Vitalpac app saves 400 lives at Queen Alexandra Hospital in Portsmouth

Philip Astle, SCAS chief operating officer and, right, Paul Jefferies, assistant
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HUNDREDS of patients’ lives are being saved each year thanks to new technology developed at a Portsmouth hospital.

Specialists at Queen Alexandra Hospital in Cosham have developed an app called Vitalpac, which records people’s details on an iPod and will alert nurses if a person’s health is deteriorating.

Consultant Paul Schmidt ''Picture: Paul Jacobs (142755-6)

Consultant Paul Schmidt ''Picture: Paul Jacobs (142755-6)

Thanks to this the hospital said it has seen 15 per cent fewer deaths – meaning up to 400 lives a year are being saved at QA.

The app has been so successful that now 40 hospital trusts across the country have taken the idea on board and are adopting the system.

Nurses record patients’ blood pressure, pulse, oxygen levels and other observations on an iPod.

This is automatically uploaded onto the software, which flags up 
whether there may be a problem with the patient.

It means patients can be seen more quickly and by the right team before the their health reaches a critical state.

Dr Paul Schmidt is a consultant physician in acute medicine at QA, and helped develop the technology.

Dr Schmidt said: ‘Observing patients and making accurate records provides a safety net to guard against their deterioration.

‘We believed traditional paper charts were not doing the job well enough so we designed an electronic system to support staff.

‘Its introduction was followed by a significant drop in deaths.’

The idea came about in 2005, before being introduced in the medical assessment unit in QA, in 2006.

It was then taken up by a hospital in Coventry, so both sites could compare and record its results.

In 2010, around 397 fewer patients than expected died at Portsmouth.

In Coventry, the figure was 372 patients.

Staff nurse at QA Cielo Lawton, who has used the system for several years, said: ‘This is so useful to have and use.

‘Because it’s paperless and all stored on the iPod, it means it’s easier to access patients’ details.

‘All the information is easy to get to and it can alert you if there are any problems.

‘It has made checking patients’ observations much easier and quicker.

‘We can record observations like blood pressure, heart rate, oxygen saturation, and if the patient is in pain.’

The idea has also been welcomed by patients.

Joan True, 84, suffers from Chronic Obstructive Pulmonary Disease (COPD), and stayed overnight in QA.

Mrs True, of Locksway Road, Milton, said: ‘This way of recording information is really good.

‘It’s good that the nurse can see my details from before, and they can also be updated very quickly.

‘It also means all the information is held in one place.’

The system was developed by doctors and nurses at Portsmouth working together with health improvement company The Learning Clinic.

Chief executive Roger Killen said: ‘This is a great example of a collaboration between front-line clinicians, engineers and software designers to create a system which brings clear benefits to patients and staff.

‘The British Medical Journal Quality and Safety paper confirms, based on studying results at two large hospitals, that introducing Vitalpac was followed by dramatic falls in mortality.’

Portsmouth Hospitals NHS Trust, which runs QA, has spent £45,000 on buying 300 iPods, which cover around 1,000 beds.

PHT has been paid £120,000 a year in royalties for seven years by the clinic.

Development of the idea and how it works

THE idea behind the app is for nurses to record information quickly and safely in the interests of patients’ health.

Traditionally nurses would take vital observations such as blood pressure, temperature, oxygen levels and pain levels with different tools.

This would then be handwritten on to a chart, and nurses would add up various points to work out a patient’s Early Warning Score (EWS).

This score provides an indication of the severity of the patient’s condition.

But this manual adding-up took time and opened up nurses to making human error.

This is what prompted specialists to revise the system.

Dr Paul Schmidt, a consultant physician in acute medicine, at QA helped design the app.

He said: ‘The Vitalpac software uses the information entered by the nurse to calculate a patient’s EWS, which provides an indication.

‘However, calculating the EWS requires time and accuracy, and too often busy nurses using paper and pen make a mistake.

‘Information recorded on the handheld devices is automatically uploaded to a hospital-wide system allowing nurses, doctors and managers to monitor the health of patients across all wards.

‘Staff on ward rounds have instant access to information from any device connected to the hospital network.

‘For example a high EWS triggers an alert.

‘If so, the nurse is warned to increase the frequency of their monitoring of the patient and, in some cases, to alert a doctor or a rapid response team.

‘If the EWS is low then a patient may be monitored less frequently.

‘This massively speeds up the process and means we can get to patients starting to show signs of deterioration much more quickly.’

The Vitalpac idea was thought up by professor Gary Smith, who was a consultant in critical care medicine, at QA, until 2011.

An early version of the technology was introduced to the medical assessment unit – now known as the acute medicine unit – in 2006.

It was used on 58 beds, before it was introduced to other adult wards.

The system is not used in the intensive care unit or maternity wards, as hospital death rates in these departments are low.

Technology praised by MP and Healthwatch

THE development of a hospital app to record patient observations and help save more lives has been hailed as a tremendous success.

Hampshire Healthwatch, a patient watchdog group for the county, said it is impressed by the Vitalpac.

Nurses at Queen Alexandra Hospital, in Cosham, are able to record vital patient statistics such as blood pressure, temperature and oxygen levels, and then record them on an iPod.

The information can be looked up across the hospital and picks up early signs of a patient’s health getting worse.

Healthwatch manager Steve Taylor said: ‘This is a really positive move and we welcome this.

‘Any scheme that improves patient outcomes and also has a better use of resources is always a good thing.

‘We know there are massive pressures on hospitals across the country, and it’s good to see QA has come up with this idea and it’s being picked up elsewhere.’

And Portsmouth North MP Penny Mordaunt is also backing the invention.

She said: ‘I am a big fan of this system.

‘It’s tremendous to see all the things it can screen and the information it can store.

‘And it’s a great way of empowering the nursing staff as well.

‘Nurses have said that one out of four cases where they ask for a doctor to look at a patient doesn’t happen for whatever reason.

‘But now that everything is being monitored in this way, it means messages can’t go awry and patients are put first.

‘Of course we expect staff to be able to tell how a patient is doing without help, but this will enhance their observations and support the system.

‘This is a massive kudos to Portsmouth, and it’s fantastic to see other hospitals are picking up on this.

‘I hope there is a financial reward for QA on this.’