by
Simon Shearston
Chief Technology Officer of Careful Systems
I have an anecdotal story to tell, but I have seen it before in my time in healthcare and health technology.
Some years ago, I was notified of the need for a routine operation. I got no other confirmation of it until I received a phone call from the hospital wondering where I was. As the NHS appears to rely on letters rather than email or other digital messaging, the notice must have been mislaid. I hadn’t even had the basic pre-op checks for MRSA , etc.
“Can you come in this afternoon?””I could, but I am taking blood thinners, so I don’t think it is advisable.”“Oh, that’s unfortunate.”
After a few more failed diary attempts, I eventually turn up early in the morning, expecting general anaesthesia and an overnight stay.
“No, we prefer to do it under local. Now, which side are we operating on today?”
Fortunately, I knew which side and told the surgeon (it was only going to be on one side) but it could have been pretty confusing and worrying to someone else, less aware of clinical procedures.
After a successful operation and a fitful night, I am ready to be discharged. I inform my partner to come and pick me up at around 9:00am.
Unfortunately, they couldn’t find a consultant to check me over before discharge and eventually sent a registrar. Then they couldn’t find a nurse to remove my cannula (in retrospect, I should have just done it myself and checked out).
By the time I left the hospital, it was gone 2:00pm and the bed had been taken up for most of the day.
Some things stood out for me:
1. They were not in any meaningful communication with me. Outdated letters still arrived after my visit.
2. I was told it was under general anaesthesia but it wasn’t. I was not really prepared for three hours under local after being nil-by-mouth from the evening before.
3. They did not know I was on blood thinners. I am very glad that I pointed this out.
4. They did not know which side they were operating on. Apparently, they did not have my notes.
5. We wasted a room and a bed for several hours. If just one hour was lost like this (for every bed in that hospital each day) it would total 28 weeks of a single nurse’s time.
6. My GP did not have my notes for several weeks after the operation, so I had to tell her what happened.
Here is what I would much prefer to see:
1. Timely, clear digital communications — to my phone or computer – I don’t care.
2. A digital place for me to read all I need to know about the procedure and ask questions of the team involved in good time.
3. A clear, shared record of my notes, medication and specific instructions leading up to a procedure.
4. I would rather consent to the procedure well beforehand, so I better understand the logistics and plan around it.
5. Much closer cooperation between myself, my GP and the hospital.
6. Staff should be able to share notes and actions easily with reminders and some basic workflow. There is no reason why a patient and their relatives cannot be involved in this, to a degree.
7. Data that can be captured and shared easily will speed up patient flow, saving time and money.
80% of UK households have a smart phone. 99% have used the internet in some form. This is not being properly embraced.
Our CEO believes that basic errors in a fast-moving clinical environment can present patient safety issues. If staff are left to remember things for handover, scribbling on a piece of paper or a whiteboard, then these errors can and do happen.
I agree with him and that is why I work for Careful.
Simon started his working life as a hospital porter in Reading. He qualified in radiography at The Middlesex Hospital, London before moving into technology at Kingston Polytechnic. He was a senior systems engineer at St. Thomas’ Hospital, London and eventually held senior consulting positions at Apple and Microsoft.
