System for Electronic Notification and Documentation

SEND is the evidence-based, digital charting system for vital-signs observations in hospital and for the automatic calculation of Early Warning Scores (EWS).

SEND™

SEND enables digital charting for vital-sign observations in hospital and the automatic calculation of Early Warning Scores to inform clinical decision making. The system has enhanced the clinical care of 167,000 patients to date in all the adult wards throughout the Oxford University Hospitals NHS Foundation Trust and has already generated more than 33m observations since January 2015.

Tablet computers are used for data entry and mounted on the same stands as the physiological monitors used to measure patient vital signs. This extensively researched design is intended to minimise barriers to timely data entry and facilitate viewing of current and historical observations at the point of care whilst unshackling a clinician from a hand-held device to be able to give care. A clinician’s ‘at-a-glance’ dashboard can be accessed remotely and from the nurses station, to facilitate team-based working and enable clinicians to monitor and prioritise care to patients most in need.

SEND v1.2.4 and SEND v1.3 have both been assessed as Class 1 Medical Devices and have Declaration of Conformities in place and have been submitted to the UK National Competent Authority (MRHA).

Impact

Releasing time to care – The SEND pilot study at the John Radcliffe Hospital in Oxford has produced some compelling clinical validation and has enhanced the clinical care of over 200,000 patients to date in all the adult wards throughout the Oxford University Hospitals NHS Foundation Trust.

30% Reduction

Average reduction in time to undertake a set of vital-sign observations

3.5 nurses

Equivalent time released for care per 24 hour period

33 million

Observations generated since January 2015

photo of a SEND Early Warning System stand

Designed by Clinicians

Vital sign observations are recorded and displayed in real-time on a digital version of a standard chart. This means that clinical users can view trends as they are recording a new set of observations, just like they are used to. Seeing the context lets nurses exercise their clinical judgement to spot when a supposedly normal vital sign is actually an early marker of deterioration.

Photo of a tablet device showing the SEND Early Warning System app

Useful Reporting

SEND provides real-time NICE Clinical Guideline 50 compliance data, saving time for ward managers. Reports are written so that targets are clearly and simply presented, and are designed to highlight potential problems in plain English to facilitate changes in practice.

Photo of a computer monitor showing the SEND Early Warning System desktop app

Interoperability

SEND supports important digital health and patient safety agendas; enabling better sharing of information to support, integrated, joined-up, continuous care. The system can be interoperable with your hospital EPR to support a complete patient record and audit trail.

Benefits

Invented in the NHS

Invented in the NHS for the NHS, as a direct response to a clinical need. Designed by clinicians to be faster than pen and paper.

Patient Visibility

At-a-glance information so clinicians can prioritise care to patients most in need. Digital charting enables remote access/monitoring.

Evidence-based

An evidence-based, human factors approach has ensured clinician adoption in the NHS.

Real-time Tracking

SEND displays real-time tracking information on observation timeliness and completion for each ward.

Patient Safety

Increased Patient safety - Positive Patient ID via wristband barcodes linked to clinician ID and patient record.

Supports Governance

Electronic capture of data enables detailed auditing of care and outcomes while supporting clinical governance.

In Partnership with

“Excellent innovation software, more please! Can you please change your careers and redesign NHS software for the good of humanity?”

(WARD NURSE)

Publications

2017

Quantitative Metrics for Evaluating the Phased Roll-out of Clinical Information Systems

International Journal of Medical Informatics

A ward-based time study of paper and electronic documentation for recording vital sign observations

Journal of the American Informatics Association

2016

SEND: System for Electronic Notification and Documentation

Oxford Technology Showcase

Evaluation of the effects of implementing an electronic Early Warning Score system: protocol for a stepped wedge study

BMC Medical Informatics and Decision Making

2015

Implementing an Electronic Early Warning Scoring System

Developing NHS Digital Roadmaps, London

SEND: a system for electronic notification and documentation of vital sign observations

BMC Medical Informatics and Decision Making

User-centred design for optimum development and deployment of an e-Health intervention

Digital Health and Care Congress, King's Fund, London

Integrated Digital Care Record

NHS England Case study

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