Clatterbridge Centre for Oncology NHS Foundation Trust is one of the largest specialist NHS cancer centres in the UK. Based in Wirral, Merseyside, it serves a population of 2.3 million people across Merseyside, Cheshire, North Wales, the Isle of Man and South Lancashire, delivering treatments through radiotherapy and chemotherapy services.
Q-Pulse has been used to support the management of the ISO 9001 Quality System within the Radiotherapy department for a number of years. During the last 4 years both the Quality System and the use of the CAPA and Documents module have been extended across the Trust. The recent publication of “Towards Safer Radiotherapy” has introduced the requirement to report all radiotherapy related non-conformances to the NPSA National Reporting and Learning Service (NRLS). This, combined with the need to report all non-radiotherapy patient safety incidents to the same organisation, prompted the Trust to implement the Incident and Occurrence module and work with Gael on the development of a direct link from Q-Pulse to the NRLS.
The recent developments in Q-Pulse have enabled Clatterbridge Centre for Oncology NHS Trust to combine the collation of data needed for meaningful local analysis with the fields contained in the NRLS Clinical Incident Reporting Form and to automatically upload patient safety incidents into the NRLS system.
This direct link has significantly improved the timeliness and efficiency of their external incident reporting facilitating compliance with external reporting targets that would otherwise have remained unachievable.
The Challenge
There has been a long standing requirement to report all patient safety incidents to the NRLS. Pressure from the CQC to meet this requirement along with the recent publication of “Towards Safer Radiotherapy” recommending that all radiotherapy related non-conformances are reported through the same service meant that the Trust would have to find a way of reporting all of their clinical incident data to the NRLS.
The problem facing the limited resources of the Clinical Governance team was that the only way this could be achieved with their current system was to manually input the data into the Q-Pulse CA/PA module and to repeat that manual input, with additional fields, into the complex NRLS form - a process that proved so time consuming as to make it impossible to complete for all clinical incidents. As a result, the Clatterbridge Centre was unable to meet the NPSA requirement without the introduction of change.
Karen Postlethwaite – Clinical Governance Manager (Radiotherapy) at the Clatterbridge Centre, said: “After the publication of the NPSA’s reporting requirements in the ‘Towards Safer Radiotherapy’ report, we quickly realised this would result in a tremendous increase in the number of incidents that would require external reporting by our department. In fact, we realised that we would jump from around five incidents over a six month period, to approximately 70 per month.
“To manually log the incidents and input them electronically through the NRLS form, would put a major burden on our already limited resource.
“We needed a system that would allow us to continue to effectively manage our incident reports internally whilst giving us the added ability to meet external reporting requirements with no little or no impact on resources required.
The Solution
CCO were already aware of the benefits of Q-Pulse having used the CA/PA and Document modules for some time and were extremely pleased when Gael advised them that they would welcome the opportunity help devise a direct link from Q-Pulse to the NRLS.
By using the Incident and Occurrence modules the NRLS form could be replicated within Q-Pulse and batches of incidents automatically uploaded to the NRLS system at pre-determined intervals.
Karen added: “Through Q-Pulse, we managed to streamline the whole process of reporting Clinical Incidents and preparing them for submission to the NRLS, allowing us to meet the nationally imposed reporting targets with minimal increased effort and no duplication of work.
“Without Q-Pulse the NPSA targets would have remained very much out of reach without a substantial increase in man hours to accommodate the completion of the complex on line NRLS forms.
“With the Q-Pulse form we can meet our external and internal reporting requirements in about a third of the time that it would take us if we did not have the direct link.”
The Result
“Our positive experiences with Gael and the Q-Pulse product prompted us to investigate the possibility of a Q-Pulse solution to our external reporting problem rather than to look elsewhere,” said Karen. “The difference in being able to automatically upload our Clinical Incidents electronically through Q-Pulse has been amazing. We have gone from being classed as an ‘under reporter’ by the NPSA to being able to meet their requirements simply and efficiently.
“Our next step to improve efficiency even further is to introduce a fully electronic internal system of incident reporting, completely removing the duplication of effort in the first stage of the incident reporting process just as we have managed to do in the last.
“Due to the NPSA’s reporting requirement in the Towards Safer Radiotherapy report, effective and consistent Incident Reporting within the Radiotherapy sector is imperative.
“Through Q-Pulse, we can easily achieve what is required of us with much less effort, improving the integrity and timeliness of our internal and external reporting and allowing us more time to enhance the productivity of our Department as a whole.”