Informed and Empowered
Walsall Healthcare NHS Trust
We are an integrated provider of NHS acute care in Walsall, providing inpatient and outpatient services at the Manor Hospital as well as a wide range of services in the community. We also provide high quality, friendly and effective community health services from some 60 sites including health centres and GP surgeries. There are approximately 4000 staff in the organisation serving a population of 269,000 in a densely populated suburban area in the black country. The paediatric department includes a 21-bedded ward, busy paediatric assessment unit and outpatient department, seeing over a thousand patients a week.
The Walsall Children’s Healthcare app is unique as it was born out of a patient shadowing experience which highlighted the plight of a worried mother who did not have the right information at the time that she needed it most. The intelligence gained highlighted a gap in the information available to patients and families about hospital visits, procedures and investigations. The paediatric consultant observing this experience translated this into a patients, families and staff teams enterprise to explore it further and co-produce a solution. The app introduces children and families to the teams looking after them and provides a plethora of information around procedures and investigations conducted in our department. It also allows children and young people to feedback about the service or individual clinicians they would like others to learn from. It also has protected sections for staff including guidelines and teaching timetables in the same app. With limited resources and a limited budget of £500, the app was created using in-house resources, staff voluntary time and readily available web tools. The content was developed in consultation with patients and staff ensuring that it is fit for purpose and user friendly. For example the children and young people’s section was developed following a focus group and user testing. The app continues to evolve as team members provide additional information and user feedback is responded to. Since its launch a mere 12 weeks ago, the app has been downloaded over 150 times and received in excess of 5500 page-views. It has been shared in many forums including local press and has generated national and international interest. Link to the app: https://apps.appmachine.com/walsallchildrensservice
The children’s department runs a fast-paced high turnover inpatient and outpatient service in a deprived area of the country. With a high turnover of patients it is often difficult to provide the right level of information that is in the correct format, is understandable and accessible as and when needed. We wanted to provide a platform that was free and easily accessible to families with information to improve their experience of the department and the hospital. They can see information prior to their visit, while they are in the hospital and afterwards while preparing for investigations. They can manage their outpatient appointments and give feedback all in one place.
The idea for the Walsall Children’s Healthcare app came about as a result of listening to patients/families and undertaking a patient shadowing exercise. The app was co-designed and trialled on the ward with staff, patients/families and wider departmental teams. Working collaboratively with the Patient Experience Team a survey was developed to gather feedback from patients and families. The feedback was very positive with users finding it easy to navigate and providing useful information. As a result of additional feedback information relating to car parking was added to the app. Posters and flyers were created to inform patients and families of how to access free wifi across the hospital to enable them to use the app. The Communications Team assisted with promotion of the app via social media and local press. Since inception the app has grown organically from a modest idea to have something that encompasses and empowers the department and its service users. Careful thought was given about how to make the app widely available and it was agreed to launch it free on apple and google app stores. The app is continuing to evolve as team members provide additional information and user feedback is responded to.
It was important to us to measure the impact of the Walsall Children’s Healthcare app and respond to this intelligence throughout its development. The site chosen to host the app allows for detailed information to be gathered including downloads by device and geography as well as page views. We were able to drill down to which sections of the app were used and how long (in seconds) people spent in them, allowing careful crafting of the content to maximise benefit and maintain interest. This content has been carefully curated by the team and is therefore credible and kept current. Updates to the app can be done in real time and in response to feedback or novel information. The links/pages have been created in response to patient/families/staff input through surveys, discussions and formal meetings. The results demonstrated that 100% of patients/families found the app easy to use and liked the appearance; 90% of those surveyed felt the app had all the information they needed. There have been over 5500 page-views and the multimedia section in the app are amongst the most commonly accessed (see attached screenshot). We now have examples of children having watched the app videos and being better prepared for what would otherwise be frightening tests. For example, one young boy said after an MRI brain scan, “That was easy!”. The staff section of the app was developed at their request and helps increase the quality of care through making accessible training schedules and clinical guidelines. A measure of its success is that GPs and senior staff at the Walk-in Centre have also asked for the app. Their use of it now means they also access the guidelines and can attend the teaching sessions, making for more consistent care throughout the patient pathway. The app also allows for patient experience intelligence to be gathered through a link to the Friends & Family Test. To date there have been 164 downloads. The majority of these are of course in the local area, but encouragingly a significant number are across the UK. Moreover, there have been 20 in the United Sates and 1 in the Philippines! As can be seen in the attached screenshot, this is an idea that has captured others’ imagination and is already spreading. A survey of app users will be undertaken in the near future to inform future developments.
The Walsall Children’s Healthcare app is continuing to evolve and grow ensuring it is up to date and relevant. The introduction of the password protected areas for staff has been a great boost as they are using the app on a daily basis on the unit. This has kept the app fresh and in the forefront of peoples mind so it is promoted to families and children. Specific pages have been added recently covering allergy and asthma. Other teams in the department are currently putting together information to have their own page within the app. In the future this can be extended to encompass other departments that have input into children’s care including surgery, radiology, pharmacy and community paediatrics. In order to future proof this project funding is being explored from different sources e. g. crowd funding and Trust Charity.
Our Walsall Children’s Healthcare app is a fresh, innovative, user friendly and cost effective platform for providing information to both service users and staff members and supports the National NHS drive to develop apps providing digital health tools and services that can connect patients to the information and services they need, when they need them, helping people to access care and information in a convenient way � (NHS England April 2017). Evidence suggests that we are a �smart phone using generation� who like to be able to access information at the touch of a fingertip, 24 hours a day, and that paper formats are often not considered the most appropriate way of communicating and providing information. The app is therefore the perfect format. As our app is constantly being reviewed and information added providing users with instant access to up to date evidence-based information. The Trust is committed to developing a culture in which staff are empowered to make improvements in quality and safety, to support better patient experience. The main contributing factor to its success is team working across the service including clinical and non-clinical staff, patients and families working co-productively to develop and promote the app inspiring innovation across the trust. This has made it relevant and responsive to the needs of the service users and the department in an easy to use format. In the future the app will grow to include other departments and is already being used as a model for other departments and trusts to develop their own versions relevant to their populations.
Key Learning Points
Clinical engagement from the outset will mean the product will be fit for purpose and used as intended. There are a number of websites that allow for app development. Choose one with the lowest upfront costs to allow for proof of concept and organisational support. Subsequently Executive sponsorship will help gain buy-in from the governance team, who are key to organisational approval. Remember why you are doing this and ensure it remains fit for purpose. This helps diminish the temptation to add bells and whistles that do not add genuine value for users. It will also help with engagement of patients, carers and staff to ensure it is co-produced.