Rotamap

Case Study: Streamlining Clinician Contact - Software Enabled Efficiency in Healthcare

Manish Thakrar, Medical eRostering Project Lead, University Hospitals of Leicester NHS Trust - 2024

Introduction

In the healthcare sector, efficient communication is paramount, especially when it involves contacting on-call clinicians for urgent patient care needs. Traditionally this process involves going through a switchboard, which could introduce delays and potential miscommunications. University Hospitals of Leicester NHS Trust (UHL) explored how the implementation of Rotamap’s ‘Overview’ tool facilitated transparency and efficiency in contacting on-call clinicians, bypassing the traditional switchboard method for colleagues within the Trust.

Background

UHL is one of the biggest and busiest NHS Trusts in the country, serving over one million residents of Leicester, Leicestershire and Rutland. UHL has a substantive medical workforce of approximately 2,800 staff, and a bustling emergency department (one of the largest in the country).

Challenge

Initially, UHL had two main challenges with its existing system for contacting on-call clinicians, which centred around:

Solution

To address these challenges, UHL implemented Rotamap’s Overview tool – a web based portal (and supporting mobile app) which automatically amalgamates all the on-call data from every department that had deployed Medirota or CLWRota - Rotamap’s online rostering systems.

In doing so, the first challenge was addressed by ensuring the Switchboard had instant updates to see which clinician was on-call for any given department and in a uniform format, all in one place. Any subsequent changes to a department’s schedule were automatically fed through in real time from each department’s online rostering system to the Switchboard's Overview for on-calls. This eliminated the dependency on individuals to proactively keep the Switchboard appraised - in a timely manner - of any late changes to a previously published schedule. This reduced the administrative burden and the window for human error.

Through close consultation with UHL, Rotamap designed and released the Overview mobile app which addressed the second challenge. Access to the Overview app was given to senior leaders, Consultants, and the operational management team, allowing direct access to the on-call Overview on the go (via iOS and Android mobile phones and tablets). This allowed senior staff to directly contact on-call clinicians without first going through the Switchboard, avoiding delays from callers having to queue for the Switchboard.

Implementation

The implementation of the Overview and its supporting app involved several stages:

1. Needs Assessment: UHL conducted a thorough assessment of its communication challenges and identified the specific requirements for the software solution.
   
   
2. Rotamap Consultation: Rotamap generated an Overview for UHL’s Switchboard using their Mapping feature. The mapped on-call activities then pull any updates through in real-time, saving any additional need or duplication of effort by departments to keep the Switchboard appraised of updates to their on-call schedules.
   
   
3. Training and Adoption: Switchboard team leaders received training on using the Overview, including how to filter from scores of on-call activities from dozens of departments across multiple sites; how to toggle from daily to weekly views; and how to add additional local information to supplement the information fed from a department’s on-call schedule. Rota teams also received a consultation from Rotamap and / or the Medical eRostering Project Lead to advise how the solution takes shape based on each department’s decision-making (and ultimate control) over which of their on-call activities should be mapped across to the Overview for viewing by colleagues outside their department.
   
   
4. Key Success Factors: The following three factors implemented by the Trust ensured success in overcoming the challenges above:
   
   
   1. Leadership Support - Further to an internal presentation by the Medical eRostering Project Lead to the Trust’s senior clinical team (chaired by the Medical Director and attended by the Deputy Medical Directors, Clinical Directors and Deputy Clinical Directors) support was secured to advise all Consultants to share a contact number in Medirota/CLWRota (supported by an updated Trust equipment policy, of which more detail below). This was achieved with a memo from the Medical and Clinical Directors to all Consultants.
      
      
   2. Equipment – To secure support from all Consultants, the Trust offered each Consultant (who may have been relying on their personal mobile phone number) an option to either receive an eSIM card for their mobile device, or a Trust supplied mobile phone. In doing so, Consultants were able to support the request from the Clinical Leadership to share their contact number in Medirota/CLWRota without any need to share their personal contact number. Linking Consultant numbers to hashed extension numbers also allowed direct contact without the need to display individuals’ numbers.
      
      
   3. Reporting – the Medical eRostering Project Lead generated a weekly report for the Medical Director and Deputy Medical Director (Project Senior Responsible Owner) highlighting the level of compliance for Consultant phone number sharing by the Clinical Management Group (CMG) and departments. This was used by the Medical Director and the Deputy Medical Director as necessary to urge Clinical Directors to increase compliance for their respective services.

Data

Reduced number of calls to switchboard

Over the course of two years the Overview mobile app has been accessed by UHL colleagues more than 11,700 times, meaning clinicians and managers avoided waiting to access the Switchboard queue. An illustration of this can be seen in the graph below which shows the count of inbound calls asking for the on-call clinician to switchboard reducing as the On-call Overview was rolled out:

We can also view this data by comparing based on the month of the year:

Reduced call duration

Not only did the number of calls reduce but the time taken for those calls to come to a conclusion reduced:

Looking in more detail, we can map call duration by month, as shown in figure 2 below. We can see that more calls over time are finished around the 25 second mark and fewer calls last longer than a minute (this went from 2,346 in June 2023 to 1,142 in August 2024).

Results

The implementation of the ‘Overview’ for on-calls and its mobile app yielded several positive outcomes for UHL:

Reduced Response Times:
By bypassing the switchboard, medical staff could contact on-call clinicians quicker, leading to faster response times for urgent patient care needs.

Business Process Improvement:
Uniformity in the way on-call information is presented to call handling agents on the Switchboard meant quicker identification of the on-call clinician.

Enhanced Efficiency:
The real-time feed from each department resulted in greater accuracy for calling the correct on-call clinician at first pass. Direct calling facilitated by Rotamap services increased overall operational efficiency within the hospital, reducing bottlenecks and delays.

Enhanced Patient Care:
With quicker access to on-call clinicians and improved communication capabilities, UHL is better equipped to deliver high-quality patient care, particularly in emergency situations.

Testimonies

Several anecdotal statements from colleagues (some noted below) provide testimony to the success of deploying Rotamap’s Overview to bring about system improvement, greater efficiency, and transparency; all of which contribute to better patient care:

"We can’t wait until all services move their on-calls to the Overview"
- Switchboard Team Leader

“So much simpler and it’s instant; everything is there. It’s so much better”
- Switchboard Team Lead 2

“The On-Call Overview system has significantly enhanced the ease and efficiency of identifying the on-call personnel”
- Switchboard Team Lead 3

"The Overview is great; it makes life so much easier to see all services in a single view"
- Divisional Deputy Head of Operations

"The Overview app will save a lot of time – there are lots of colleagues who would find this information helpful"
- Medical Consultant

Conclusion

By leveraging software solutions like Rotamap’s Overview and its mobile app, UHL successfully overcame communication challenges associated with contacting on-call clinicians.

The implementation of this technology not only improved business process efficiency but also had a positive impact on patient care outcomes by reaching the correct on-call medic at first pass, and in less time than it took before the On-Call Overview was introduced.