In 2017, the Trust identified a cohort of patients who have not been tracked appropriately through its patient administration system, Lorenzo. It is not uncommon for Trusts to experience this kind of issue as a result of any new system implementation.
Around 85,000 patient records in total, some dating back to 2015, were identified as not having tracked properly. Following an initial review of those 85,000 records, a total of 7,433 patients have been identified as requiring further clinical input across various hospital departments. To set this in context, the Trust sees around half a million patients in outpatient clinics alone every year.
Ellen Ryabov, Chief Operating Officer at Hull and East Yorkshire Hospitals NHS Trust, said:
“Earlier this year, we identified a number of patients who had not been appropriately tracked through our patient administration system, prompting a review of those patients’ records.
“For completeness and assurance, we have reviewed records back to the implementation of the new Lorenzo system in 2015. The system itself is not the issue, rather its capabilities have helped us to identify the problem and all of the patients affected by it.
“We are confident that we have now identified all patients whose records had not tracked correctly, and those patients within this group who require further clinical input. To clarify, patients identified as requiring ‘further clinical input’ do not necessarily require medical treatment, but could need any of the following; discharge from the hospital; a results letter being sent to them; adding to a separate waiting list; being seen by a doctor or nurse in clinic; or further tests or treatment.
“The clinical review process, and that of contacting patients who require further clinical input, are both well under way, and these patients are being prioritised as appropriate.
“An investigation seeking to establish how the issue was able to occur will be undertaken in due course, once the review of all patients has been completed and all further clinical input arranged. Our focus and our priority at this stage is on patient care first and foremost.
“We would like to apologise to anyone who has been affected by this issue and remind people that we will be contacting them directly if any further action is required on our part. We would also like to thank those staff who have worked exceptionally hard to validate records in a very short space of time.”
The process for validating (reviewing) records comprises two stages:
- Admin validation, whereby Trust staff reviewed each record to ensure that all actions required on the patient’s record had been completed. The admin review of circa 85,000 records has now been completed in its entirety.
- Clinical review – following the above review, and where there is no definitive record of a required action being completed for a patient, the relevant consultant is asked to review the patient’s record again to determine what further action now needs to take place. Those considered highest risk and those dating back the furthest have been prioritised for review, and this work is now more than 50% complete. The Trust is working towards an end of March deadline for the completion of all clinical reviews.
The Trust has also established a committee, chaired by the Medical Director, which meets fortnightly to consider any cases where the patients’ conditions may have deteriorated or there is a view that the patient may have come to potential harm as a result of the tracking issues. Duty of Candour is being enacted in all cases where it is appropriate to do so.