Podcast transcript
Anna:
Hello and welcome to this Scan4Safety podcast. My name is Anna Stec, Senior Project Manager for Scan4Safety at NHS England. And today I’m joined by Ricky Tenchavez of the Scan4Safety team at Doncaster and Bassetlaw Teaching Hospital NHS Trust.
During this episode, Ricky will share with us some insights from implementing a Scan4Safety system and share details of the approaches they used and the benefits they’re now seeing as a result.
But before we get started, for those that don’t know, Scan4Safety is a pioneering NHS programme which started in 2016 to support the introduction of barcode scanning technology to improve patient identification and the tracking, traceability and inventory management of medical equipment and supplies. It is focused on supporting the NHS to realise the benefits of this technology, to enhance patient safety, improve operational efficiency and reduce costs and wastage within NHS hospitals.
So welcome, Ricky, and thank you for joining us. Do you want to introduce yourself and explain a little bit about your background and how you got involved with Scan4Safety?
Ricky:
Yeah. Thank you Anna. So hi everyone. My name is Ricky Tenchavez and I’m the implementation lead of Scan4Safety here in Doncaster and Bassetlaw Teaching Hospitals Trust. So I am a registered nurse by profession here in the UK, but I do have years of experience with project management under the IT department back in the Philippines.
And so while I was still working as a staff nurse in Lincoln County Hospital, I felt like I can still do more. So I explored opportunities for me to practice the project management, and I came across to this ad in trac jobs, which says implementation lead for Scan4Safety. So I tried my luck as I read through the job description and said, I think I can do this one, but as to the nature of Scan4Safety, I only get to learn it when I started my job because I got to do some research on what Scan4Safety is, why it was being introduced in the UK, and why is it important and beneficial in a trust.
Anna:
And in many organisations Scan4Safety seems to start with procurement focus and grows from there. So it is really interesting that you have a clinical background. How do you think that has helped you?
Ricky:
I think it was an advantage that I have a clinical background because even though Scan4Safety encompasses both, procurement and the clinical teams, having this clinical background can actually bridge the gap between two processes. And especially when you deal with clinical healthcare team, you need to be able to relate to them, understand the nature of their job.
And so because I can speak the same language as they do. So really it’s ability wise, I can come across to them and let them understand more the objectives and benefits of Scan4Safety, that can be something that they can appreciate, because they are the ones that contribute in order to drive this process in their workplace.
Anna:
And where I did the Scan4Safety journey start at Doncaster and Bassetlaw. What was the motivation to get it started?
Ricky:
So, there was already an IMS and point of care process that was introduced back in 2016, but the Scan4Safety actually started in the trust when I started back in November 2022. So it is when we further explained to the teams that when we say Scan4Safety, it’s not just merely scanning, but there has to be guidelines that would be aligned with what we call Scan4Safety.
So the point of care process was actually already existing in the orthopaedic theatres in both Doncaster Royal Infirmary and Bassetlaw District General Hospital. But when we did Scan4Safety, it was a complete overhaul. It was really introducing what it should be. So instead of merely scanning because all the staff members in theatres thought that it’s just procurement, oh, we’re doing this because it’s for reordering, and all that.
But when we did the reintroduction or sorry, not reintroduction, but when we introduced Scan4Safety, it was really a project plan which started from training, giving them the theory behind Scan4Safety. So because it’s only when they understand why they’re doing it that they will appreciate why they had to do it. And then the same time, we also have started the GLN deployment, so global location number.
So it’s as soon as I started, we’ve continued monitoring until it was all deployed in all three sites of our trusts. And then we have also secured the GS1 compliance of our patient wristband, which is the GSRN piece of Scan4Safety.
So yeah, and now we’ve already gone live with 28 theatres. And we’re going to interventional radiology next, by the end of this month.
So when we started discussing about the deployment of Scan4Safety, we actually did an assessment on the areas which ones cater more complicated cases or specialties but the size of the area. So we started because it’s already existing in orthopaedics. So so that it’s just going to be a concept of Scan4Safety that we will be introducing.
So as far as scanning they already have that idea. But it’s just a culture change that we needed to do. But then it was when we think like okay, this particular theatre has these specialties, and it’s not that massive. So our attack would be more of getting first the smaller ones, and then we go massive, massive until we are able to roll out everything in all the theatres in a span of a year and a half.
