In a remarkable demonstration of innovation and efficiency, Nottingham University Hospitals NHS Trust (NUH) has designed, set-up and tested a fully-electronic system for testing frontline NHS workers for COVID-19. The reconfiguration of the Inform Sexual Health system took just one day to complete and is now playing a pivotal role in the Trust’s management and containment of the virus, while supporting the wider community in achieving an overall strategic response to meet the national requirements for staff and household contacts testing.
The process starts when staff, or their household contacts, become symptomatic, which causes the staff member to be absent from work. When staff members report their absence, a designated person/manager uses a triage system of questions and, if the criteria are met, they are advised to call the sexual health team’s call centre to book an appointment over the phone. This has to be at least 24hrs after symptoms are first noticed. Demographic details, along with area of work and vehicle registration and colour information are collected and inputted into the system. Patients are then assigned appointments based on availability and issued with automated SMS confirmations.
The system assigns patients to one of three zones within the sexual health clinic’s car park and, one hour before the appointment is due to take place, a staff member prints off a barcoded label for swab kits. When patients arrive, a member of the security team reconciles the vehicle registration with the appointment on the system, before directing the vehicle to the appropriate zone. The affected staff member remains in their car, winds down their window and their details are checked. A sexual health nurse takes a swab and the test is complete, with the average test process taking just 95 seconds.
Following this process, kits are sent to the Trust’s laboratory for same day processing and results are returned to the system from the laboratory, where a nurse checks the results and generates an automated SMS result notification to all staff or household contacts immediately. This level of efficiency is particularly helpful for testing of household contacts, as staff who are well themselves can return to work quickly (usually within 48hrs) when their contacts’ test is negative.
The use of barcodes rather than handwritten labels have improved laboratory capacity and reduced errors, particularly useful in times of unprecedented demand on pathology services. This is thanks to Inform’s pre-existing integration with the laboratory systems and use of barcoded labels. The fully-electronic management of COVID-19 testing for staff has improved the efficiency of turn-around of results for staff and their household contacts in a timely manner, by the streamlined approach made possible between the sexual health service and the laboratory.
Key to integrating existing sexual health and laboratory IT systems was the Data and Systems Manager for Nottingham Integrated Sexual Health service, Howard Gees, and the IT Manager of the pathology laboratory at NUH, Karim Premji.
Howard explains “the Trust was in a fortunate position as the Sexual Health service has previously customised the Inform system to create a new organisation within the software to accommodate HIV patients, so the service had a solid blueprint to work with to fulfil the Covid-19 testing brief.”
The process of reconfiguring the system was rapid and required the creation of a new organisation in the system (with one location and three zones), as well as robust user acceptance testing.
The system is now playing a central role in actively limiting the transmission of the virus and safeguarding patient safety, by ensuring non-infectious healthcare professionals can return to work as quickly as possible.
Dr Ruth Taylor, head of NUH’s Sexual Health services, states: “the agility of this testing development would not have been possible were it not for the existing sophisticated yet user-friendly design architecture of the Inform system and the support from the people behind the products at Inform, who continuously go above and beyond to support the needs of our staff and patients.”
Susan Bunn, Inform Health’s Commercial Director, believes that Sexual Health services are perfectly placed to bolster NHS staff testing for COVID-19 and was pleased to support NUH’s reconfiguration free of charge.
Susan comments: “What NUH NHS Trust has achieved, and in such a short timeframe, demonstrates how Sexual Health services have the experience and capabilities needed – experience of testing for infectious diseases, laboratory integrations, automated notification methods and the ability to contact trace – to take up the mantle and redeploy systems and expertise to reduce transmission of COVID-19.
“The dedication of the teams and, in particular, Howard Gees’ talented and tenacious approach to adapting the Inform system, while working collaboratively with our developers, has created a fast, accurate, efficient and fully-electronic method of managing COVID-19 testing for NHS staff.