East Cheshire NHS Trust VitalPAC Business Continuity Page 1
Document Title: Executive Summary: This plan provides clear instructions on Business Continuity when VitalPAC functions are unavailable Supersedes: This policy will impact on: All areas where patient observations are taken using VitalPAC Financial Implications: None identified Policy Area: Clinical Document Reference: ECT002699 Version Number: 0.5 Effective Date: June 2015 Issued By: Heather Cooper Review Date: March 2019 Author: APPROVAL RECORD Committees / Group Consultation: Approved by: The Learning Company Impact Assessment Date: Date VitalPAC Steering Group SQS VitalPAC Board SQS June 2015 March 2017 July 2015 March 2017 March 2017 Version History Version Date Author Changes 0.1 10 th June David First Draft 2014 Sellers 0.2 23 rd June David Review by Heather Cooper 2014 Sellers 0.3 28 th Nov Heather Review by Heather Cooper 2014 Cooper 0.4 27 th July David Annual Review by Board 2015 Sellers 0.5 March 2017 Heather Cooper Review by Heather Cooper Page 2
Contents 1. Aim and scope... 4 2. Fault Notification... 4 3. Actions for ward staff... 5 4. Resolving the problem... 6 5. BCP activation... 7 6. BCP de-activation... 7 7. Staff responsibilities during VitalPAC BCP... 7 a. Senior ward nurses (Ward Manager during working hours)... 7 b. IT Helpdesk... 8 8. Contact details... 8 Page 3
1. Aim and scope The aim of this Business Continuity Plan (BCP) is to minimise the risk to immediate patient care in the event of a failure of the VitalPAC system. It covers the following types of failure: servers (i.e. VitalPAC web server or the database server) data loss/corruption wireless network wired network (between wireless network and servers) application software (i.e. on ipads or Tablets ) Power supply. Please read the Operational Policy and Troubleshooting Guide in conjunction with this Plan The following types of failure are not in the scope of this BCP: individual ipads and Tablets feeds from other systems 2. Fault Notification The VitalPAC system is robust and allows for the continued collection of patient observations on ipads even if the wireless and wired networks and the servers are unavailable. If a user experiences problems accessing the system, they should first check whether it is a problem with an individual ipad rather than a system problem. The steps to follow are detailed in the VitalPAC Operational Policy and Troubleshooting guide which are recommended to be in hard copy format alongside the BCP available on wards. All documents will be available via a web portal however, these may or may not be accessible e.g. during a power outage. All VitalPAC system faults should be reported, in the first instance, to the Trust Helpdesk. It is recommended that TLC Helpdesk is contacted in addition, to inform of nature and footprint of issue (e.g. Software problem on 3 wards etc.) when BCP is invoked and also when business as usual occurs. The identified Ward Superusers / Ward Managers are able to troubleshoot user queries and minor system problems. The Learning Clinic will support the VitalPAC System and can be contacted, by the Trust Helpdesk, on the numbers shown in Appendix 2. Page 4
3. Actions for ward staff In the event of a major system failure and activation of the BCP, ward staff will need to start recording observations on paper charts. It is essential that they continue to also capture readings on the ipads ( dual recording ), so that, when the system is fixed, there will be a continuous electronic record of observations. The ipads automatically store the previous 5- days of observations which can be viewed at any time and referenced should a system failure occur and they also store observations indefinitely which have not been uploaded. The Mini ipads and Doctor ipads Airs are reliant upon the wifi network and servers to operate and do not store any data, therefore in the event of a system failure, they will not display charts or be available nor will it be possible to enter information. The table below details actions to be taken in the event of a system failure. TYPE OF SYSTEM FAILURE Confirmed failure of the local wireless network Confirmed failure of the servers or of the wired network (assuming the whole hospital wired network has failed) Suspected or confirmed data loss or corruption RECOMMENDED ACTION 1) Inform the Trust ICT Helpdesk on 0844 800 9982 or servicedesk@cmcsu.nhs.uk 2) Print off charts up to time of failure from the VitalPAC CLINICAL application set up on the ward PCs 3) Dual-record observations on ipads and paper TPR charts 1) Inform the Trust ICT Helpdesk on 0844 800 9982 or servicedesk@cmcsu.nhs.uk 2) Dual-record observations on ipads and paper charts 1) Inform the the Trust ICT Helpdesk on 0844 800 9982 or servicedesk@cmcsu.nhs.uk 2) Dual-record observations on ipads and paper charts IMPACT ON VITALPAC Nurse ipads continue to display observations taken up to the time of system failure. However, whilst the system is down, observations captured on each Nurse ipod are only displayed on that ipod The VitalPAC CLINICAL PC application remains accessible but only displays data captured up to the time of system failure Tablets