Better NHS IT could avoid 16,000 deaths

Better use of advanced clinical information technology in England's hospitals could help prevent 16,000 deaths a year, according to figures cited in a new report.

University Hospitals Birmingham NHS Foundation Trust includes the figure, based on its own experience, in a report submitted to the public inquiry into high death rates and poor care at Mid Staffordshire NHS Foundation Trust between 2005 and 2009.

The trust says that use of its locally developed PICS clinical system, now offered commercially with CSE Healthcare, has led to a 17% fall in deaths among emergency patients over 12 months, which would equate to 16,000 deaths prevented across England.

Other key patient benefits set out in the report include using clinical IT systems to closely monitor and reduce medical errors, particularly missed medications. Evidence suggests that hospitals may miss one dose in every five.

The system running at University Hospitals Birmingham provides staff with automated reminders to give patients their prescribed drugs to ensure patients get the drugs they have been prescribed.

The same system also includes prescribing decision support and safety alerts that issue warnings to prevent doctors and nurses accidently giving prescriptions which could harm the patient.

As a result of introducing the system and rigorously policing its use the trust says the number of medication errors has been halved at Birmingham University Hospitals.

The trust report says this fall in medication errors has significantly improved patient safety and also led to a sharp fall in deaths for patients admitted as an emergency.

Clinicians and managers each have a personal dashboard that shows them key indicators that matter most to them.

This includes missed medications and other clinical activities that are monitored on University Hospitals Birmingham's computer database. It also includes falls, checks for blood-clots and infection control.

The system also generates automatic alarms and alerts when staff key-in clinical information that could give cause for concern, such as changes to a patient's temperature, heart rate, or blood pressure.

This triggers an alert in the Critical Care Unit, prompting an outreach team to be dispatched to wherever they are needed in the hospital.

Where mistakes arise, the real-time feedback to senior executives enables them to call staff to account, with regular reviews to assess and explain performance.

Trust medical director, Dr Dave Rosser, told the BBC that one in five doses of a drug is not given to a patient in hospital.

"It has become over the decades culturally acceptable for drugs not to be given to patients, and what we've been trying to do here is turn round that culture and say every single dose is important."

Dr Rosser added that if his trust's approach was adopted across the NHS, this would equate to 16,000 deaths avoided.