With 1,700 trained health and social care professionals now able to use the Dorset Care Record (DCR) and 11,400 records accessed last month, we’ve been looking at the areas where partners find real benefits and highlighting comments made in recent case studies.
Preliminary analysis over the past few months has shown that the DCR is widely used by pre-admittance and pre-op clinicians and by specialist respiratory, kidney and heart consultants across our three acute hospitals.
Across our two local authorities, there is also consistently heavy use from Mental Capacity Act and Deprivation of Liberty Safeguard teams as well as occupational therapists, physiotherapists and social workers.
Additional information to help professionals better understand people’s medical history and current situation and quicker, more up to date details, enabling better coordinated and safer care, are often cited as reasons for people using the DCR.
Here are some comments from partner case studies from across the Our Dorset partnership:
Dorset County Hospital:
Dr William McConnell, respiratory consultant: “I’ve been using it for patients in clinics to check their past medical history and their current medication as well as other things I need. It is very useful to be able to check if they (patients) are using medication and treatment correctly – for inhalers for asthma. And the other thing we commonly link to and look at is spirometer records (how much air you can breathe out in one second. Often we don’t have access to it but it’s a quality indication for us and really important that we have this available.” (March 2020)
Chloe Mackenzie, digital lead midwife: “We will be able to access GP records which will mean that midwives can ensure women have all the support needed to have a healthy, successful pregnancy from the start. Sometimes, information can take between 2 and 7 days to get from partners.” (June 2019)
Dr Paul Murray, consultant nephrologist: “Having ease of access to see current and repeat prescriptions is extremely useful. People often remember to bring their prescription to our clinics but sometimes they bring pieces of paper dating back years….The problem we’ve had in the past is what has happened regarding patient vaccination history and whether the immunisation has worked. The DCR enables me to see when and which vaccine they’ve had – very useful – as patients, understandably, tend not to have a clear recollection.” (May 2019)
Kay Elliot, arrhythmia specialist nurse: “I have been using the DCR on an ad-hoc basis and have found it particularly helpful with patients who have complex needs. It is particularly useful when patients are not able to provide a comprehensive medical history and for those who are uncertain of their drug regimes and/or allergies.” (September 2019)
Royal Bournemouth and Christchurch/Poole Hospitals
Sally Papworth, RBCH pre-admission team manager: “Our team had to phone GP surgeries and it was taking up to 20 minutes to get the results. The DCR enables us to see this information immediately and this reduces pressure on both GP staff and our team. Having information on patient allergies is also extremely useful for us as often people forget exactly what allergy they have. This additional, real-time information ensures that patients have a safe and consistent journey through their service.” (February 2020)
Dr Rob Willington, consultant in acute medicine: “Shared records have the greatest potential to reduce harm and improve care.” (March 2019)
Dr Matt Thomas, consultant geriatrician: “The DCR has elevated our ability to look at the patients record above that provided by the Summary Care Record. As it has a user friendly interface with no smart card required I can access it anywhere and get the latest information from primary care on my patients. Most recently, it has been of use in seeing who has been immunised for flu, so allowing us to make the correct choices around prophylaxis when they have been exposed.” (January 2019)
Dr Mike Wheble, consultant in acute medicine: “It is vitally important information is available rapidly and 24 hours a day so that if a patient arrives at 11pm the consultant knows their full medical history. The DCR will not only benefit us in terms of saving time and providing more accurate and consistent care but also GPs and social services. .. The DCR will benefit social care practitioners providing then with transparent and relevant information.” (September 2017)
Dorset HealthCare
Liz Eaton, PA to consultant psychiatrist: “I find the DCR very useful if we have a patient leaving hospital as I can see the discharge summary and the medications provided. It’s important that medications don’t contradict each other.” (May 2020)
Diane Burgess, matron at Swanage Hospital: “I think everybody’s hoping to get a bigger overview of the patient care. We’ll be able to see records that we couldn’t before, including social care that the patients have had in their home. It will help if we’ve got elderly patients that we’re going to discharge if they need any extra help.” (July 2019)
Christine Noble, health and social care coordinator: “As a health and social care coordinator I will find DCR really useful in my role, as I gather information from different services, the GPs and hospitals.” (June 2019)
Dorset Council
Rachelle, Mental Capacity Act team lead: “I am using it for duty at the moment, so that we can see if referrals or deaths are Covid related. I know admin are using it a lot for Not Granted (Deprivation of Liberty Safeguards) authorisation. The information about mental disorder diagnosis is very helpful too.” (June 2020)
Roxy Shannahan-Creasy, mental health professional: “I use the Rio system (community and mental health) and Mosaic (adults services) and the DCR to see what’s going on. I like the DCR because it stops duplication of information and means that we don’t constantly have to ask people the same question, which gets them really fed-up. Dealing with people with cognitive impairment, it’s also useful to go back and see what they said in the past.” (January, 2020)
Julie Phillips, senior support officer, Purbeck: “I use it for anything and everything, particularly when I can’t find the information needed in Mosaic or from hospital records. It allows me to see if the patient is safe and also if information has changed since I last looked at the person’s GP Summary Care Record.” (January 2020)
Clare Collett, occupational therapist in North Dorset locality team: “We had an enquiry where there seemed to be no diagnosis for the lady in question but we had been told she was on medication supporting a diagnosis. I was able to go on the DCR to see if there was an official diagnosis and I was able to see the lady’s medical history regarding recent falls, which was quite useful. It was a case of being able to use the system in real time.” (April 2018),
Bournemouth Christchurch and Poole Council
Michelle Pattenden, Deprivation of Liberty Safeguards social worker: “I find it useful as it means we are no longer having to phone the hospital switchboards to see if patients have moved wards or are still in hospital. We aren’t always told if someone has been discharged. We need to get hold of this information to ascertain the degree of urgency regarding referral. The information on the DCR provides a more holistic approach – we can see what medication someone is on or what tests they are having. It is used every day by our assessor team.” (December 2019)
Jeremy Streets, occupational therapist, Bournemouth: “People come to us often with vague references about some spinal problems or a memory issue or about a heart condition. We can now, through seeing their medical records of their conditions, have a better understanding of what is in W
Kelly James, occupational therapist, Christchurch: “I started using the DCR as soon as it was made available. I use it as part of information gathering for OT assessment. I use it every time I write a new assessment, which means I go there probably on a daily basis to check medications and diagnosis.” (December 2019)
Yeovil Hospital
Clinical nurse specialist: “The use of the Dorset Care Record has been really useful when assessing patients with diabetes admitted to Yeovil District Hospital. Historically, Dorset patients are more difficult to assess when admitted due to the lack of information available via the GP records. Being able to access blood results and recent GP consultation records has prevented repeat bloods…and assisted with acute history taking. This has helped speed up the length of stay in hospital regards diabetes as clinical decisions are made more promptly.” (June 2020)
“Being able to access medications and DCH appointments has avoided phone calls to patients and having to write to GPs recommending patients are put on medications – eg, for bone health.” (June 2020)