We caught up with Dr Thomas Kus, a Paediatrician working within the Gloucestershire Hospitals NHS Foundation Trust, to discuss how the Cinapsis SmartReferrals App has transformed his region’s Paediatrics service.
What were the problems you were facing prior to using Cinapsis?
I'd say the main issue was that the lines of communication between primary and secondary care professionals in the region were inefficient, intrusive and ineffective.
For example, when a Gloucestershire GP needed to contact a consultant in the hospital, they formerly had to call the switchboard, who could bleep the paediatrician on-call (regardless of whether they were in the middle of a consultation or other important matter). When going to the ward phone to ring the switchboard back, the consultant would spend time taking down basic patient and caller details on a paper referral form, and then take that to the Assessment Unit.
This was a frustrating system which resulted in time wastage and delays for clinicians and patients.
In addition, if two calls came through the switchboard at the same time, the second call was held. More often than not, this second call would be dropped, and the GP on the other end would eventually refer the patient to A&E (often unnecessarily) as a precaution.
Not only was the workflow problematic, but the use of paper referral forms meant that if any details were left off, they couldn’t be included in the patient’s record, resulting in lost clinical information. The eventual outcome of the paper referral form was never recorded in the patient’s record, meaning that gaps in knowledge followed the patient throughout the course of their treatment.
How did you begin working with Cinapsis?
The Trust initially launched a partnership with Cinapsis in the Acute Medicine service, replacing the department’s pagers with the SmartReferrals App. After the success of the initiative (83% of referrals from primary care eliminated), I worked with the CCG and Cinapsis to develop bespoke referral pathways appropriate for the Acute Paediatrics team.
And what differences did you notice after the launch of SmartReferrals in Acute Paediatrics?
Right away, the whole referrals process seemed to start working much more efficiently. GPs could now use the app to send a message or make a call directly to a consultant, who could easily respond on their own mobile phone as soon as they were able to.
Personally, I feel that I can now spend more time talking about the problem at hand, instead of taking patient and caller details from the switchboard.
The phone app is non-intrusive, and my team has the option to pause their rota with one tap when on-call. The service operates a call cascading system, so if two calls come through at once, the second call will be passed to the next person on the rota. This means that no enquiry is left unanswered.
Additionally, the image and document sharing feature really helped to improve the accuracy of the advice given, as the doctor had access to the complete case information when making a decision.
Consultants and GPs alike are very happy about the automatic patient note upload feature, which ensures that all communication, decisions and outcomes are digitally added to the patient notes.
What about auditing and safeguarding?
Previously, internal auditing was difficult because the lack of digitised data made it impossible to analyse service delivery.
However, because Cinapsis automatically links to the patient’s electronic record, the Trust now has an overview of all referral data. This is being used to improve service delivery and drive a focus on referral prevention.
Similarly, safeguarding concerns used to be difficult to address - for example if the account that a child’s family had given to the GP differed later down the line. But now, because all the conversations between the GPs and consultants are recorded and linked to the patient’s record, Cinapsis can be used to check recordings, times and other details to allow for efficient safeguarding.
What has been your overall impression of working with Cinapsis?
It's been a problem-free experience. The Cinapsis team’s responsiveness to clinician feedback is second to none, with suggested developments or improvements sometimes implemented within days!
There is a real joy in having a system where developers listen to clinicians with an exceptional can-do attitude
Thanks for talking to us Dr Kus!
If you’d like to find out how the Cinapsis SmartReferrals App could transform the communication and referrals system in your healthcare institution, get in touch with a member of our team today.