Guy’s and St Thomas’ NHS Foundation Trust

Background

Guy’s and St Thomas’ NHS Foundation Trust (GSTT) is part of the South East London Elective Orthopaedic Network (SELEON) collaboration. Alongside King’s College Hospital NHS Foundation Trust (KCH) and Lewisham and Greenwich NHS Trust (LGT), their aim is to ensure that patients in South East London receive world-class outcomes following elective orthopaedic surgery.

Amplitude was awarded the contract for all three Trusts and was instructed to provide an electronic platform to record National PROMs for hip and knee primary and revision arthroplasty surgery.

The Approach

The Amplitude pro enterprise™ platform was launched at Guy’s and St Thomas’ NHS Foundation Trust in October 2020 with the focus being on increasing National PROMs compliance and streamlining their data entry processes.

The Trust’s system is managed by their dedicated Clinical Outcomes team, who work with the consultants to ensure patient records are kept up to date. As soon as a patient is offered a surgery date, they are sent an SMS message inviting them to register to Amplitude and complete their online pre-op Patient Reported Outcome Measures (PROMs). Patients will also be sent an information leaflet in the post alongside their surgery confirmation letter, explaining what PROMs are and the importance of collecting their surgical data.

If patients do not complete their pre-op scores within a set time frame, they will receive up to three follow-up emails that are sent directly from the Amplitude platform. Anything still outstanding will then be passed over to the Clinical Outcomes team who will then call up patients and offer them assistance in completing their remaining tasks.

Although this process is not unique to Guy’s and St Thomas’ NHS Foundation Trust, it is one that required a lot of system training and continued support from their Account Manager. Therefore, both virtual and onsite training was carried out to ensure every member of the Clinical Outcomes team was equipped to support and run the new platform. The process gets patients involved from the very start of their surgical journey, and it is for this reason that Guy’s and St Thomas’ NHS Foundation Trust have such high National PROMs compliance.

The Result

The Amplitude pro enterprise™ platform has been implemented at the Trust for just over two years and has allowed the Trust to collect data that is relevant, precise and representative. The data is also retained locally and can easily be accessed by consultants for reporting and auditing purposes.

The reporting functionality of the platform has also allowed the Trust to drill down and quickly identify which patients have outstanding tasks before they come in for surgery. This has allowed the Clinical Outcomes team to easily locate patients who have outstanding pre-op tasks and patients who have not had a procedure form added to the records after surgery.

To date, Guy’s and St Thomas’ NHS Foundation Trust has one of the highest Q1 National PROMs compliance rates in the Amplitude network. The Trusts statistics for October 2020 to March 2022 can be seen below:

*Number of pathways = number of active patient cases

**% Completed Q1 PROMs = percentage of mandated Q1 National PROMs questionnaires completed by patients

Future developments

The team at Guy’s and St Thomas’ NHS Foundation Trust are continuously striving to become the leading NHS Trust in the Sout East London area. Therefore, they are committed to refining and expanding their digital processes to ensure their patients continue to receive world-class outcomes. Guy’s and St Thomas’ NHS Foundation Trust plans for further developing the outcomes programme include:

• Improving Q2 National PROMs compliance rates.

The Trust already has an exceptionally high Q1 compliance rating, which is largely due to the streamlining of their data collection process. Plans are now in place to monitor and promote patient Q2 engagement.

• Annual / bi-annual review of patient outcomes scores, utilising Amplitude’s reporting functionality.

Regularly reviewing patient outcomes scores will allow the Trust to ensure they continue to operate at a high clinical standard. There are also plans to take a deep dive into patients ‘returning to activities’ questionnaires so that the Trust can evaluate improvements in their patient’s quality of life. These reports can then be used to highlight areas for improvement, identify any trends, and can be used to congratulate Consultants on outstanding clinical achievements by providing quantitative data on their work.

• Monitoring of patient reported complication.

Now that the Trust has collected a substantial amount of patient data, they are able to review the outcomes of patient procedures and report on any complications post-surgery. This will help the Trust to identify if there are any patterns amongst their patients and assess what improvements can be made to further reduce the risk of complications post-surgery.