Anna:
That’s fantastic. That’s really quick rollout, very well done. And can you talk us through can you talk us through the key steps involved in setting up Scan4Safety in a department?
Ricky:
Yes. So we started with a project plan. So our project plan would involve kickoff meeting determining first what are the specialties of that area. What are the the size and all of that. And so we meet with those specific areas that the managers and the potential Scan4Safety champions. And then once we’ve already done the kickoff meeting, then we do the business process mapping.
So we get what’s the current process and see how we can incorporate Scan4Safety in those processes. How can we target efficiency. So let’s say for example if they’re manually recording their implants, with the introduction of Scan4Safety, that should eliminate the manual task. And then proceed with a digital recording. So that’s part of the business process mapping.
And then after that we proceed with our data gathering. So we get all the information about what the items they use. Who are the surgeons, the consultants, the procedures they do, what are the theatres that have been used. And then after that, we do our data set up in the system. So we start first with setting them up in our user acceptance test environment to see.
And then we do our testing. So I do conduct all the testing, end to end testing and specific testing for that specific data. So we know that it’s going to be working fine if we move them to production. And so once we’re done with the data set up and our user acceptance testing, then we conduct our training.
So the training that I have devised in our trust whenever we do our deployment is like a four day training. So one day for Scan4Safety champions and then three days training. But those three days will have the same content. So it really depends on which, or who are the staff who can attend to a specific day.
Because as we all know, if they are working in theatres or maybe in any clinical area, they will always be busy. They couldn’t probably get out of theatre and attend a session. So I said, we’ll have three sessions. Just attend wherever you whenever you can. And that includes also our inventory management procurement, sorry, our inventory management theatre assistant.
So we gave all those, those training dates and at the same time we also prepared our how to guides, which are both soft copies and hard copies in a folder to be given in each of the theatres so they can have references if they need anything. And then once we’re done with the training, then we proceed with our pre go live preparation.
So that’s basically setting up everything in production, making sure that all bases are covered. We’ve already done our risk assessment even before we started the deployment. And then once we’re done with our pre-deployment, that’s when we do our go live. So I am personally present in the area for the next two months until everything is stable.
But in that span of two months, post, go live. So there is what we call a compliance audit process, where, we go to I mean, I go to a theatre, I observe how they do it. Are they scanning the implant before they give to the scrub team? Because as we all know, if it’s Scan4Safety, it’s not just scanning and that’s it. But we have to maximize the system that we have, because the system, the genesis system that we’re using can actually detect if an item is expiring, if it’s expired product, part of a product recall, or it’s a wrong body side. So that’s going to be part of the guidelines.
And then scanning of the wristband as well. So those are clearly communicated to everyone so that once they practice Scan4Safety they’d be more comfortable with it. And then it can be a second nature to them already. And then once we see that the compliance audit is favourable, it has a really good result, although we’re not expecting 100%, but we see like it’s 95 or 96% overall, then the project team will say, okay, we’re happy with this one, and let’s put this area to business as usual, and then we can plan for the next deployment.
So that’s basically how we go through with our our roll out or our deployment to any area.
Anna:
So what was your approach to engaging with staff within the trust during introduction of Scan4Safety? You mentioned it wasn’t always easy, and to convince them that it was the right thing to do and to get on board.
Ricky
Yeah, I think anyone would ask me, Ricky, what was the most challenging, part of the deployment? I would always say it’s really just letting the people actually do it. So, when I started Scan4Safety, when I started planning. So I said I probably need to have a strategy in order to have the people actually embrace and do this process.
So I only had two strategies. So that’s engagement and communication. Engagement is I made sure that they feel that they belong, that they contribute to the success of the process. To whatever the vision or the mission of this process, they are part of it. So we keep them engaged. So engagement would include being there, total support, because that was also what was lacking before when they implemented a point of care process not yet Scan4Safety in orthopaedics. It was not really very smooth because of lack of support. Whenever they have issues, they don’t know who to go to. So there were loads of complaints and issues when I went there and listened to, you know, their thoughts about the current practices that that they were doing. And so that was the main, target is really to provide utmost support.
And if they have any issues, it has to be resolved as soon as possible. If not, I go with my second strategy, which is communication. So communication is really key. So whenever there’s a new process that need to be implemented everyone needs to know. So instead of just sending it to the managers and waiting for managers to send it to the staff, I just make it a point to get all the email addresses of the staff and then send it to them, especially if they are the ones that really need to be informed.
