Sheffield Children’s Becomes First Specialist Paediatric Trust to Integrate System C’s CMM Across EPR Pathway

Sheffield Children's NHS Foundation Trust has gone live with its integrated electronic prescribing and medicines administration (EPMA) solution provided by System C. They are the first paediatric trust in England to integrate CareFlow Medicines Management (CMM) with their own patient administration system (PAS) and other care coordination solutions, aiming to advance digital maturity, improve the inpatient process and provide a more transparent solution to medicines management.

The transition from paper drug cards to CMM took place across ten inpatient areasover three weeks from 11 September 2023. Phase two will focus on the remaining inpatient areas, Outpatients, the Emergency Department (ED), Becton Centre and Ryegate Children's Centre. The integration is a key milestone in Sheffield Children's Digital Strategy to achieve HIMSS EMRAM Level 5 digital maturity accreditation by March 2025.

Sheffield Children's procured the WellSky EPMA system through a tender process in 2020, before this was acquired by System C. Clinical and operational teams at Sheffield Children's were already using a suite of System C's EPR solutions including the PAS, CareFlow Connect, Vitals and Patient flow alongside the TMS Insight Pharmacy Tracker System. The Trust then worked with System C to join up the solutions across the entire pathway, linking information from multiple systems and integrating workflows between acute and community care , such as the discharge prescription feeding through to the GPs via the discharge summary.

The Digital Team conducted an extended and rigorous period of testing, including a pilot on one acute ward, to streamline processes in prescribing, administration, dispensing and patient movement. Detailed work was carried out to configure the drug files on CMM for Sheffield Children's to meet paediatric requirements, and the ambitious implementation plan to include infusions and its use in theatres.

Since going live on 11 September 2023, 1217 different staff have logged into CMM with 40,559 drugs having been prescribed for 4,353 patients. Staff at Sheffield Children's have reported prescribing efficiency and patient safety improvements as they have visibility of a patient's medication history and drug schedules, on one screen, from anywhere.

The Digital Team along with additional medical, pharmacy, nursing staff, and 'super users' from across the trust, worked together to raise awareness and train staff in the lead up to implementation and were on hand to support the wards 24/7 during the go-live period. Inpatient areas were grouped together based on the movement of patients through the hospital, to reduce the impact on flow as patients went between paper and electronic prescribing areas.

Figures accurate as of 21 December 2023.

Karen Bourne, Lead Pharmacist and Janet Dodd, Matron for Digital Technology, Sheffield Children's NHS Foundation Trust said:

"We wanted to aim high with our EPMA file build to optimise the system for our children and young people. We included additional functionality such as drug infusions and drug protocols to maximise the use of EPMA for our complex paediatric requirements.

Our multi-disciplinary approach to the planning and vigorous in-house testing ensured a smooth and successful implementation. We found a face-to-face communication approach resulted in good engagement with our clinical leads, the Executive Board, and end users.

A multi-faceted training programme including demonstrations, videos, user guides and most importantly direct support for users during and post implementation has proved essential. A key success was the team being visible and accessible to users at the time they required support with distinctive Digital Team t-shirts and a designated mobile phone number."

Nick Wilson, CEO, System C said:

"We have provided Sheffield Children's PAS for over ten years but as the trust has become more digital-focused, it gave us an opportunity to work together to integrate CMM and our other solutions, at scale, for the first time. This whole-team effort will transform the way staff work by providing all the information they need in one place."

The Trust went out to tender in 2020 for an EPMA solution, with specific paediatric criteria in relation to the wide variation in children's medicine dosages. CMM's bid was successful in 2021 before being acquired by System C in the same year. CMM is deployed in more than 200 trusts, health boards and hospitals in the UK, Europe and South Africa.

The next part of the Sheffield Children's digital journey is to implement Workspace, PDS/CPIS, and Clinical Narrative Document Exchange from System C.