The Royal Wolverhampton NHS Trust pioneers mortality data collection with ground-breaking eForms project

The Royal Wolverhampton NHS Trust (RWT) currently stands as one of West Midland’s largest acute and community providers, with more than 960 beds across three sites. In order to provide the best possible patient care on such a large scale, the Trust continues to place emphasis on the improvement of its Mortality Review process - revolutionising data quality and collection for accurate statistical reports.

The Challenge

Back in 2018, RWT’s “unexpected death” statistics were higher than predicted. Though demographics and working patterns of the local population could potentially justify these figures, the Trust felt it could not account for all of these deaths to its own satisfaction.

The original Mortality Review process consisted of four paper forms, completed manually by healthcare professionals at various stages of patient care. However, this created disparate paperwork and documents – often creating difficulties when reviewing deaths in complex circumstances.

The Solution

Using NDL Digitise, the project consisted of nine different eForms, workflows and dashboards – all integrated seamlessly and securely with the Trust’s existing systems.

The new process

The Trust’s new, streamlined mortality reporting process is as follows:

1. Patient deaths are registered on the overarching PAS system, triggering the entire workflow.
2. The Bereavement Centre team access the central dashboard, which links to the suite of Learning from Death eForms associated with the administration of the case. The relevant forms are completed as the case progresses through each stage.
3. Once the mandatory forms are completed, the case moves into the clinical workflow, appearing on the Medical Examiner’s worklist. The case remains on the bereavement dashboard until all admin stages are completed.
4. Depending on the information provided by the Medical Examiner, the case will move to the Structured Judgement Reviews (SJR1 and SJR2 forms) stage, or straight to the “no further action required” (NFA) dashboard - where it will remain for 12 months before archiving.
5. The MRG (Medical Review Group) and Directorates can access all of the data captured by the eForm system via their own designated dashboards, allowing them to decide next steps. This is key for high-levels of governance, and the ability to provide case-related information for any requests from relatives or other relevant parties.
6. Any feedback or investigation findings are then reported, allowing the Trust to continuously improve the standards of care and outcomes for patients.
7. Reporting Services then use the data in a suite of mandatory government reports.

The Benefits

The new digital solution provides RWT with improved visibility over its mortality data, allowing better analysis of patient deaths. With its previous approach, the Trust was only able to complete a limited number of reviews – the new eForm structure now allows the Trust to process every case in a timely manner. Further impacts include:

Visibility

• Visibility of active cases has streamlined mortality processes for Medical Examiners
• The Medical Review Group receives a summary form of key data for its review, which is then used to implement Learning Outcomes
• Directorate Dashboards allow for the review of relevant summary data for both learning and good governance
• Information is readily available in the case of an SJR

Data Quality

• The digital workflow and mandatory fields ensure relevant locations are populated with essential morality information
• Enhanced variety of field formats provides scope for accurate data input
• Data traceability and an easily accessible audit trail due to one system
• Reduced risk of data loss or GDPR infringement
• Partially completed eForms can be saved and transferred between staff members for ensured completion

Efficiency

• External parties, such as HM Coroners and General Practitioners, can be notified automatically through the workflow
• eForms are pre-populated with information already held in back-office PAS systems – such as demographics, admission details, GP and NHS numbers
• New eForms inherit data previously entered into the system – for example, information captured in the bereavement centre or ME eForms will then automatically populate within the SJR1 and SJR2s later in the process

What’s next?

Following the success of the Learning from Death process throughout the pandemic, the Trust rapidly applied the same eForm format to a number of other key trust operations, such as PPE order management, COVID-19 LAMP testing and Diabetes & Podiatry clinical systems. The Trust now has everything in place to deploy eForms across the breadth of its service.

To hear more about NDL’s Digital Transformation Suite in action, don’t forget to take a look at our other customer Success Stories. To learn how eForms could help your public sector organisation, don’t hesitate to get in touch.

Image Rights: Richard Law / New Cross Hospital