Imperial College Healthcare NHS Trust maternity service provides care for around 10,000 babies and their mothers each year throughout pregnancy, labour, and the postnatal period. The Trust introduced the Cerner electronic patient record system including a maternity module for clinical documentation in 2014.
Contractions and foetal and maternal heart rate are monitored using cardiotocograph (CTG) devices. Previously, the readings were printed out on rolls of paper. Midwives added handwritten clinical observations to these ‘foetal strips’ and used them to make critical decisions about the management of labour. These paper records were hard to share to quickly get a second opinion. They were prone to fading over time so did not always provide a permanent record and they were not integrated into the electronic patient records for our patients.
Key learning points
- Make sure that all contributing stakeholders are fully involved from the outset. As well as the maternity service and the IT team, this project required involvement from the medical equipment team for the cardiotocograph devices and estates for wiring and wall mounting of equipment.
- Understand the working environment thoroughly. Test the new equipment and how it is going to work in practice in a labour room. And if existing kit is used, ensure that it is fit for the new purpose. Ensure there is sufficient bandwidth for all of the new transmission of data.
- A significant risk identified in the early planning stages was the process of using the equipment with the next patient. The previous patient has to be ‘dissociated’ before the new patient is associated to ensure that data goes to the correct patient record. This has to be managed carefully.
- Equipment that takes advantage of wireless connectivity is more expensive but can last longer and give better patient experience – there is less risk of damage from wires being pulled out, and the patient can move around more freely.
To request access to the blueprint of this project, please email: firstname.lastname@example.org