The hospital had over 62,000 boxes records being held across 4 libraries, and with another supplier. Their storage arrangements made it difficult to locate records quickly and easily, they also relied on the use of temporary sets of notes when the original notes could not be located.

Space was an immediate issue, but they also had a requirement to consolidate all their records in one place and mitigate clinical risk. This would enable them to locate records quickly and easily, reduce large volumes of temporary notes and enable them to save money on resources and redistribute to support patient care.

They were also aware that by having patient records at different sites they did not have a standardised process for their clinic prep. Variations were based on clinicians’ personal preference.

The uplift project of relocating records off site was to take place over 14 months.

An immediate requirement was supporting the site. They did not have a sufficient storage space for records on site but had a clinic prep team of 12 people with a combination of roles. We picked up the patient records, indexed and catalogued them storing them in one of our facilities – as an ongoing service we now return the records clinically prepared. This enabled the site to save money on resources and redistribute to patient care quickly before we started the main uplift project.

Minimising the time records are unavailable

A detailed project plan was put together working with the Trust to successfully transfer 1million notes. A key concern was minimising the time the record was out of action. We achieved this through a dedicated logistics and inbound team working out of hours, ensuring all records being transferred were processed and available within 24 hours. We indexed and catalogued all 1m records, adding a new barcode and uploading every record onto our system.  Managing and storing the records off-site was a quick and cost-effective way to create the required clinical space and provided a consolidation of records.

Prior to the main uplift they wanted to empty a site quickly so they could exit from a lease. We made this a priority so they could save money but also make the records more accessible as they did not have any staff based at this site.

A standardised approach to clinic prep

Like many trusts they were struggling with recruitment, they also were aware that by having a clinic prep team on site it was costly and took up valuable space. Every site had their own way of clinic prep based on personal and historic preference, we worked with them on a standardised approach to their clinic prep, engaging with key stakeholders from each site to ensure that their requirements were considered. The outcome was a standardised, version-controlled operating procedure that drove efficiencies and quality through consistency of approach.

In addition, we implemented an automated ordering system, prioritising records for delivery by appointment order rather than by request order. This removes the administration time required to request files and ensures that records are delivered on time for all patient appointments, even if scheduled for the following day.

Supporting clinical staff

In order to reduce admin time for clinical staff so they could concentrate on patient care, we not only prepared the file ready for clinic prep but we split into the six different departments and delivered to one hub. Each file was also put in the order based on the time and date of the appointment.

Reducing temporary records

The hospital wanted to reduce their temporary records. During the audit we carried out upon intake, all records were barcoded and tracked. We pick all the records for a patient at point of request and merge them into the main record. We’ve been doing this since 2019 and have removed/merged 30,000 temporary notes. Through outsourcing to Restore Information Management we’ve improved their pick rate to 99.9% helping to mitigate clinical risk.

Improving the use of data and cost efficiencies

In 2020 during the pandemic, they experienced several cancelled appointments, but they had a limited centralised view of this. Based on activity trends and information gathered through our automated ordering system, we proactively quantified this, reviewed their cancellation process, and put measures in place to make short-notice changes due to cancellation. This reduced their spend by up to £40k, by simply not picking records for cancelled appointments.

The hospital repurposed the libraries for front line clinical services, providing a more cost-effective solution moving them offsite. Restore now manage all the Trust’s files, providing them with a completed set of medical records ensuring patient information is available when needed.

The consolidation and improved accessibility of files has reduced the creation of temporary notes and loose filing, allowing for more complete patient histories, supporting better patient care, and improving data protection.

We’ve increased the standard of clinic prep and provided cost savings through providing this service for them.  The standardisation of each record also supports a more cost-effective future digitisation.

The automated ordering system we developed has dramatically reduced the time staff spend placing requests for records, allowing them to further focus on patient care.

• Reduced staff who can be released into patient care
• Released clinical space, reducing costs
• Created a compliant process through the trust
• Transfer of 1.1m million records
• 2,400 retrievals a day
• 100% pick rate
• Removed 30,000 temporary notes
• Costs savings of £40k through advising changing dates of cancelled appointments
• Full tracking of patient notes
• Total images scanned in 2022 5940
• 463,580 files prepped in 2022