Midlands Partnership NHS Foundation Trust

Patient observations streamlined in England’s 2nd largest mental health Trust


With a low-code mobile app solution, Midlands Partnership NHS Foundation Trust (MPFT) reduced admin overheads by 15 days per mental health patient observation - allowing clinicians to deliver more consistent and congruous checks to further ensure patient wellbeing.

MPFT is the second largest mental health Trust in England. As the Trust cares for a large number of mental health patients with variable needs, regular observation checks are essential - but were often challenging, due to the paper-based system originally in place.

The challenge

MPFT is commissioned to deliver mental health and forensic in-patient services across both St Georges Hospital and The Redwoods Centre. With patients staying on these wards requiring unique levels of care, many individuals receive regular observation checks to monitor their current state and ensure their wellbeing. And, as those receiving treatment on these wards experience moderate to severe mental health issues, they’re also essential for both staff and patient safety.

In order to provide the best possible care, these observations take place round the clock at regular intervals, depending on each patient’s individual requirements. Each ward cares for up to 20 patients at a time, with individual observation intervals as often as every 5 minutes, or as infrequent as every hour. Due to this regularity, clinicians often rotate these checks between them, according to availability.

The original process

The original process was paper based, recorded in handwritten forms on shared clipboards. The completed physical documents would be delivered by hand to the administration team, who would then enter the information into their clinical system. Due to admin overheads, this process could take around 15 days per observation.

The team at MPFT identified several issues with the original observations process, prompting them to pursue a more streamlined approach:

Paper wastage

Numerous sheets of paper would be required for each observation, which could take places as regularly as every 5 minutes for some patients. As the Trust is dedicated to lowering carbon emissions and environmental impacts, they highlighted the need to reduce paper use and printing throughout observations.

Time constraints

Due to the length and manual nature of the original process, it would take 15 days for observation records to arrive in the system, meaning this information would not be readily available to clinicians for two weeks. This made handovers challenging for observation staff, which then could impact the quality of care provided to patients.

Data loss

With the original process relying on written forms, this data could be easily lost in transportation. As these notes could potentially include sensitive personal information about patients, the original process posed a significant GDPR and data loss risk. As well as this, missing records could impact patient care, as previous relevant information can assist in care.   

Lack of reports

As each observation was recorded by hand - with a 15 day wait for this information to become available on the clinical system – generating effective reporting with this method extremely difficult. To review a patient’s observation history, nurses would often have to sift through written notes to find the information they needed – a highly inefficient and time-consuming process.

In line with these requirements and issues, MPFT compiled their specifications and began reaching out to suppliers. They aspired to create an end-to-end digital solution that would improve the environmental impact of their operations, as well as convenience and accessibility for ward staff. After liaising with a number of suppliers, the Trust chose to utilise NDL Digitise to help craft their digital observations solution.

The solution

After development in collaboration with NDL, MPFT were able to test the first version of its digital observation app on both pilot wards for feedback. Named eObs, the app was to be accessible on both mobile and tablet devices to be used by ward clinicians in real-time.

The app provides a detailed overview of each patient’s observation requirements, guiding clinicians through observations paper-free. Pulling patient information from MPFT’s EPR RiO, and recording information into its own SQL database, the app provides a faster, more dynamic observations process for clinicians and patients. It’s wide range of features and functionality includes:

  • Patient name and bed information
  • Patient observation level and interval information
  • Observation statuses, including complete, due, and overdue
  • Observation records for the previous 72 hours
  • Timed syncing to avoid system overloads and connection latency
  • Integrated digital observation forms
  • Offline recording functionality

Clinicians found the digital process to be more efficient and convenient than the previous paper process, but were also able to provide constructive feedback to ensure the app was well tailored to its purpose. Following its pilot, eObs was then amended in line with this feedback, entering the second phase of its deployment. This launch was greatly successful, and eObs was scheduled for deployment on a further 11 wards.

The benefits

The eObs app helped to streamline the observation process for clinical ward staff. With a digital app accessible anywhere at any time, and with patient observation information readily available, clinical staff were able to deliver more consistent checks to their patients. However, many more benefits were also found in digitising the clinical observation process, such as:

  • Greatly reduced admin overheads
  • Consistent data records
  • Faster service for patients
  • Improved record keeping and data quality
  • Better workflow visibility
  • Reduction in lost data
  • Improved decision making due to better reporting
  • Increased data security
  • GDPR compliance through secure data servers
It’s been amazing to be part of such an innovated project that we are now using across a number of wards. the support from IM&T, NDL and all the clinicians involved has been incredible. Thank you to everyone!
Emma Davies, Inpatient Mental Health Wards Quality Matron

Looking forward

After the success of eObs in its pilot wards, the MPFT team then began to deploy it in a further 11 wards – providing even more patients and clinicians with a secure, consistent, and faster observation process. The team also aspire to develop further mobile apps, for use in a number of other service areas within the Trust. As well as this, MPFT continue to deliver innovation by adopting use of NDL Automate - our low-code RPA product.

To learn more about our Digitise and how it could benefit your organisation, get in touch with a member of our team. For more public sector digital inspiration, don’t forget to take a look at our other Success Stories and blogs.

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"eObs has been one of MPFT’s key digital innovation projects over the last year. Using mobile applications, and appropriate devices, has helped the Trust digitise observation information and have it available to clinicians almost immediately through a reporting platform. The eObs dashboards and RAG statuses have improved visibility of observation statuses for each patient. The sustainability aims of the organisation are also being met through reduced use of paper and printing."

Jack Gould, Senior IM&T Project Manager.