07 Sep 2020
Dr Saif Ahmed: Digital COVID-19 tracker for care homes can have transformative impact across Greater Manchester
As cases of coronavirus began to rise dramatically, the ability of the virus to rapidly spread within care homes and put some of the most vulnerable in society at risk became an urgent issue to solve.
Care home staff needed support to track outbreaks among their residents and coordinate care with GP practices, social care and hospitals to optimally support residents.
In this blog, GP and clinical lead Dr Saif Ahmed explains how health and care professionals from Greater Manchester began working with tech company Safe Steps to solve this issue, creating a UK-first digital innovation in the process.
In Tameside and Glossop, we had been working with company Safe Steps for around 18 months to integrate their falls prevention app in our intermediate care unit and care homes, after first being introduced to them by Health Innovation Manchester. We had already begun to see the benefits of this as in the first 6 months it has been used almost 3,000 times and helped to reduce falls in the first 6 months by 21%. The work has also been nominated for three HSJ Patient Safety Awards.
But then in March, COVID-19 struck and the crisis prompted us to ask if there was a way to repurpose the falls prevention app to support care homes, as it was already in use in some homes. We knew that because of the multimorbidity and frailty of our care home residents, they were at a much higher risk of COVID-19. Unfortunately, outbreaks were happening and people were passing away, so we had to act.
We worked to modify the app into a COVID-19 tracker, allowing care home staff to input information about a resident’s COVID-19 related symptoms into a digital platform, which can be shared directly with the resident’s GP and NHS community response team to ensure that a swift assessment and response can be put in place. We also were able to add additional information such as advanced care plans and DNACPRs so we were prepared for any admission to hospital and could ensure the wishes of the resident were adhered to.
Essentially, the tracker uses a set of questions that carers can complete for each resident within 30 seconds and easily monitor for any changes. And because it was so simple and easy to use, uptake within care homes has been fantastic. Carers have themselves seen the benefits of using the app and have been regularly logging in to update the tracker as part of their day-to-day business as usual. We know staff are incredibly busy and if they weren’t seeing the benefit of the tracker, they simply wouldn’t continue to use it.
We’ve now just reached the milestone of 100% coverage in Tameside and Glossop with all 41 care homes using the app and proactively supporting over 1,300 residents, which is a fantastic achievement. In the first four months since it was first rolled out more than 70,000 resident assessments have taken place, including 971 residents assessed in a single day in August. We’re also adding more features into the app to provide additional support and information including recording soft signs of deterioration through RESTORE2 mini and monitoring oxygen saturation – one of the key signs of deterioration.
The COVID-19 tracker also allows the NHS to more closely monitor how care homes are doing during the pandemic thanks to a visual dashboard that displays the COVID-19 tracker information at an aggregate level. This, combined with the creation of a black alert system in Tameside and Glossop providing an overall picture across care homes in terms of staffing, PPE and situation reports, has allowed the locality to better to monitor the situation in care homes, know which are in need of more support and manage outbreaks when they have occurred.
In the past we’ve acted very reactionary with care homes and haven’t used the assets within care homes – the carers themselves – to proactively support the health of residents. Carers know their residents best and can pick up on the earliest signs of deterioration. By improving the digital literacy and capability of our care homes and empowering the staff we can tap into this information in a way we have never been able to do before. The tracker now lets them inform us when that’s happening and ensure we can react as quickly as possible, preventing hospital admission if we can and respect the wishes of the patient.
A key to the success of this work has been the partnership working and having key leaders supporting the project. Because, if you don’t have strong leadership and buy-in from the system, it won’t get rolled out. One of my roles is as the ageing well system lead for Tameside and Glossop so I have links with the NHS, neighbourhoods, adult social care and public health so we were able to bring those people together very quickly.
Having those links across the system, knowing who to pull in and creating a motivated team who see the benefits of the tracker has enabled us to move at pace to get this in place. The system know there is an urgency for this innovation and it drives us to deliver it quickly as we know the importance it will have in supporting us to increase the quality and safety of care for our residents. It is also vital to have the support from Health Innovation Manchester to drive the project forward and make it achievable at a rapid pace.
The benefits of the COVID-19 tracker can have a transformative impact for care homes across Greater Manchester which is why we are passionate about rolling it out to more localities. I do believe if we can get it rolled out across GM it will be a game-changer. Care homes in Salford and Stockport are already starting to use the app and we’re actively engaging with other areas to get the app embedded in the system as we approach winter and a potential second wave of coronavirus.