrated bronchoscopy (endoscopy) documentation system using Endobase for Respiratory and Gastroenterology NoS networks Author: Dr R J Brooker and Dr S Loganathan (NHS Grampian) Approver: Owner: Version History Version Date Summary of changes Initials Changes v1.0 Filename and Path Distribution Name Division Title Board Page 3 of 11

4 2. Background [including a brief and clear description of purpose and history of project current services/ assets, related constraints, current inequalities and drivers for change, baseline evidence, define delivery. Contextual text a rational of why this needs to be done. National exception/drive]. Since its inception the Paediatric Respiratory Medicine MCN has performed flexible bronchoscopy at RACH for all patients from the five North of Scotland Health Boards using Olympus hybrid fibre-bronchoscopes. Images are captured directly onto CD- ROM discs for subsequent review and archiving. Data about the procedure including operator performance, outcomes and complications are manually entered into a Microsoft Access database. This system is at risk due to loss of images from disc or file corruption, personal data security, and inadequate data capture of all procedures. Review of images is possible in RACH but not at other paediatric units in the North of Scotland. The NHS Scotland ehealth strategy aims to develop a full electronic patient record which will necessitate the ability to record clinical images related to procedures. In addition discussions have taken place with gastro colleagues who do not currently have a fit for purpose integrated documentation system for patients requiring endoscopy across the North of Scotland. All gastro patients from Grampian, Highland, Orkney, Shetland and 30% of Tayside patients (due to lack of capacity and requirement to carry out emergencies for Ninewells patients) require endoscopy to be undertaken in RACH theatres. The system would be used across both specialties encompassing all paediatric North of Scotland bronchoscopies and the majority of endoscopies. NHS Grampian has already purchased the Endobase integrated documentation system, as part of the new integrated theatre at Aberdeen Royal Infirmary, and this bid will provide the additional hardware and software to enable its use in the paediatric environment. 3. Key Aims and Objectives [Data audit, benchmark, how this will sit within service in Scotland). The key aim of the project is to: Improve documentation as part of the electronic patient record to facilitate patient management, improved patient care and cross-specialty working. Objectives: To record reports/images/complication/technical aspects of paediatric endoscopic procedures in keeping with NHS Scotland ehealth strategy Review difficult cases/unexpected findings with other specialists/health care professionals To improve and simplify the booking process of patients for endoscopic procedures To allow benchmarking of procedures/complications to other Scottish paediatric centres and Europe Audit of procedures/complications/operator performance and outcome Page 4 of 11

5 To develop database of endoscopic findings for research to improve knowledge To facilitate access to images for educating specialist trainees and allied health professionals in endoscopic appearances To take a lead role in the usage/development of integrated endoscopic electronic records for other Scottish University Children s Hospitals 4. Project Scope (and any exclusions) Patients from the 5 NoS Health Boards (NHS Grampian, Tayside, Highland, Orkney and Shetland) are seen and treated in RACH as part of the North of Scotland Paediatric Specialist Respiratory Network (NoSPRN) and Gastroenterology, Hepatology & Nutrition Network (NoSPGHANN). Installation of the integrated Endobase electronic documentation system will assist in improved data capture and management of patient information for respiratory and gastro patients. In addition, this will serve as a valuable training and education resource for multi-disciplinary teams across multiple sites. (Olympus Medical already manufactures the RACH Theatres endoscopy hardware, which gives confidence in compatibility with this Endobase documentation system software and long-term support). 5. Expected Outcomes (as per logic model diagram/implementation plan, Level 1 Appendix 1, list outcomes) Patients will benefit from improved access of their flexible bronchoscopy and endoscopy images within paediatric respiratory medicine and gastroenterology in the North of Scotland and quaternary units, and cross-specialty working e.g. ENT, to review difficult cases and unexpected findings. Patients will have confidence in a service that is being regularly audited with the outcomes benchmarked to other units using Endobase across UK and Europe. Paediatric respiratory and gastroenterology physicians will benefit from an integrated database with robust and secure storage of clinical images as part of the electronic patient record NHS Boards will benefit from secure data storage, bench-marking of the services to other units, and identification of technical problems in support of the ehealth strategy. Easy access to images will improve teaching and education to trainees in general paediatrics, respiratory paediatrics, gastroenterology, paediatric surgery and ENT. 6. Roles and responsibilities (see Glossary for a description of terms dependant on Projects) Project Sponsor - NoSPG Project Lead n/a Project Manager n/a Page 5 of 11