with VitalPAC WARD will not display any information Doctor/Outreach ipads will not display any information Nurse ipads continue to display observations taken up to the time of system failure. However, whilst the system is down, observations captured on each Nurse ipod are only displayed on that ipod. The VitalPAC CLINICAL PC application cannot be accessed. Tablets with VitalPAC WARD will not display any information Doctor/Outreach ipads will not display any information Nurse ipads, PCs, tablets, etc. will continue to display observations and other patient and clinical information. However, whilst data loss/corruption is addressed, observations and other information in VitalPAC should be used carefully. ACTIONS WHEN THE SYSTEM IS FIXED Data captured on the ipads whilst the system was down is uploaded so that VitalPAC is up to date Data captured on the ipads whilst the system was down is uploaded so that VitalPAC is up to date Staff will be informed if any information is lost or corrupted and so not available in VitalPAC. Paper charts used for these patients must be filed in the Page 5
TYPE OF SYSTEM FAILURE Failure of the Nurse application software on ipads Power failure RECOMMENDED ACTION 1) Inform Ward Manager, in the first instance. If only one ipod is faulty, use a functioning one. If the problem relates to all ipads, contact the ICT Helpdesk who will then log the fault with The Learning Clinic if they are unable to rectify problem. 2) Print off charts from the VitalPAC WARD or CLINICAL PC applications. 3) Record observations on paper charts 4) Paper charts used during system downtime must be kept in the patient notes. 1) Turn off 50% of ipads and use remaining 50% to record obs; swap to turned off ipads when power drops below 30% 2) Dual-record observations on ipads and paper charts IMPACT ON VITALPAC The Nurse ipads stop working. The VitalPAC CLINICAL PC application should be accessible, depending upon the nature of the problem, and can be used to view information up to the ipads ceasing to work Tablets with VitalPAC WARD should be accessible, depending upon the nature of the problem, and can be used to view information up to the ipads ceasing to work ipads with VitalPAC DOCTOR should be accessible, depending upon the nature of the problem, and can be used to view information up to the ipads ceasing to work ipads (VitalPAC NURSE and VitalPAC DOCTOR) continue to display observations taken up to the time of system failure. However, whilst the system is down, observations captured on each Nurse ipod are only displayed on that ipod. ipads have approximately 10-hours of power from fully charged The VitalPAC CLINICAL PC application cannot be accessed Tablets with VitalPAC WARD will display information until the battery is discharged?? Doctor/Outreach ipads will display information until battery is discharged ACTIONS WHEN THE SYSTEM IS FIXED Data captured on paper charts whilst the system is down will not be stored on the VitalPAC system. Paper charts used during that period must be filed in the patient notes Data captured on the ipads whilst the system was down is uploaded so that VitalPAC is up to date. *NOTE: Observations captured on ipads during an outage will be stored until uploaded. 4. Resolving the problem The Trust ICT Helpdesk will rectify any problems in co-ordination with The Learning Clinic helpdesk as needed. If the problem is likely to continue for an extended period of time, the VitalPAC operational project team will meet and liaise closely with the ICT Helpdesk and Ward Managers to ensure the system is fixed as quickly as possible and that staff are briefed on developments. The VitalPAC operational Project Team, will decide best course of action depending on impact in their specialist areas. The team includes representatives from: Ward Managers Outreach IT Therapy Dietician Page 6
5. BCP activation The BCP should be initiated by the Trust ICT Helpdesk / Ward Managers (during office hours) or on-call IT staff / Site Managers (outside of office hours). This decision should be based upon the nature of the fault and likely duration. Any BCP action must also be included in the on-call briefing information. 6. BCP de-activation Once any problem has been fixed, the Trust ICT Helpdesk / Ward Managers (during office hours) or on-call IT staff / Site Managers (outside of office hours) will check that all ipads and Tablets are connecting and that observations can be viewed electronically on PCs. Once this is confirmed, the BCP will be deactivated. A post incident report will be prepared within one working day by the IT Helpdesk for internal wifi / network problems and VitalPAC Account Manager for software related problems. 7. Staff responsibilities during VitalPAC BCP Staff activating or deactivating the BCP should contact the following and pass the message VitalPAC Business Continuity Plan activated or VitalPAC Business Continuity Plan deactivated as appropriate: During Business hours: VP project manager VP systems manager a) Outreach Team b) Super Users on the wards c) VitalPAC Project Team tbc d) On-call ward doctors as per rota or via Switchboard Out of Hours: a) Night Practitioners b) On-call ward doctors as per rota or via Switchboard a. Senior ward nurses (Ward Manager during working hours) Inform IT on-call and inform of problem and potential plan On confirming VitalPAC BCP activated, the senior nurses will: a) Inform their ward staff that VitalPAC is not available b) Ensure that ward staff continue to use the VitalPAC ipads to collect patients observations and transcribe onto paper charts dual recording On receipt of the message VitalPAC BCP deactivated the senior nurses will: a) Check that the VitalPAC PC application is now available and observations taking during the BCP period appear on the electronic charts b) Inform all ward staff that VitalPAC is available again and that they should: Page 7
