Clinical risk – Risk Register

The problem

A large London teaching hospital identifi ed its pacing practice as a major source of uncontrolled clinical risk. The many thousands of high risk patients under follow up, use of paper notes, and absence of daily physician presence in the pacing clinic were typical of many hospitals.

The solution

The situation was placed high priority item in the Trust’s clinical risk register. The board authorised funding for a comprehensive paperless solution designed to minimise clinical risk and allow oversight of pacing data to all clinicians. An open tender process was held, judged across multiple criteria including ability to reduce clinical risk and price. The PACENET database was chosen from three tenders.

Implementation

The board assigned a single individual to liaise between Clinical Network Systems, the Trust’s IT department, the pacing clinic, and clinicians, to bring board-level authority to ensuring a speedy implementation. Data from over 25,000 previous pacing procedures, and all associated hardware, were imported into the PACENET system, so that the database was fully populated when it went live.

The result

Patient records are available from any computer terminal, and at other locations by VPN into the hospital. Comprehensive audits are now being performed across over 20,000 patients. Annual audits which previously took weeks to complete can now be completed in a few hours. New hardware alerts from the MHRA and manufacturers can be responded to in hours without reference to paper notes. Clinical risk has now been demonstrably controlled and managed.