Health> Vol.6 No.5, February 2014

Going “paperless” in an English National Health Service (NHS) breast cancer screening service: The intriduction of fully digital mammography

DownloadDownload as PDF (Size:140KB)  HTML    PP. 468-474  

ABSTRACT

Objective: To test the feasibility of a fully paperless system, termed “paperlite” in a UK breast screening service. To demonstrate in NHS practice, how workload and workflow could be improved by moving to a paperless system and discovering what impact this has upon the complexity within the service. Setting: Warwickshire, Solihull and Coventry Breast Screening Service in the West Midlands of England. Methods: Quality improvement methodologies were employed, including value stream mapping, task analysis and a time-and-motion study. Results: The screening centred screened approximately 50,000 women per year. If they were to implement a paperless system, the administrative workload would decrease. The time saving per batch of screens, which could be achieved by moving to the paperless system ranged from 19 to 56 minutes (mean = 36 minutes). When calculated by batch the mean time saving per woman screened by moving to the paperless system was 42 seconds. This equates to 583 hours of administrative work per year in a centre screening 50,000 women. Conclusions: The paperless system has many benefits compared to the original system in terms of reductions in waste, time and cost. The simplification and standardisation of the process resulted in fewer tasks and interfaces where errors could occur, hence inadvertently improving patient safety. The limitation of the work is the heavy reliance on technology, live interfacing with computer databases and software stability is necessary for a paperless system to be used in NHS practice.

Cite this paper

Taylor-Phillips, S. , Grove, A. , Hoffmeister, S. , Wheaton, M. , Coult, S. , Essex, J. , Hackney, J. , Cioccio, S. and Clarke, A. (2014) Going “paperless” in an English National Health Service (NHS) breast cancer screening service: The intriduction of fully digital mammography. Health, 6, 468-474. doi: 10.4236/health.2014.65065.

References

[1] NHS Breast Screening Programme (2012) NHS Breast Screening Programme 2012 Annual Review.
http://www.cancerscreening.nhs.uk/breastscreen/publications/2012review.html
[2] NHS Information Centre (2012) Breast Screening Programme, England 2010-11. The Health and Social Care Information Centre, Screening and Immunisations team. https://catalogue.ic.nhs.uk/publications/screening/breast/bres-scre-prog-eng-2010-11/bres-scre-prog-eng-2010-11-rep.pdf
[3] ONHS Quality Improvement Scotland (2008) Health Technology Assessment 10 determining the most clinically and cost-effective way of implementing digital mammography services for breast screening in NHS Scotland. www.nhshealthquality.org
[4] Cross, M. (2013) Experts question size of savings from NHS going “paperless”. BMJ, 346, f438.
http://dx.doi.org/10.1136/bmj.f438
[5] Limb, M. (2012) NHS will be paperless by 2015, says commissioning board. BMJ, 345, e6888.
http://dx.doi.org/10.1136/bmj.e6888
[6] Purves, I.N. (1996) The paperless general practice. BMJ, 4, 1112-1113.
http://dx.doi.org/10.1136/bmj.312.7039.1112
[7] Waring, N. (2000) To what extend are practices “paperless” and what are the constraints to them becoming so? BMJ, 50, 46-47.
[8] Carr-Bains, S. and de Lusignan, S. (2003) Moving to paperlessness: A case study from a large general practice. Informatics in Primary Care, 11, 157-163.
[9] Hippisley-Cox, J., Pringle, M., Cater, R., et al. (2003) The electronic patient record in primary care—regression or progression? A cross sectional study. BMJ, 326,1439.
http://dx.doi.org/10.1136/bmj.326.7404.1439
[10] Harvey, J. (2008) End of the paper trail: Moving towards a paperless ward round. The Psychiatrist, 32, 67-68.
http://dx.doi.org/10.1192/pb.bp.106.014225
[11] Allan, R. (2010) Paperless NHS hospital medical records. Clinical Medicine, 10, 315.
http://dx.doi.org/10.7861/clinmedicine.10-4-315
[12] Grove, A.L., Meredith, J.O., MacIntrye, M., Angelis, J. and Neailey, K. (2010) Lean implementation in primary care health visiting services in National Health Service UK. Quality & Safety in Health Care, 19, 1-5.
http://dx.doi.org/10.1136/qshc.2009.039719
[13] Department of Health (2013) Quality in the new health system. Maintaining and improving quality from April 2013. A draft report from the National Quality Board.
https://www.wp.dh.gov.uk/publications/files/2012/08/nqb-quality-draft.pdf
[14] Fillingham, D. (2007) Can lean save lives? Leadership in Health Services, 20, 231-241.
[15] Esain, A., Williams, S. and Massey, L. (2008) Combining planned and emergent change in a healthcare lean transformation. Public Money & Management, 28, 21-26.
[16] Wilson, G. (2009) Implementation of releasing time to care—The productive ward. Journal of Nursing Management, 17, 647-654.
http://dx.doi.org/10.1111/j.1365-2834.2009.01026.x
[17] Roueche, A. and Hewitt, J. (2012) “Wading through treacle”: Quality improvement lessons from the frontline. BMJ Quality and Safety, 21, 179-183.
http://dx.doi.org/10.1136/bmjqs-2011-000545
[18] Kaminski, G.M., Britto, M.T., Schoettker, P.J., Farber, S.L., Muething, S. and Kotagal, U.R. (2012) Developing capable quality improvement leaders. BMJ Quality and Safety, 21, 903-911.
http://dx.doi.org/10.1136/bmjqs-2012-000890

  
comments powered by Disqus

Copyright © 2014 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.