Elsie
Electronic Pre-Operative Assessment App
(NHS L Elsie ePreOp App)
Staff Briefing
Elsie
Electronic Pre-Operative
Assessment App
(NHS L Elsie ePreOp App)
Staff Briefing
ELSIE is the new digital Pre-Operative Assessment platform, (ePreOp) from NHS Lanarkshire, designed to replace the previous “paper based” system.
That system, despite being of a high clinical quality, required every patient to physically attend a hospital and answer questions with a nurse.
Notes were difficult to access and remote working was not possible.
Now, patients will receive a text message with a link to the Elsie app. They download it from the app store and using a code contained in the text, they can start inputting their medical history in minutes.
Our quickest fully completed Elsie Pre assessment so far has been 26 minutes!
NHSL has worked with a provider (Buddy Healthcare) over the past two years to build and customise a bespoke digital system. The new process was tested with patients prior to its launch and staff training has begun.
Dr Miriam Stephens, Lead for Preoperative assessment in Lanarkshire, explains,
‘Before COVID-19 there was an 8-week wait for Patients to get a preoperative assessment appointment.
‘We were very short-staffed and our processes, while very robust, were very old-fashioned. Everything was on paper, whereas the rest of the hospital is digital. This paper system created a lot of unnecessary work for the team and other clinicians in the hospital.
‘This has been an enormous project for our team across Lanarkshire, easily the biggest innovation we have seen in the last twenty years.’
Mandy Gilroy, Charge Nurse, Preoperative Assessment, University hospital Wishaw, who has been heavily involved in its development says,
‘One of our issues is we don’t have enough space for our staff to work on-site in Wishaw. With the NHS L Elsie ePreOp App, we can get our nurses to work more flexibly. We won’t need to wait for one of our doctors to physically come to the preoperative assessment clinic anymore. They can do their work remotely, on any site in Lanarkshire. It will make our processes much more efficient. It feels like we are catching up with the rest of the working world.
‘We had long felt an electronic system would be better, but with Buddy Healthcare’s Elsie app, we have a fully interactive system. The patients don’t have to take time off to come all the way to hospital, or even do a telephone appointment in many cases. They can fill in a lot of the details themselves on the app. Our specialist nurses will check it, and for a lot of patients, they wont need to see us at all at pre assessment.’
The system has the added benefit of being more environmentally friendly, reducing both paper usage, and time spent travelling by both patients and staff.
With the Elsie App, the hope is for many patients, they will complete questionnaires at home, have them checked remotely by a nurse and then not need any further input. This will greatly increase turnaround time for many patients undergoing minor or intermediate types of surgery.
The Elsie App also allows the patient to message their preop nurse directly to ask questions, and vice versa. They will receive reminders about important tasks before, and after their surgery, with the opportunity to fill out documents and receive information to ensure they attend the hospital on the day of surgery on time including guidance on Hospital layout, parking and even public transport options.
These active reminders are great for patients as they are often bombarded with a lot of information at the one time. This way, it is delivered in more manageable, bite-size chunks..
Patients only need to attend the hospital for pre-operative appointments when they are required to attend for further tests, scans or occasionally shared decision making/high risk clinics.
As staff members in the hospital, you are being briefed to ensure you understand the implications of this to the workings of the hospital. Since there is now a digital record of the patient’s preoperative assessment, it can be shared easily across the hospital, where appropriate. Staff should therefore now be better-informed of the status and history of any patient undergoing a procedure. The collection of the pre-operative patient data is automated and the clinical dashboard gathers and visualises the patient-submitted data.
Frequently Asked Questions
- How does a patient start to use ELSIE?
- How does ELSIE Work?
- What if the Patient doesn’t have a Mobile, or cannot do this for themselves?
- What if they get stuck?
- How is their Information used?
- What are the benefits for staff?/a>
- What are the benefits for patients?
- When will this happen?
- Will Preoperative assessment services be interrupted?
How does a patient start to use ELSIE?
The preop nurse will have registered them and sent an email or text message to each patient with the instructions of how to download the ELSIE App onto their phone (from the appropriate App store both Apple iOS and Android devices), along with a special unique activation code.