So yeah, it was very challenging. But when you are there with them, that’s when they appreciate that whenever they’re helpless, there’s someone already there to help them. And that was a key. That’s why the adoption or the way they progressed with Scan4Safety is much faster, not perfect of course, we cannot expect everyone to really learn it 100%, but their engagement, the quality of questions that they ask you will know that, they are getting there.
And it’s also because of the support that you give. So it’s just fortunate that I have a clinical background that I can go there. I can relate to them, they can relate to me. But for me personally, whoever probably will lead scout for safety deployment in any area, someone has to be there, especially when they do baby steps to learn the process.
So that was basically the key. It was very challenging getting all those complaints, but it will just be probably first or second or third week. But after that, once they see you that they’re there and once they call out for help and you’re there, everything is going smoother and smoother.
Anna:
Does the trust have a specific Scan4Safety team, and which people and teams have you worked closely with?
Ricky:
So in our trust, we don’t have a Scan4Safety team, unlike other trust where they really have a dedicated one with like a director or a manager. But in our trust, when we talk about Scan4Safety, there’s no specific teams. It’s really just me.
But we do have a project team where, so that involves our head of procurement. We have our theatre service manager, we have our, previously, our e-procurement manager and our operation and flow manager from theatre. But as to a dedicated team for Scan4Safety, unfortunately we don’t have it. The planning and execution centres to me as the implementation lead.
I’m closely working with Genesis, the system that we’re using to drive Scan4Safety. So they’re very, helpful as well if we have any questions. But, on our end, we tend to be more self-reliant and resolve it on our end before we actually go to Genesis. If they couldn’t resolve it any more.
And then we also have a close coordination with the patient safety governance team here. So they are the ones who we check if there are any Datix that are related to patient safety that could have been prevented by the Scan4Safety process.
So and then not working closely. But we also get in touch with the finance team because they also have some questions on the data that we can pull out from the system that we’re using. And then we’re helping them determine what are the efficiency that they can come up based on the digital data that that we can gather.
Anna:
Can you tell us who do you report to the outcomes and benefits of Scan4Safety or your progress?
Ricky:
So we have a project team. So we have our head of procurement and then our theatre service manager. So currently I, I discuss with both of them about the progress the deployment and then what are the the benefits as well as the efficiencies that we’ve done so far, like the changing of the ophthalmic lenses and the removal of the manual process of doing excluded devices.
So those are the things that I, I report to them on a bimonthly basis. However, we also have a project board, but it’s just composed of myself, Richard, our head of procurement, Marie, our theatre service manager, and our, medical director, Dr Nick Mallaband. And so that meeting would be a high level one because it’s for our medical director.
So we just give them, the updates where we are right now. What have we accomplished so far? What are we doing? What are the next steps? So we’re always trying to look for future use cases.
Anna:
Well, that just shows. And we see that in different areas at national level generally that procurement and finance are now trying to engage with clinical staff to communicate better that if you Scan4Safety, it’s not just procurement project, but it is patient safety initiative.
Ricky:
Yes. And it’s really for me, I realise that it’s really important to really get a buy in from the clinical side and that they really had to be sold with the idea because if, if the clinical side will be half hearted or not really interested. So it’s really just going to be a 110 effort from a specific team introducing something.
But if it’s not embraced fully, then that’s going to be a really big challenge.
Anna:
And you mentioned slightly that you’ve been working with the system provider. I wanted to ask you a little bit more about was there any support from outside of the trust? Who else helped you?
Ricky:
Well, maybe not directly, but I can say indirectly other trusts have helped me because when we do our GS1 adoption group meetings or our northern Scan4Safety, I get to hear experiences from other trust. I get to learn how they do it. And there’s especially are the demonstrator trusts like Leeds and then Hull trust, which is quite advanced already.
So, you know, whenever I attend these meetings, I get a lot of input and say, oh, is it going to be applicable to our trust and all that? So I get to have these insights and these ideas. So indirectly, they actually, help and support me with the implementation of Scan4Safety in our trust.
Anna:
In our previous conversation, you mentioned to me that you’ve established a, superuser position and there’s other people that are there day to day to help, other, members of staff. Can you tell us a little bit about that? Because I think that sounds like it works really well.