continue to use the VitalPAC ipads to record patients observations Stop dual recording on paper charts c) File the paper charts in patients notes d) Work with the VitalPAC System Administrator to ensure that all corrective action has been undertaken b. IT Helpdesk On receipt of the message VitalPAC BCP activated, the System Administrator will: a) Double check that wards areas are aware that the VitalPAC system is not available b) Ensure that nurses in charge know that their staff should continue to use the VitalPAC ipads to collect patients observations and transcribe onto paper charts dual recording On receipt of the message VitalPAC BCP deactivated the System Administrator will: a) Check that the VitalPAC PC application is available and observations taking during the BCP period appear on the electronic charts b) Confirm that dual recording on paper charts can cease and that staff should continue to use the VitalPAC ipads to record patients observations c) Confirm with senior nurses that paper charts should be filed in patients notes 8. Contact details Trust ICT Helpdesk Telephone: 0844 800 9982 Email: servicedesk@cmcsu.nhs.uk The Learning Clinic Helpdesk Telephone: 0845 680 1315 Email: helpdesk@thelearningclinic.co.uk Oxygen Web Portal: https://helpdesk.thelearningclinic.co.uk/ Page 8
Equality Analysis (Impact assessment) Please START this assessment BEFORE writing your policy, procedure, proposal, strategy or service so that you can identify any adverse impacts and include action to mitigate these in your finished policy, procedure, proposal, strategy or service. Use it to help you develop fair and equal services. Eg. If there is an impact on Deaf people, then include in the policy how Deaf people will have equal access. 1. What is being assessed? VitalPAC operational Policy, VitalPAC Business Continuity Policy Details of person responsible for completing the assessment: David Sellers Project Manager VitalPAC Project State main purpose or aim of the policy, procedure, proposal, strategy or service: (usually the first paragraph of what you are writing. Also include details of legislation, guidance, regulations etc which have shaped or informed the document) Operational policy for the use of VitalPAC, covers documentation of patient observations, during inpatient stays Business Continuity policy for VitalPAC, document how observations will continue to operate if the VitalPAC system is unavailable. 2. Consideration of Data and Research To carry out the equality analysis you will need to consider information about the people who use the service and the staff that provide it. Think about the information below how does this apply to your policy, procedure, proposal, strategy or service 2.1 Give details of RELEVANT information available that gives you an understanding of who will be affected by this document Cheshire East (CE) covers Eastern Cheshire CCG and South Cheshire CCG. Cheshire West & Chester (CWAC) covers Vale Royal CCG and Cheshire West CCG. In 2011, 370,100 people resided in CE and 329,608 people resided in CWAC. Age: East Cheshire and South Cheshire CCG s serve a predominantly older population than the national average, with 19.3% aged over 65 (71,400 people) and 2.6% aged over 85 (9,700 people). Page 9
Vale Royal CCGs registered population in general has a younger age profile compared to the CWAC average, with 14% aged over 65 (14,561 people) and 2% aged over 85 (2,111 people). Since the 2001 census the number of over 65s has increased by 26% compared with 20% nationally. The number of over 85s has increased by 35% compared with 24% nationally. Race: In 2011, 93.6% of CE residents, and 94.7% of CWAC residents were White British 5.1% of CE residents, and 4.9% of CWAC residents were born outside the UK Poland and India being the most common 3% of CE households have members for whom English is not the main language (11,103 people) and 1.2% of CWAC households have no people for whom English is their main language. Gypsies & travellers estimated 18,600 in England in 2011. Gender: In 2011, c. 49% of the population in both CE and CWAC were male and 51% female. For CE, the assumption from national figures is that 20 per 100,000 are likely to be transgender and for CWAC 1,500 transgender people will be living in the CWAC area. Disability: In 2011, 7.9% of the population in CE and 8.7% in CWAC had a long term health problem or disability In CE, there are c.4500 people aged 65+ with dementia, and