It is therefore very important that when they receive a text message to invite them for Pre-operative assessment using ELSIE, that they download the APP onto their mobile or other smart device, and register using the supplied onboarding code. The Patient is given a set amount of days to register before the team will be alerted that this hasn’t been done and a reminder can be sent either automatically or manually generated.
How does ELSIE Work?
The patient receives the invitation to start using ELSIE. They then read some prior information, about the hospital and their procedure. They are given a number of small questionnaires to fill in, each taking less than 10 minutes. Depending on the answers they give, once reviewed by a nurse, they might receive further questionnaires to complete. The Patient is given a set amount of days to complete the process and through the clinical dashboard the staff can monitor their progress as well as interact with them to help them with the process.
If at any time, the Patient requires help, they can message for help from within ELSIE. This puts them in direct contact with the preop team.
If they are called for tests or scans, or asked to take a telephone call, they will receive notifications in the ELSIE App.
What if the Patient doesn’t have a Mobile, or cannot do this for themselves?
If they are not confident at using a mobile APP, they can ask a family member, or carer, to help them – their “Buddy”.
If they have no ‘Buddy’ to help, they can inform the team who will then carry out an assessment over the telephone.
What if they get stuck?
If at any time, they feel unsure or nervous about any process, they can ‘message’ the team in the hospital who can help them in a number of ways.
They shouldn’t feel uncomfortable or shy about contacting the preop team, as they want to help the process to be as smooth for them as possible.
How is their Information used?
Any information or communication they provide on ELSIE is secure, personal and only seen and used by the preop team and surgical team, to better handle their surgery. We will not share any of the information outside of its intended use.
Dr Miriam Stephens, Lead for Pre-Operative assessment in Lanarkshire explains, “Like many services we have a few patients that forget to attend appointments. With the new app, patients will get automatic reminders. Not just of appointments but of their surgical date. They will also get reminders when they have specific medicines to take or not to take before surgery. We give patients a huge amount of information before surgery, it is hardly surprising sometimes they don’t take it all in”.
The app stores it all in the one place, and lets the patient refer to the App for their preoperative instructions any time they like.
What are the benefits for staff?
Patient notes will be available to view online at all stages of their journey. Clinicians can log in and check on the status of their patient. Patients will not need to wait for a Preoperative Assessment appointment to be available so will reduce waiting times.
Patients can contact the service using the in-App messaging service at any time during the day or night reducing phone calls into the service, although responses from the Preop team will be limited to normal working hours. Patients can start their Preoperative assessment immediately. If fit and healthy, they can be ready for surgery in less than a week.
We will be able to work more flexibly, with facilitation of home working and better cross site cover as well.
What are the benefits for patients?
Quick access to Preoperative Assessment. This will reduce waiting times for surgery. They can reduce or in some cases even avoid trips to the hospital.
Patients need not take time off work to attend appointments. They can enter their information at home when it is convenient to them, and contact the service using the in-App messaging service, giving the Patient agency to ask any question they might want to ask.
When will this happen?
We began testing on the UHW site in late March, and have now gone live. Once all of our staff are trained in UHW, we will move to UHH and then finally, UHM. In total the switch will probably take around 4 months.
Will Preoperative assessment services be interrupted?
We hope that by switching over in a controlled, gradual fashion, we will minimise any problems and have plans in place to cope with any contingencies that might arise.
Further Information
For further information please contact:
One of our Elsie Medical Development team;
- Dr J N François Taljard (Project Isla lead for NHS L ELSIE ePreOp)
Consultant Anaesthetist (UHM) NHSL Clinical Lead eHealth
Email: francois.taljard@lanarkshire.scot.nhs.uk
- Dr Hamish McKay, Consultant Anaesthetist UHW, Lead for Obstetric Anaesthesia
Email: hamish.mckay@lanarkshire.scot.nhs.uk
- Dr Shona McConnell, Consultant Anaesthetist UHH, Lead for Pre-Operative Assessment in UHH
Email: shona.mcconnell@lanarkshire.scot.nhs.uk
- Dr Miriam Stephens, Consultant Anaesthetist and Pre-Operative Assessment Lead for NHS Lanarkshire.
Email: miriam.stephens@lanarkshire.scot.nhs.uk