6 Clinical Leads Dr RJ Brooker and Dr S Loganathan Steering Group Cameron Matthew, Unit Operational Manager, NHS Grampian Carolyn Duncan, Network Manager, NoSPG Dr R J Brooker, Consultant Respiratory Paediatrician, NHS Grampian Dr S Loganathan, Consultant Paediatric Gastroenterologist, NHS Grampian Duncan Munro, Network Services Manager, ehealth, NHS Grampian Work Team Dr R J Brooker, Consultant Respiratory Paediatrician, NHS Grampian Dr S Loganathan, Consultant Paediatric Gastroenterologist, NHS Grampian Duncan Munro, Network Services Manager, ehealth, NHS Grampian Nick Schneeberger, Olympus Medical 7. Outline Project Plan Endobase has already been purchased and is in use in Aberdeen Royal Infirmary, NHS Grampian. There has been agreement in NHS Grampian to use the existing server space for the storage of paediatric images and data (Duncan Munro confirms this). Network cabling and endoscopy equipment in RACH theatres meets minimum system requirements. Computers in RACH theatres, clinicians offices, and the system manager probably meet minimum system requirements but need checking. NHS Grampian currently has a programme of upgrading computers across the Foresterhill campus. Following purchase of the additional hardware and software it is anticipated that installation and training for the users, will take less than 2 weeks. 8. Project Budget Software, installation and training cost is as per quote attached of 23, Key Stakeholders and Types of Communication Key Stakeholders Role/ Title Type Of Communication Clinical Leads Consultants Verbal and written documentation with local clinical staff and UOM Service Manager Unit Operational Manager RACH Same as above but with clinical staff and liaison with theatre staff with regards installation/training Supplier Nick Schneeberger, Olympus medical Supply of software, installation and training NHSG ehealth Network Services Manager Duncan Munro Network server Page 6 of 11

7 10. Risk Register To be completed following agreement to proceed. Exit Strategy The current system of image data capture, archiving and dissemination across the respiratory network (NoSPRN) is limited due to the fact images are currently saved directly to CD-ROM discs. This poses a risk to provision of the best patient care due to potential loss of images from discs or by file corruption. Patient data security could be compromised and improved patient outcomes for North of Scotland patients may be hampered. Lack of a fit for purpose data system for bronchoscopy and endoscopy for respiratory and gastroenterology networks is currently not ideal when trying to deliver the best possible care for patients. Currently there is no electronic system for gastro patients due to lack of Health Board funding to purchase an electronic system. Patient electronic data files will be required to fit in with the NHS Scotland e-health Strategy of developing and providing a full electronic patient record in future. If purchase of the Endobase software does not proceed, the current system of saving images onto CD-ROM will unfortunately have to continue and there will continue to be no suitable system for gastroenterology endoscopies. This bid is an add-on to the Endobase system that has already been purchased by NHS Grampian for ARI. Tendering for the system will therefore not be required. Purchase of a suitable system has been requested previously within child health NHS Grampian but due to lack of funding this has not been possible. After initial purchase and installation of the add-on Endobase software, if there are any unanticipated ongoing costs (including maintenance contracts), these will be taken on by NHS Grampian. 11. Equality & Diversity Impact Assessment To be completed following agreement to proceed Patients will benefit from improved access of their flexible bronchoscopy and endoscopy images within paediatric respiratory medicine and gastroenterology in the North of Scotland and quaternary units, and crossspecialty working e.g. ENT, to review difficult cases and unexpected findings. Patients will have confidence in a service that is being regularly audited with the outcomes benchmarked to other units using Endobase across UK and Europe. The Endobase system is currently in operation in Aberdeen Royal Infirmary and will ensure smooth transition of bronchoscopy data for complex respiratory paediatric patients when transitioning to adult services. Page 7 of 11

