Evaluating the use of remote monitoring in care homes

Our Patient Safety Collaborative (PSC), as part of the National Patient Safety Improvement Programme, worked with NHS North Central London Integrated Care System (NCL) to support adoption of an innovative digital solution Whzan Blue Box to manage deterioration in care homes residents.

Using lessons learned from our pilot, the use of the Whzan Blue Box has been rolled out to 116 care homes across the North Central London.

Background

Over the last few years care homes have increasingly introduced the use of digital solutions to measure resident’s vital signs and calculate the National Early Warning Score (NEWS2). The use of digital technology to enable remote monitoring and consultation became critical during the COVID-19 pandemic, with system-wide uptake rapidly accelerating.

In 2019 UCLPartners Patient Safety Collaborative (PSC), as part of the National Patient Safety Improvement Programme, worked with NHS North Central London Integrated Care System (NCL) to improve the ability of non-clinically trained staff to recognise, escalate and communicate the early signs of deterioration, using an innovative digital solution Whzan Blue Box in 8 care homes.

Although the rollout of the Whzan Blue Box overall has been very successful, there were care homes where the uptake was not easy and in some where it stalled. There are various contributing factors to that, with barriers to adoption encountered at both care homes level and within the primary care service that support them.

Study findings

UCLPartners PSC team conducted a qualitative study to improve the understanding of how Whzan Blue Box has been used, what the barriers and enablers to its use were, and consider whether there is scope to expand its use to assist with the delivery of the Enhanced Health in Care Homes Framework. Insights were gathered through a set of semi-structured interviews with participants compromising GPs, care homes staff, community nursing team and residents.  Study findings

Successful implementation was underpinned by a clear escalation pathway, robust communication, and clearly defined roles. Where Whzan Blue Box usage was less established, this was sometimes due to factors within the care home, such as lack of time and staffing issues. Also, the lack of engagement with Whzan Blue Box was often due to GP’s concerns that they may find themselves overwhelmed with the volume of physiological data without any other clinical context and increased workload. Those who had successfully adopted Whzan Blue Box had developed solutions to these concerns.

Primarily, they ensured that a senior person within the care home, able to interpret the results in a clinical context, communicated the results to the GP and/or primary care staff. There was no expectation for the GP to sit at their desks, manning their Whzan portal – abnormal results were proactively flagged by the care home staff. When used in this context, both GPs and care home staff found Whzan Blue Box improved the quality and efficiency of their work.

Ultimately, what came across is that both sectors felt strongly that Whzan Blue Box was of benefit to residents. Care home staff were more confident to escalate concerns, and GPs liked having both vital signs data and contextual information about the resident. Stories of residents receiving more timely care in an appropriate setting were commonplace.

Read the full evaluation report.

View accompanying short videos describing the application and benefits of using Whzan Blue Box from a GP and care home staff perspective.

For more information contact Rebecca Dubben, Patient Safety Programme Manager Rebecca.Dubben@uclpartners.com