Odyssey clinical decision support helps nurses prioritise and care for patients effectively over the phone and offer best practice at all times, says Florence Road Lead Nurse, Dawn Douglas
Florence Road is a six-partner practice in London, supported clinically by four practice nurses, two nurse practitioners and a healthcare assistant. Like many practices, we serve a very diverse but also transient patient population, which brings many challenges to ensuring safe and effective delivery of healthcare.
In 2000, we had a practice population of around 11,000 patients and needed a better way to manage demand for same-day appointments. The approach needed to be consistent, objective and evidence-based to ensure the safety of our patients and provide best management for the ever-growing demands on our service.
We wanted to use our skill mix better, provide telephone assessment when safe and suitable to do so, and quickly identify patients who needed more urgent intervention.
We needed a robust process to help us identify those who could safely be given a routine appointment or self-care advice. It was also important that the solution was acceptable to both patients and staff.
A rapid means of creating detailed and auditable documentation of what had been explored and agreed with the caller was necessary. The nursing team also needed to be able to use their knowledge, skills and experience and not feel they were being driven by a software programme.
Our research led us to the market-leading electronic decision support tool, Odyssey. This had been used for several years by our local out-of-hours service to support nurse triage, and we knew of its effectiveness.
This clinical decision support software had been developed by Plain Healthcare from NHS research and practice. We have now used Odyssey for more than 10 years to assess around 30,000 calls from patients requesting same-day appointments without any complaints or errors. It has consistently met our needs as we continue to improve our service to patients.
The nursing team assess all callers requesting same-day appointments supported by the software, which is embedded within our EMIS system. Many of these callers are happy to self-manage with appropriate and consistent safety netting.
Odyssey offers best practice self-care text when a patient's problem is identified as non-urgent or suitable for advice.
With Odyssey we are confident that the assessment undertaken and advice given is always evidence-based, and a detailed record is easily created and available for any future consultations. Our nurses consolidate their learning with every assessment, and the average call time is around five minutes. Together, we save a significant number of appointments and therefore cost to the practice.
We are now able to allocate appropriate appointment times for patients in the knowledge that the timeframe is safe in relation to their unique presentation. This reduces pressure on receptionists and enables us to plan capacity more effectively. GPs now see more complex problems and the nursing team deal with issues relating to minor illnesses.
We have recently merged with another practice and our list size has increased to 14,000. In the last year, our nurses used Odyssey to safely assess and prioritise more than 3,500 patient requests for same-day appointments.
With more practices now understanding the patient care and cost-saving benefits of nurse telephone triage and reception prioritisation, Plain Healthcare has recently developed a web-deployed version of the software, "Odyssey PatientAssess", specifically for GP practices.
We have been involved in testing this and the accompanying eLearning tools, and found that 30 minutes with the "Get Started" module, followed by access to a practice site, equipped our staff very well to carry out both receptionist sorting and prioritisation, as well as nurse telephone assessment.
Dawn Douglas is Lead Nurse at Florence Road Surgery in Ealing, London
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