Ricky:
Yes. So we do have what we call Scan4Safety champions. So these are the individuals who are working in a specific area. So they are either ODP they are a scrub nurse, or health cares. So what we do with these champions are they serve as our first line of support. So whenever there’s going to be questions about oh, why is my procedure not showing up? Why is this surgeon unable to, you know, I mean, like I couldn’t relate anything, or why is this item not getting picked up? So these champions are readily available to actually give them the answer. But in, in times when these champions are busy or they are faced with questions that they don’t know the answer. So that’s when they reach out to me as the superuser in the trust.
So fortunately, on our end, because most of the issues can be filtered already on our end. So the resolution is being given to them as soon as possible. So I try to filter them on my end and then if there’s anything already that I couldn’t answer, I couldn’t figure out. That’s when I reached up to Genesis for help.
But probably 90% of our issues, we can already filter it ourselves here in the trust. So that’s and then we also have our inventory management theatre assistants who are equally capable of like investigating because our most common issues are like barcode not scanning, or there’s an implant that did not generate an automatic order because of any issues. So we all help each other as a team here.
And so the resolution is much faster.
Anna:
And in our previous conversations, you talked to me about the guidance that you’ve developed to assist staff, so that they understand the importance of scanning and to ensure that they were scanning the right things at the right time. Can you tell us a little bit about that guidance?
Ricky:
Yes. So, we’ve built Scan4Safety guidelines for both inventory management and end point of care. So speaking with point of care. So when we talk about Scan4Safety it’s really aiming for patient safety. So two guidelines that we’ve introduced, very important ones are, number one, they need to scan the patient wristband before the start of the procedure so that they will know that whoever they’re recording in that Genesis handset is actually the same with the one wearing the wristband.
So traceability wise, we can definitely get all the patients that receive, who receive that particular item for an investigation or for product recall. Another one is scanning the implant before. Well all items but especially implant. Before giving to the scrub team because the system that we’re using right now has the capability to show up warning messages like is it expired. Is it expiring, is it a part of a product recall. Or if it’s a wrong body side. So these things we need to capture first before we actually open anything. Because if you open an implant and it’s wrong, it’s a waste because it’s not going to be used. So those are probably two of the major guidelines that we’ve placed for point of care in theatres.
And so currently, we’ve put them in their bulletin boards. We also have our how to guides in each of the theatres. And inside the theatre we have the list of the point of care process flowchart and then the chronological order, how they do it, and our Scan4Safety reminders. So we’ve managed to target all media.
So we have emails. So we have our visual aid which you know some people would prefer to really see it there. Some would prefer to use the digital way. So we’ve tried our best to cater all learning methods from each of individuals. And then if they have any more recommendations and how they can receive better information. So we try to cater and give it to them as much as possible.
Anna:
Thank you for sharing that. That’s a really good practice. That sounds really good.
Ricky:
Thank you.
Anna:
It sounds like a lot of hard work has gone into getting to where you are today. What are the main benefits the trust is now seeing as a result of Scan4Safety? How has it impacted on things like cost savings and operational efficiency?
Ricky:
For efficiency is we were able to eliminate, a few task manual tasks done by staff and even from finance. So let’s say, for example, recording of implants. So well, there are still other theatres who prefers to actually have this, notebook, put all the stickers. So it’s still, you know, it would probably take them like 10 seconds to do it.
But, I’ve already communicated with everyone that because we’re digitally recording these items so we can actually forego the manual one and then if you, if you even want to ask, Riky, we need to know what implant did this patient has gotten? So it’s okay. Just give the D number and we’ll give you all the items or the implants used on that patient.
So we’ve already shared that one. So some of the areas are already not using the notebook. So that’s operational efficiency definitely on their end. And another soft savings that we did is the ordering of our ophthalmic lenses. So it was the staff members who orders, I mean, who ordered this. The ophthalmic lenses directly to the supplier’s website.
So now because we’ve gone live with Scan4Safety and it can already be auto ordered when they scan it and use it. So we now have removed that task from our theatre staff members to our inventory management theatre assistants. So that’s going to be an efficiency on their end, so they can focus more on the patient and probably other tasks related to clinical activity instead of ordering. Because we try our best to really move all the ordering from the theatre staff members to our inventory management.
