Bradford Teaching Hospitals
Baby View – Neonatal Intensive Care Video Conferencing Project
Bradford Teaching Hospitals NHS Foundation Trust is responsible for providing hospital services for the people of Bradford and communities across Yorkshire. We operate over several sites, including Bradford Royal Infirmary, which provides the majority of inpatient services, and St. Luke’s Hospital, which predominantly provides outpatient and rehabilitation services. Employing 5000 staff, covering a large and multi-cultural population we aim to be responsive to the needs of both patients and their families/carers. We look for new ways to improve patients experience; this joint collaboration between the Information Technology, Neonatal services & the Chief Nurse team is an excellent example.
There is often delay of a few hours before parents of critically unwell neonates can see their babies in Neo-natal Intensive Care. We have implemented and are using a state of the art and ground breaking video conferencing facility through a secure platform, allowing parents of sick babies to be able to see the baby and converse with the clinical team looking after the baby from anywhere in the world. This technology has enabled parents to be able to see their infant’s real time and engage visually with the clinical team. This process has decreased parental anxiety, enhanced family integrated care with the additional health benefits to the infant. Parents can make a video call from PC, Laptop, Max, SmartPhone or Tablet to the team looking after their sick baby. Feedback from parents has included “I used this at night time and could see that my baby had settled before I went to bed,” and “I was in a different hospital to my baby for three days and this eased the anxious feeling.” Feedback to date has been 100% positive from parents and neonatal staff. Approximately 40-50% of families with sick babies in the unit are using the system.
This project is very special, it was based on a concept and driven forward with passion and commitment, and it proves collaboration between teams can work effectively. Both clinical and non-clinical staff and management, were absolutely of the belief that it was the right thing to do for patients. Each member of the team brought different knowledge and skills to the project. The end goal was to enhance integrated family care. We are the first unit to develop and implement this service in the region and possibly within the country. With the overwhelmingly positive feedback from both families and the staff, we believe that this intervention will help us support parents through a long and potentially distressing neonatal journey.
This is an NHS wide issue, with parents of ill children sometimes finding that they live in one place, and have babies in separate Neo-natal Units, because of clinical requirement. An example identified early in the concept was of parents living in York, with one baby (twin) at Leeds and the other at the Bradford Neo-natal unit.
The Bradford Neo-natal unit has 31 cots and provides intensive care services to sick neonates born within and outside the Yorkshire Neonatal Network. There are about 600-700 admissions every year and most are admitted to the unit within minutes after delivery. This means that the babies (some of who are critically unwell) may spend most of their first few days away from their parents, while the mothers are recovering either in the delivery suite or the postnatal wards. There are an increasing number of babies who are transferred to the unit from other hospitals in the region. This is a very distressing time for parents and the challenges of not getting to see the babies as early or as often as they would like to, disrupt early bonding, influence early expression of breast milk and adversely affect their overall experience in the hospital.
Project team established comprising:
Assistant Chief Nurse, Neo-natal Consultant, Neo-natal Clinical Nurse Specialist, Network & Security Services Manager
- Scoping parental interest and needs through informal discussion. Engagement with IG and development of local policy, to ensure the solution meets all requirements and is approved at board level
- Source finances, paid for through Charitable Funds
- Promotion of the idea and involvement of all key stakeholders, to ensure ‘buy-in’ from all disciplines (clinical and non-clinical)
- Neonatal staff training and education – use of the technology as well as the need for the process through patient stories and demonstration.
- Identifying teams within the organisation for financial, technical and practical solutions and providing evidence of positive impact on patient experience.
- Market research and engagement with suppliers, allowing the ability to implement a potential solution on a trial basis. Testing of new technology, to ensure reliability and sustainability and capitalise on joint interests with suppliers to deploy a third party solution
- Develop parental information leaflet to facilitate access to videoconferencing, continuing evaluation and feedback.
- Positive parental feedback and satisfaction survey – (100% positive – All parents found this a very beneficial experience and did not have any technical difficulties) evidenced by numerous testimonials
- Staff experience survey – 100% staff identified this as a process to enhance patient experience and demonstrated need for further investment (i.e more video units to facilitate multiple calls at the same time)
- Technical validation of the solution – IT department – ensure reliability and usability
- Frequency of use – monitoring regular use of the facility
- Significant local media interest, also showcase opportunity. Showcase Event to the Chair of the CQC who visited the trust in October. This gives a very strong message that our organisation is innovative and committed to our patients care and wellbeing. This has created a great deal of interest from other departments within the organisation who have thoughts and ideas about how technology can help them
The system is working well and is firmly embedded in the department. We are now keen to expand this into other services. Currently the Bradford area has a low breast feeding take-up and the traditional service face to face service is not showing the desired/needed increases. A secure, simple to use video conferencing facility would mean that patients could dial in when they had a problem, or needed some support with breast feeding, which is expected to provide more focussed support to new mothers. Other services have also registered interest into how Technology might support their services. Any enhancement to improve patient experience will be considered.
Relevance to Others
Whilst a number of pilots using solutions like Skype have been used for other NHS video conferencing applications, the Foundation Trust rejected these because they felt that they were not secure enough. The FT was also looking for a simple solution and the Cisco Jabber solution fully meets this. The secure technology has created much interest from a lot of other services in the organisation and also created media interest from local media. There was high profile interest from the Care Quality Commission Chair who visited the Foundation Trust in October 2016. The solution could be used for remote clinics, supportive outreach clinics such a breast feeding. The use of technologies in supporting patient experience will be included in our engagement vision over the next few years.
Key Learning Points
Understand what the need is and what the solution might be, in this case it was secure useable technology. Created a project team who are all committed to the end goal, this cannot be about individual achievement. There were challenges along the way which we worked together to solve. For example:
- Identifying an appropriate and user friendly platform (for parents / clinicians), engaging with necessary supplier
- Information governance and IT security
- Parental support and engagement
- Staff support and engagement
- Multidisciplinary staff involvement and motivation
- Resources particularly finances
The project group was small we worked on short term achievable actions, meeting on a regular basis to keep the momentum. We purposely managed the project ourselves, to prevent creating a level of bureaucracy.
Most importantly keep the focus, there are currently so many other challenges and constraints in the NHS. Seeing first-hand the effect on families and reading the feedback was the best motivator for our team