The project undertaken by Jayex was to deploy patient check-in and calling solutions into Imperial Hospital Healthcare Trust. Imperial have Outpatient activity figures of over 1.5 million patients per year who attend multi-disciplinary clinics across 6 sites.
The Trust had specific drivers which included improving data quality to specifically reduce postal costs as well as streamlining Outpatients' services.
Jayex commenced this significant project by deploying patient check in kiosks and patient calling screens in the MOPD at Charing Cross Hospital. The solution offers a wide range of configurability from which the Trust chose to deploy patient check in with a selection of both mandatory and non-mandatory demographic updates. Patients had the opportunity to review and update their demographic information at the kiosk which would then intuitively direct the patient to the correct waiting area.
Jayex project teams worked with the Trust to configure all workflows to the system making it easy for both clinical and reception staff to view and manage patient flow. Clinical staff are currently using the system to manage the flow of patients through to calling them for consultation via patient calling screens.
Within a 2 month time frame, the Trust has witnessed an unprecedented adoption rate (in excess of 70% for both check-in and calling consistently and up to 95% quite frequently) which has far exceeded the critical success factors set by the Trust. This is in part a result of Jayex having sufficient resource to be site based during go-live periods to help consolidate learning from training sessions and to steer users towards autonomy with the system.
Plans are now in place to embark on the next phase of the project, which will see patient flow solution extended to the Oncology/Clinic 8 department to demonstrate how the solution can robustly support multi-clinic check in.
The project was completed within 8 weeks and involved setting up a steering group, project plans, monitoring calls and escalation processes which helped all staff work towards an agreed go live date.
The main challenges of the project were to deliver to a very tight timeline in engagement with key stakeholders from the Trust whilst maintaining a robust project methodology. The Jayex project delivery and Trust teams worked collaboratively to achieve and exceed expectations.
Prior to full roll out we demonstrated Proof of Concept Success
Background to the project: Self-service check in involves the use of electronic kiosks to offer patients a fast track check in service as an alternative to attending a reception desk. Electronic check in supports the full process of patient check, which involves arriving a patient into the ICHIS PAS, reviewing and updating their demographic information, signposting and alerting clinical staff to patient arrival.
The Trust sought to implement self service check in to assist with the following Trust drivers:
- Improving the patient experience
- Releasing capacity at the front desk
- Improving data quality
- Achieving efficiency savings across the Trust
The timescales for the project would also involve deployment prior to the implementation of the new Cerner Millennium PAS at the Trust.
Proof of Concept
The Trust were presented with the opportunity to deploy a self-service system on a 'Proof of Concept' basis by Jayex Technology, who completed a full site survey of in scope departments and supported the deployment of 4 check in kiosks at the MOPD at Charing Cross Hospital. Jayex were invited to complete this project due to their unique offer to prove the business benefits of self-service prior to committing to a longer term investment and their relationship with the PAS supplier Cerner ensuring a robust, seamless and real time bi-directional fully integrated approach (Cerner selected Jayex as their preferred Self-Service partner).
As part of the Proof of Concept phase, the following solutions and functionality has been deployed:
- Patient check in
- Demographic review and update
- Advanced patient tracking
- Reporting Module
- Patient Calling
Critical success factors
The agreed critical success factors for the Proof of Concept included:
- Patient self-arrival rate more than 60% - this measured the proportion of patients who used the kiosks to register their arrival in the clinic.
- Patient demographic update rate of more than 30% - this measured what proportion of patients who used the kiosks also updated their demographics.
- Doctors calling 50% - 80% patients electronically via the screens/audio system
- Timely arrival feeds into the ICHIS PAS system
Data to monitor the achievement of these metrics was collated and circulated on a daily basis.
The PoC has exceeded expectations and stats below show performance against metrics
Patient self-arrival rate more than 60% - this target has been exceeded with an average adoption rate of 70-80% with some days seeing adoption at 95-100%.
Patient demographic update rate of more than 30% - this target has also been exceeded with an average demographic update rate of 70%.
Doctors calling 50% - 80% patients electronically via the screens/audio system - this target has also been exceeded with an average of 60-70% of patients being called using the calling screens.
Timely arrival feeds into the ICHIS PAS system – Throughout the Proof of Concept stage, the feedback into ICHIS has been in real time.
The Jayex solution has exceeded the targets set as critical success factors throughout the Proof of Concept phase.
Aspects of the project that are worthy of particular note are the obvious reduction in queues into the department and the clear impact this is having on both the patient experience and pressure on frontline staff. The overwhelming response from patients updating their demographic information at the kiosks will have a significant impact on improved patient data and therefore support reduced DNAs. Significantly, the increased number of email addresses and mobile numbers collected will support electronic communications with patients, which could inform processes for patient correspondence in the longer term.
The patient check in workflow involves the review of several patient demographic fields. Due to payment implications, patient and GP address are mandatory by default. Additional fields which were selected as mandatory by the Trust included ethnicity and home telephone number. The ease with which patients can use the system is evident by the increased amount of non-mandatory demographic information that patients are volunteering at the kiosks. Even with patients taking time to provide extensive information at the kiosks, average check in times are significantly low at an average of 55-60secs.
As the critical success factors for the Proof of Concept phase have now emphatically been exceeded, the Trust then approved roll out to other in scope departments.
Feedback from staff:
Patient Check in
'The system is so easy to use and has really helped to relieve the stress on the Reception Team. This is a very busy department and we usually have longs queues which can lead to a lot of stress for both patients and staff. The queues have reduced significantly already which has had a huge impact on both the staff and patient experience'. Dawn Ettienne, Administrative Supervisor
'Self-service is vital to improving the quality of the information we hold about patients. Queues are already down to a minimum in our busiest clinics and reception staff can now concentrate on helping patients who need more attention. Taking the pressure away from frontline staff is helping to enrich their job'. Howard Lewis – Self Service Project Manager
"Patient Calling works wonderfully. It's very clear, audible and visible. It saves time and it's easy to track a patient's whereabouts" Susan Bishun, Outpatient Care Assistant
"I find Patient Calling a very useful and efficient tool. The nurse team also see it as a positive step forward for the department and its user friendly. One of the main benefits is that the patients names are read out clearly and pronounced correctly" Sister Perlita Steele
"Patient calling is useful and easy to use. It has made part of my job my easier and I have had positive feedback from my patients. It saves time and I would definitely recommend it to colleagues in other departments" Lina Slusniene, Outpatients Sister