SEND: a system for electronic notification and documentation of vital sign observations

Abstract

BackgroundRecognising the limitations of a paper-based approach to documenting vital sign observations and responding to national clinical guidelines, we have explored the use of an electronic solution that could improve the quality and safety of patient care. We have developed a system for recording vital sign observations at the bedside, automatically calculating an Early Warning Score, and saving data such that it is accessible to all relevant clinicians within a hospital trust. We have studied current clinical practice of using paper observation charts, and attempted to streamline the process. We describe our user-focussed design process, and present the key design decisions prior to describing the system in greater detail.ResultsThe system has been deployed in three pilot clinical areas over a period of 9 months. During this time, vital sign observations were recorded electronically using our system. Analysis of the number of observations recorded (21,316 observations) and the number of active users (111 users) confirmed that the system is being used for routine clinical observations. Feedback from clinical end-users was collected to assess user acceptance of the system. This resulted in a System Usability Scale score of 77.8, indicating high user acceptability.ConclusionsOur system has been successfully piloted, and is in the process of full implementation throughout adult inpatient clinical areas in the Oxford University Hospitals. Whilst our results demonstrate qualitative acceptance of the system, its quantitative effect on clinical care is yet to be evaluated.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-015-0186-y) contains supplementary material, which is available to authorized users.

Early warning score adjusted for age to predict the composite outcome of mortality, cardiac arrest or unplanned intensive care unit admission using observational vital-sign data: a multicentre development and validation

“…The database includes vital-sign measurements of adult patients, aged at least 16 years, hospitalised in any of four hospitals of the Oxford University Hospitals (OUH): John Radcliffe Hospital (large university hospital), Horton General Hospital (small district general hospital), Churchill Hospital (large university cancer centre) and the Nuffield Orthopaedic Hospital, between July 2013 and March 2018, and in a single large district general hospital Portsmouth Hospitals (PH) between January 2010 and March 2017 (further details on the hospitals can be found in online supplementary table A1, appendix A). The data were collected using the system for electronic notification and documentation (Sensyne Health) in OUH14 and VitalPAC (System C) in PH 3…”

A ward-based time study of paper and electronic documentation for recording vital sign observations

“…Oxford University Hospitals (OUH) NHS Trust planned to replace a paper chart-based EWS system with the SEND e-Obs system in a phased roll out. [9] This created the opportunity to establish the effect of the introduction of an e-Obs system on the time taken to record vital signs observations across three wards in two university teaching hospitals.…”

A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: A multi-centre database study

“…A database of vital sign observations was collated from adult (aged at least 16 years) acute admissions to the Oxford University Hospitals (OUH) group and Portsmouth Hospitals NHS Trust (PH) as part of the Hospital Alerting Via Electronic Noticeboard (HAVEN) dataset 18 . Clinical staff recorded patients' vital signs at the bedside using the System for Electronic Notification and Documentation (SEND, Drayson Health, www.draysonhealth.com)19 in OUH and VitalPAC…”