c.1430 aged 65+ with dementia in CWAC. 1 in 20 people over 65 has a form of dementia Over 10 million (c. 1 in 6) people in the UK have a degree of hearing impairment or deafness. C. 2 million people in the UK have visual impairment, of these around 365,000 are registered as blind or partially sighted. In CE, it is estimated that around 7000 people have learning disabilities and 6500 people in CWAC. Mental health 1 in 4 will have mental health problems at some time in their lives. Sexual Orientation: CE - In 2011, the lesbian, gay, bisexual and transgender (LGBT) population in CE was estimated at18,700, based on assumptions that 5-7% of the population are likely to be lesbian, gay or bisexual and 20 per 100,000 are likely to be transgender (The Lesbian & Gay Foundation). CWAC - In 2011, the LGBT population in CWAC is unknown, but in 2010 there were c. 20,000 LGB people in the area and as many as 1,500 transgender people residing in CWAC. Religion/Belief: The proportion of CE people classing themselves as Christian has fallen from 80.3% in 2001 to 68.9% In 2011 and in CWAC a similar picture from 80.7% to 70.1%, the proportion saying they had no religion doubled in both areas from around 11%-22%. Christian: 68.9% of Cheshire East and 70.1% of Cheshire West & Chester Sikh: 0.07% of Cheshire East and 0.1% of Cheshire West & Chester Buddhist: 0.24% of Cheshire East and 0.2% of Cheshire West & Chester Hindu: 0.36% of Cheshire East and 0.2% of Cheshire West & Chester Jewish: 0.16% of Cheshire East and 0.1% of Cheshire West & Chester Muslim: 0.66% of Cheshire East and 0.5% of Cheshire West & Chester Page 10
Other: 0.29% of Cheshire East and 0.3% of Cheshire West & Chester None: 22.69%of Cheshire East and 22.0% of Cheshire West & Chester Not stated: 6.66% of Cheshire East and 6.5% of Cheshire West & Chester Carers: In 2011, nearly 11% (40,000) of the population in CE are unpaid carers and just over 11% (37,000) of the population in CWAC. 2.2 Evidence of complaints on grounds of discrimination: (Are there any complaints or concerns raised either from patients or staff (grievance) relating to the policy, procedure, proposal, strategy or service or its effects on different groups?) None 2.3 Does the information gathered from 2.1 2.3 indicate any negative impact as a result of this document? No 3. Assessment of Impact Now that you have looked at the purpose, etc. of the policy, procedure, proposal, strategy or service (part 1) and looked at the data and research you have (part 2), this section asks you to assess the impact of the policy, procedure, proposal, strategy or service on each of the strands listed below. RACE: affect, or have the potential to affect, racial groups differently? Yes No No impact on Race, staff will follow the trust interpretation policy if required as they did previously when recording observations in paper format. GENDER (INCLUDING TRANSGENDER): affect, or have the potential to affect, different gender groups differently? Yes No No Impact on Gender DISABILITY affect, or have the potential to affect, disabled people differently? Yes No Page 11
No impact on disability staff will follow the trust interpretation policy if required as they did previously when recording observations in paper format. AGE:, affect, or have the potential to affect, age groups differently? Yes No No impact on Age LESBIAN, GAY, BISEXUAL: affect, or have the potential to affect, lesbian, gay or bisexual groups differently? Yes No No impact on lesbian, gay or bisexual groups RELIGION/BELIEF: affect, or have the potential to affect, religious belief groups differently? Yes No No Impact on Religion CARERS: affect, or have the potential to affect, carers differently? Yes No No impact on carers OTHER: EG Pregnant women, people in civil partnerships, human rights issues. affect, or have the potential to affect any other groups differently? Yes No No impact on other groups Page 12
4. Safeguarding Assessment - CHILDREN a. Is there a direct or indirect impact upon children? Yes No b. If yes please describe the nature and level of the impact (consideration to be given to all children; children in a specific group or area, or individual children. As well as consideration of impact now or in the future; competing / conflicting impact between different groups of children and young people: c. If no please describe why there is considered to be no impact / significant impact on children VitalPAC is not operational in Paediatric wards 5. Relevant consultation Having identified key groups, how have you consulted with them to find out their views and that the made sure that the policy, procedure, proposal, strategy or service will affect them in the way that you intend? Have you spoken to staff groups, charities, national organisations etc? Not needed. 6. Date completed: Review Date: 7. Any actions identified: Have you identified any work which you will need to do in the future to ensure that the document has no adverse impact? Action Lead Date to be Achieved 8. Approval At this point, you should forward the template to the Trust Equality and Diversity Lead lynbailey@nhs.net Approved by Trust Equality and Diversity Lead: 8.3.17 Page 13