Great Western Hospitals NHS Foundation Trust


Historically, the Orthopaedic Department at Great Western Hospitals NHS Foundation Trust required significant manual input and administrative resource to manage their National Joint Registry (NJR) and National PROMS data submissions. At the time, clinical staff would complete paper NJR forms and administrators would be required to submit cases from these paper forms, directly to the NJR. Apart from these processes involving a mass duplication of efforts, there was no way for the Trust to access the clinical data, or use it for evidencing or reporting on patient outcomes and clinical service levels.  Furthermore, patient management was an entirely manual process that was supported by paper processes, again requiring high administrative resource to support. 

As a result, Great Western Hospital approached Amplitude Clinical Outcomes to transform and streamline their NJR and National PROMs data submission processes. 

The Approach

Amplitude worked with the Trust to adapt their existing NJR Minimum Data Set (MDS) process to enable it to support an entirely administrative approach. 

The Amplitude pro enterprise™ platform was launched in January 2021 and is primarily used to collect NJR and National PROMS data for electronic submissions to the NJR and NHS Digital. The NJR currently only accepts Hip & Knee data for electronic upload, therefore the Trust makes use of the Amplitude Hip and Knee Arthroplasty pathways. 

The Result

To date, the platform has been collecting data that is representative, accurate and meaningful, therefore providing valuable insight into the Trusts’ clinical outcomes. The platform also has an intelligent interface with Medway, which ensures all patients who are booked for an “Outpatient T&O Appointment” are automatically added to Amplitude and allocated to an appropriate pathway and consultant. This ensures that manual data input is kept to a minimum, saving the Trust valuable time and resources. 

Since the platform was launched 2021, there has been a steady increase in NJR compliance. In fact, Great Western Hospital has one of the highest NJR compliance rates in the Amplitude network. This is largely due to the dedicated involvement of the administrative team at the Trust, whose input and collaborative approach is considered invaluable in successfully adopting these processes in their environment. 

Future developments

The team at Great Western Hospital is constantly striving to fine tune and increase the efficiency of their processes. Therefore, Amplitude is currently identifying other processes supported by the administrative team that could benefit from adopting electronic solutions. Other new developments that are also in the pipeline include:  

  • Involving Clinical Staff in the Amplitude process 

Usually, consultants and clinical staff would input clinical data into the Amplitude system, with administrators assisting to finalise the records. However, at Great Western Hospital, the platform supports an entirely administrative approach. Therefore, the next step would be to update this process to include clinical staff input into Amplitude, thereby further reducing duplication of efforts, creating efficiencies and providing an improved clinical structure. 

  • Extending the Amplitude service to better support Administrators 

Amplitude currently hosts seven UK registries. This means data can be recorded centrally at the Trust and then automatically sent to the relevant registry. This allows Great Western Hospital to have electronic, collaborative access to clinical and patient outcomes data at Trust level. The plan is now to work with the Trust to increase their involvement with several registry databases and generate a National Hip Fracture Database (NHFD) extract for manual upload. 

  • Extending the Amplitude service to better support Clinical Staff 

Amplitude offers a variety of comprehensive upper and lower limb orthopeadic pathways, which have been specifically designed to support elective and trauma workflows. Once these new pathways are in place, we would expect to see a reduction in manual administration and an increase in the amount of data being recorded, monitored and reported on simultaneously 

  • SMS interfacing to improve National PROMs compliance 

Amplitude relies on a valid email address being present in the system in order to contact patients to collect pre- and post-operative data, which includes mandated Q1 and Q2 National PROMs data which is mandated for hip and knee arthroplasty procedures. With patient telephone number uptake averaging at 99.9%, versus email address uptake averaging at 55%, making use of SMS as the main method to contact patients has the potential to greatly improve National PROMs compliance rates. 

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