Another of efficiency and probably cost savings that we’ve also done is our excluded devices. So these are really high-cost devices that we can get refund from NHS England. And previously before we went live at all of the theatres. So the staff members actually complete an excluded devices sheet where they put the implant, the surgeon and how many were used, etc..
And so we’ve eliminated the process already. And then because all the implants are recorded in the system, the finance team can already pull report from the tableau system which houses or stores the Genesis data, and they can run it whenever they want. So they’re no longer had to wait until it’s complete or at the end of the month for them to complete a usage report because they can already pull it, from the Tableau system.
So that’s also one of the things that, we have seen as a benefit. So it can definitely save time. It can have some soft savings. As to the hard savings, I am yet to actually, you know, get to know how finance is doing it. But in our trust, we have our regular par level review. So, this par level review would ask each area, not just theatre, but even other areas to review their minimum and max level so that if they feel like this particular item is not frequently used, then we can reduce the max level so that we can prevent wastage.
So that’s one of the benefits of having Scan4Safety, and IMS process, actually is reducing the waste because we are only ordering based on how frequent they’re using it. Well, except for holidays or specific days where they have to really increase the orders to cover those, days that they’re not present, but on a regular basis.
We do have that par level review to ensure that we don’t have any waste, or we are only ordering based on what they need.
Anna:
Can you tell me who came up with this idea to create your post? Who was it in the hospital that wanted Scan4Safety implementation?
Ricky:
You’d be surprised. It actually came from procurement.
Anna:
Really?
Ricky:
Yeah. It did not come from the clinical side. So. And that’s why I think it was from procurement that the business case was done. And so once it was approved then that’s when we checked the scope. So what is this business case all about. What are we aiming. So it’s really more of. And that is why it’s just a two-year post.
Because their initial aim is to implement Scan4Safety in all of the theatres. But now, because we were able to finish it earlier than expected. So we were able to look for, other areas where we can actually implement Scan4Safety before I leave.
Anna:
I’m just thinking about future plans. You said that the funding was only for two years, but you’ve done so well that now you’re looking at new areas where you can start, implementing Scan4Safety. Can you tell us a little bit more about the next steps, for Scan4Safety in your organisation, are there new areas or innovations you’re exploring?
Ricky:
Yes. So, we are going to deploy Scan4Safety in interventional radiology, end of this month, probably first week of October. And then we’re also looking at deploying this one to audiology department because audiology also has like bone anchored hearing aids and all that. And then just probably last month we also received a request from the digital asset team if or even from the medical devices team, if we can cater the traceability under Scan4Safety.
Anna:
Well, it’s fantastic to hear that from members, clinical members, of the organisation not being interested in Scan4Safety, now they can see and hear about it, see it in action and then there’s more and more engagement from new areas and people coming to you to ask if it’s possible to help them implement it in other areas.
That’s a really big achievement.
And is there anything you would do differently, if you could go back and start again?
Ricky:
If there is something I could have done differently? In all honesty, I could have made much, much extra effort to put, Scan4Safety under the radar of the trust because unfortunately, Scan4Safety is not part of the trust initiative. So that’s why they weren’t able to really give focus on continuing Scan4Safety even for this financial year.
But I could have, you know, I was able to talk to a different senior manager management team. So efficiency, patient safety and all that. So I was able to give them the overview on what Scan4Safety is the objectives and all that. But that’s really just it. Also make sure that you get senior management support.
It’s very important because if you yourself can foresee a really bright future of Scan4Safety in your trust, you see a lot of future use cases. Take that opportunity to get the buy in from the senior management so that they themselves can actually tell you, okay, what else do you need? We’ll get that fund for you.
But yeah. So I mean like if other trusts can do it. if our trust was able to do it, I’m sure you can do it as well. Just believe in the answers of your why’s.
Anna:
Thank you Ricky. Thanks a lot. And thank you for joining us today for what has been a really insightful and informative discussion. We’re all very impressed with what you’ve achieved at Doncaster and Bassetlaw in such a short time. And, I’m sure our listeners will find this really helpful in considering their own approaches to Scan4Safety
And to find out more about Scan4Safety, you can visit the Scan4Safety website, scan4safety.nhs.uk. You can also follow our X account using the handle @Scan4Safety. And finally, you can find a range of resources on our Scan4Safety Future NHS workspace, which is part of the wider NHS Digital Clinical Safety Strategy space.
Thank you for listening.
Publication reference: PRN01598