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The Client

Kingston Hospital NHS Foundation Trust (KHFT) runs Kingston Hospital - a district general hospital, caring for around 350,000 people in the surrounding area including Kingston, Richmond, Roehampton, Putney and East Elmbridge. The hospital has approximately 520 beds, employing around 2,900 staff directly with a further 300 contract staff.

In the last year the Trust saw over 127,000 patients in A&E, undertook almost 444,500 outpatient appointments and cared for more than 67,000 admitted patients. The maternity unit delivered over 4,900 babies.

KHFT is one of the best performing NHS Trusts nationally on cancer waiting and diagnosis times. The Trust seeks to continually improve services for its patients and in the last 18 months it has carried out a programme of quality improvement for its Haematology patients. This has included the relocation of the Haematology Day Unit (HDU) to a purpose built facility, the co-production of a patient information film to demystify chemotherapy to new patients and the implementation of the BookWise Duo system. 

The Requirement

The HDU at KHFT is a small unit of four experienced nurses supported by a receptionist. Previously the coordination of treatment was largely organised through a paper diary that was managed by clinical staff. As patient numbers grew this task became increasingly time consuming and complex. The inability to coordinate chair usage and nurse availability effectively created long waiting times for patients once they had arrived in the HDU for treatment. 

The Solution

BookWise Duo was chosen because of its ability to schedule patient appointments and allocate nurse time in a standardised and efficient way. With this technology the nurses who were previously making the bookings were freed of the non-clinical yet time consuming task. A unique element of the software was also its functionality for calculating nurse working hours too; something which is complex, with lots of variability due to each patient’s specific treatment cycle. This would be difficult, if not impossible, without technology. 

Prior to investing in BookWise Duo for the HDU, other BookWise software had been used successfully in the Trust’s Outpatient department and Education Centre for some time, giving confidence in BookWise’s products and approach, which led to the purchase of Duo. 

Implementing BookWise

Overall the implementation process ran smoothly, making the installation a success. The Trust’s Patient Experience Quality Improvement Lead (Jane Suppiah) worked alongside the HDU’s Lead Clinical Nurse Specialist (Lesley Chamberlin) to plan and deliver the implementation of BookWise Duo. Having clinical knowledge alongside project management capacity enabled the complex task of documenting chemotherapy regimes and other treatments within a spreadsheet to be uploaded into BookWise accurately and efficiently. 

As part of this process, Jane and Lesley took the opportunity to visit Nottingham’s Oncology unit, which is using BookWise Duo. This provided insight and ideas of how to mitigate potential problems and prepare for implementation.  

The Process

BookWise predicts a 28 week timeline for rollout of the system. However at KHFT this was achieved in 18 weeks. The team was keen to get the BookWise software up and running as soon as possible after the move to the HDU, and the reduced timescale was made possible due to the project leaders working together and dedicating time in the initial stages to oversee the implementation, and the staff adapting well to the new system.

In total, BookWise spent 4½ days on site with the Trust to implement the software. This involved an inception meeting, followed by training of the primary users and migrating necessary data to the new system.

The Result

With the software, the unit now has an internal system that includes dynamic patient data that can be updated following every appointment.  The software has increased quality assurance for the department, with no room for human error when scheduling room bookings.

Combining patient, facility, nurse and chair information, BookWise Duo is used to plan and produce treatment schedules in advance for each patient. Appointment times can be given by the hour, as opposed to generic ‘morning’ or ‘afternoon’ chunks that were allocated previously. As well as helping to manage staff workflows, this can also help patients holistically by giving them a more detailed overview of when they will be needed in hospital and it helps to manage their expectations.

As well as managing staff time more efficiently, BookWise has contributed to improving the patient experience within the HDU helping to significantly reduce waiting times. 

The unit also uses the data gathered from the system to analyse the actual utilisation of its rooms, and the reports can be used to assist with reviews.

Jane Suppiah, Patient Experience & Quality Improvement Lead said:

“BookWise Duo is responsive to the nature of the centre, which can be quite changeable, and it supports our flexibility. A system like this works best when everyone involved is fully engaged with it - staff have embraced it and know its value, which only helps to boost its effectiveness. Everything is accessible and reporting is good. It means we can gauge each week’s capacity ahead of time.

“The team at BookWise were supportive, with well thought out products that deliver meaningful insight. After using the system we’ve recognised that we had a stretched capacity in our unit. With the figures to prove this we can re-evaluate how we use our resources within the Trust”.