8 Page 8 of 11

9 Page 9 of 11

10 Moving from Logic Model to Monitoring to Evaluation Appendix 1 Is a Regional Approach Appropriate to Delivering your Clinical Service? (Based on Regional Planning Criteria) Yes No Moving from Identifying Needs and the Evidence-Base to Identifying Outcomes and Impacts LEVEL 1 - LOGIC MODEL Please note population of the level 1 of the model could start at any point of the process shown below (ie need not be sequential) Needs Assessment Evidence-base Resources/ Inputs Activities Outputs Outcomes/Impacts What are the needs of your patients? What is the evidence-base for your service? What resources are required to undertake activities in your service? What activities need to be undertaken to deliver your service? What services need to be delivered to achieve the stated benefits/outcomes for your patients? What benefits and changes should your patients, organisations and communities experience? LEVEL 2 IDENTIFY NEEDS, INPUTS, ACTIVITIES, OUTPUTS AND OUTCOMES Clinical Needs Clinical Resources/Inputs Clinical Activities Clinical Outputs Clinical Outcomes /Impacts Non-Clinical Needs Non-Clinical Resources /Inputs Non-Clinical Activities Non-Clinical Outputs Non-Clinical Outcomes /Impacts LEVEL 3 - MONITORING TO EVALUATION Identifying Key Aims, Objectives and Outcomes Monitoring Inputs, Activities and Outputs Monitoring Outcomes Evaluating Service Evaluating Impacts In considering needs, what are the What systems require to be put What systems require to What do the data on inputs, What has your service key aims, objectives and outcomes in place to collect input, be put in place to collect outputs, outcomes tell you achieved and Page what 10 of can 11 G:\NOSPG\Dundee\Child to monitor and Health\National\National evaluate within Delivery activities Plan\ and slippage output process\pids data across November outcome 2014\Final version data across NoSPG_Project_Initiation_Document_Integrated_Endoscopy your about the success/challenges docx be improved? your service? your service? service? of delivering your service?

11 ID Task Name Duration Start Finish Predecessors Resource Name 1st quarter nd quarter rd quarter2012 4th quarter nd quarter 3rd quarter 4th quarter Jan Feb March April May June July Aug Sept Oct Nov Dec Jan Feb Mar April May June July Aug Sept Oct Nov Dec Workforce Develop a regional workforce strategy to ensure the Network clinical Status Assessment sustained safe delivery of neonatal care in the North facilitator Completed of Scotland through modernised ways of working, On Track to complete by agreed date creative models of service delivery and regional Will be achieved but likely to be delayed collaborative working. 5 yr plan Jan-12 Dec-17 1,2,3,4 All staff Will not be met or is unlikely to be met 1 Meet clinical leads and managers to discuss identified 3 months Jan-12 Mar-12 network leads gaps for individual Boards. 2 Hold a workforce planning workshop with all stakeholders5 months Apr-12 Sep-12 1 stakeholders to identify solutions. 3 Establish workforce project board to take forward 5months Oct-12 Mar-13 1,2 Wf board solutions from workshop. 4 Manage operational and cultural change collaborativley. Apr-13 Dec-17 1,2,3 managers and staff Start five year workforce plan Appendix2 Education Develop regional standardised education programmes E&T subgroup inclusive of all neonatal staff across the network.to ensure patient safety and equity of quality. Take forward the work of the education and training subgroup of the neonatal steering group 24months Jan-12 Dec-13 1,2,3,4,5,6,7 staff and E&T group 1 Scope current education provision. 3months Jan-12 Mar-12 2 Carry out a training needs analysis across the region. 5 months Jan-12 May-12 3 Develop a regional programme. 4months Jul-12 Oct-12 1,2 4 Develop an implementation plan and audit framework. 4months Jul-12 Oct-12 1,2,3 5 Deliver programme. 12 months Oct-12 Oct-13 6 Audit programme. 3months Oct-13 Dec-13 7 Review training across region. Jan-14 Review 2014 Care Pathways Develop clear care pathways for Neonatal care in Network clinical the north of Scotland. lead On-going work Take forward work of service development subgroup of Neonatal steering group on-going Jan-12 on-going 1 Develop first 4 pathways ensuring clear communication 6months Jan-12 Jun-12 Service development structure and guidance is available. subgroup 2 Develop regional clinical forum. 3months Apr-12 Jun-12 3 Review first draft of pathways against Quality framework. 6months Apr-12 Oct-12 1,2 4 Neonatal steering group to sign off pathways for 3months Oct-12 Dec-12 1,2,3 implementation. 5 Standardise policies, procedures and clinical guidelines on-going Jan-12 Dec-12 on-going review where appropriate. on-going work Transport Develop collaborative working agreements, pathways and guidelines with the Scottish Neonatal transport service, the Scottish Ambulance Service and the Neonatal Network. 1 Hold discussions with the Service development 8months Jan-12 Sep-12 subgroup of the Neonatal steering group and SNTS and SAS to develop pathways and identify roles and responsibility during the transfer process. 2 Review pathways at regional clinical forum. 3months Sep-12 Nov-12 1,2 3 Sign off agreements and pathways at neonatal steering 1month Dec-12 Dec-12 group. 4 Implement across region through clear communication. 3months Jan-13 Mar-13 1,2,3 network clinical lead SNTS& SAS Page 11 of 11