Emergency Medicine Handbook App

Name: Angela Hall

Email: Angela.hall@rlbuht.nhs.uk

Service/organisation: Royal Liverpool & Broadgreen University Hospitals NHS Trust

Who asked: I was approached by both an Emergency Dept. Consultant & the Director of Medical Education…

What did they say? …who asked if I would project manage the conversion of our Emergency Medicine Handbook into a mobile App. The Handbook, a 580p document covering 21 specialties and contributed to by 48 clinicians throughout the Trust had resided on our Hospital intranet for several years. The handbook covered the management of common acute conditions that may be presented by either in-patients or people arriving at the Emergency Department. It links in with relevant Trust Policies & protocols, useful contact information & also local, regional and national guidelines. As the ownership of smart phones is almost universal among NHS clinicians, they wanted to provide this information in a more portable format, providing easy access to the evidence base, available when and where our clinicians needed it most, at the point of care, where rapid answers are required by clinicians to improve safety as timely intervention improves outcomes for patients.

What did you do? Having established that our own I.T. Dept didn’t have the capacity to tackle such a project in the allotted time & given that the Director of Education had agreed to allocate funding for such a project, I made contact with 3 companies. Based on price, experience & location, we chose a company based in Warrington called Appitized who already had experience of producing 10,000 Apps worldwide.

The App development process was as follows:

  1. App Project Specification agreed and signed off
  2. Initial App Designs completed
  3. App Design feedback/changes (if required)
  4. App Designs approved by customer
  5. App Development begins
  6. Testing of 1st app version
  7. Bug fixing (if required)
  8. App complete

We were given an estimated time of 12 weeks to complete the App. However, in reality, it took 6 months. This was mainly due to delays whilst I liaised with several Departments within our Trust e.g. our Risk Department in allowing us to have Trust policies made available outside of the Trust; our Data Protection Office to ensure that Non-Disclosure & Information Sharing Agreements were signed by all relevant parties; our legal Dept. in authorising our disclaimer notice; the time it took to get our App enrolled in the App Developer program in order for it to get hosted on the App store.

The App is now freely available to download for both iPhone and Android devices on the ITunes and Google play stores. The App can be searched by keyword, phrase or category. Bookmarks can be created for easy access to favourite sections. Users can provide feedback for each page or section. At the heart of the App is a simple to use ‘Content Management System’ which means that both the Android and iOS Apps’ clinical content can be updated as and when required e.g. if a Trust Policy is updated or the management of a condition changes, then, in real-time, we can instantly send out a ‘Push notification’ to all users of the App to notify them of any changes. We have also ensured we can view statistics on downloads and usage data at ‘App Annie’ – a programme which provides App analytics.

I had a marketing campaign to promote the App producing newsletters & 6ft pull-up banners strategically placed throughout the Trust. I’ve made presentations to junior Doctors at induction and other educational meetings. We produced a short video of the App which is available via YouTube: – http://www.youtube.com/watch?v=HVwHdjw-z8Q&list=UUMFqG-mErXVSx_7YjGeebkA

Bay TV Liverpool, an Internet based TV Channel, picked up the story and came to the Royal to do a news piece on our innovative creation: https://appitized.com/project/nhs-handbook-app/

How did it help? We have had nearly 6000 downloads in 86 countries, suggesting that the App is being used to provide the correct care in environments where there may be limited access to this information.

As a result of this, the App has won a national MOMA award for the best marketing of an App in the public sector, beating the Ministry of Defence. Locally, it has also been awarded the ‘Chief Executive’s Award’ and the ‘Star of the Night’ award in the Royal Liverpool & Broadgreen University Hospitals NHS Trust’s annual ‘Make A Difference’ Awards ceremony. Aidan Kehoe, Chief Executive of the Trust, explained why it won these awards: “The ED app provides clear benefits to our staff and patients in improving the quality of care whilst providing a more efficient way of working. It supports our culture of learning and in creating the app, the team demonstrated enthusiasm and commitment to our values, going above and beyond to deliver a product of exceptional quality. This app demonstrates our commitment to working with our staff and investing in the latest technologies to improve patient care.”  Kiera Vaughan, one of the junior Drs and star of the BBC3 Junior Doctor’s series said “The app is a great idea and I have used the app when treating patients with a wide variety of illnesses to ensure their management is in keeping with the latest guidance. This handy app has links to current guidelines, useful contacts and trust policies as well as advanced life support protocols making it an invaluable patient safety reference tool.

More recently, in 2016, we have entered it for the patient safety and congress awards and are eagerly awaiting the outcome.

Please see also the article:

Connecting its workforce to corporate knowledge & best practice:  how the Royal Liverpool & Broadgreen University Hospitals NHS Trust (RLBUHT) Library Service is utilising clinicalskills.net

Please note this is a full-length version of an article that appeared in the HLG Newsletter, volume 33 number 2.