the Hospital
NHS Lothian is the UK's second-largest health authority, with 21 hospitals, 126 GP practices, 180 community pharmacies, 173 dental practices, and 112 ophthalmic practices. They have over 27,000 staff that provide a comprehensive range of primary, community-based, and acute hospital services across Edinburgh, East Lothian, West Lothian, and Midlothian.
The CHALLENGE
NHS Lothian previously used a digital quality auditing system built and managed by a one-person company. However, it wasn't very user-friendly or designed to support the full extent of their auditing and ward accreditation needs.
When the owner retired in 2020, Lothian lost access to the system. As a result, the deputy and senior charge nurses had to go back to using paper or complex Excel sheets to input quality data. And with no standard way of doing this, closing the loop between information and action to improve quality became a significant challenge.
This was when they considered building a bespoke digital quality auditing system in-house. Unfortunately, at the time, due to the pandemic, their internal IT team simply didn't have the capacity to undertake a project of this scale. What they needed was an off-the-shelf, quick-to-implement and easy-to-configure product that they could use to manage their nursing and care assurance audits.
After evaluating a few different products, they zeroed in on MEG.
the Solution
NHS Lothian had a very clear and specific goal — to meet the national nursing and care assurance standards with the help of ward/department quality assurance tools. With this objective in mind, the implementation team at MEG got to work.
The first step was to take their existing IPC (Infection Prevention and Control) audits that were either on paper or Excel and transfer them to MEG's digital Audit Management tool. Then, as each audit went live, Lothian's project management team developed SOPs (Standard Operating Procedures) and how-to guides to help their staff use the audits effectively. However, the Lothian team soon found the guides weren’t a mandatory requirement:
The next big thing MEG tackled was LACAS. Also known as the Lothian Accreditation Care Assurance Standards, this serves as a ward accreditation and quality assurance tool, auditing 13 standards across 18 different forms five times a month.
Before MEG, nurses at Lothian used a multi-tab Excel spreadsheet to manually pull data from different forms and audits, and complex formulas to calculate their ward accreditation scores. With every ward using a separate spreadsheet, the Lead Nurses for Quality Improvement and Standards would end up with 80+ Excel spreadsheets to validate at the end of each cycle. The entire process was extremely laborious and time-consuming. Simply put, they needed a better system.
Over the next six months, MEG’s implementation team worked with NHS Lothian to build a custom, fully-configurable digital ward accreditation tool — LACAS. Automatically pulling data from the various internal systems Lothian used, we created 18 digital audit forms and a single summary form that combines the results of the audits to produce a ward accreditation score.
We also built a single dashboard that visually displays every ward's audit data and score across the different hospitals, eliminating the need for spreadsheets altogether. This information can be extracted at any given time by the management and sent directly to the National Excellence in Care Measures dashboard.
When the LACAS tool was launched, the project management team at Lothian offered 30-minute drop-in training sessions for the staff to show them how to use the system. However, as was also the case with the IPC audits, the short how-to videos and guides were more than enough to get them by.
Below are sample images of MEG’s Nursing Accreditation Care Assurance Standards dashboards - similar to those used by NHS Lothian.
(Please note that all data displayed in the images below is taken from a MEG demo account and does not correlate to NHS Lothian in any way.)
“MEG is a very visual system. The dashboard allows you to view all your wards and their compliance scores at a glance. So it’s really effortless to evaluate and keep track of which wards are performing well and which need improvement - there’s almost no friction there.
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THE OUTCOME
Today, MEG is used by 1100+ NHS Lothian staff to perform audits and track their compliance against the National Nursing and Care Assurance Standards.
MEG’s digital system has made it possible for Clinical Nurse Managers to aggregate data across different wards, month after month and visualise it on a single dashboard. As a result, they can compare their ward accreditation scores over time, identify areas of improvement, and tweak their processes to improve compliance. Management now have complete oversight of ward performance in real-time — something that was missing before MEG. Also, no more spreadsheets!
Meanwhile, the implementation team at MEG are busy building new fully-configurable audits for NHS Lothian and making minor changes to existing audits to make them even more efficient and user-friendly.
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