Using Work Experience to develop a feature for a digital solution used by a regional NHS Foundation Trust.
During the summer, The Curve provided a work experience placement for Megan, one of the many students who reached out to us to enquire about a possible work experience placement with us.
As with our summer interns, we don’t specifically have a scheme currently in operation for work experience placements. However, having received so many requests and such positive feedback from those who have taken part in the past, we are in the process of formulating a more structured scheme moving forward.
We are always pleased when we are contacted by students from within the Sheffield Region, and we are always looking at ways in which we can help and support the next generation of talented people interested in software and technology.
Providing these placements creates an excellent opportunity for students and interns to develop their software and technology skills whilst benefiting from a real world working environment. Equally this also allows us to understand what technologies and systems are currently being taught so we can adapt and ensure we’re up to date with the latest teachings – helping us adapt and support the interns working alongside our team.
This project involved building upon an existing System – a software application used to record, aggregate and disseminate OPEL (Operational Pressures Escalation Levels), a method used by the NHS to measure the stress, demand and pressure a hospital is under. This system was developed in conjunction with an NHS Foundation Trust to provide their operational command centre with a state of the art monitoring and reporting capability across the Trust.
The OPEL Framework is used to manage the day to day variations in demand across the health and social care system as well as the procedures for managing significant surges in demand. There are four OPEL stages that a trust or hospital can be operating at reflecting the operational pressures it is currently under, these levels are;
- OPEL One – The local health and social care system capacity is such that organisations are able to maintain patient flow and are able to meet anticipated demand within available resources.
- OPEL Two – The Local health and social care system is starting to show signs of pressure. The local A&E Delivery Board will be required to take focused actions in organisations showing pressure to mitigate the need for further escalation.
- OPEL Three – The local health and social care system is experiencing major pressures compromising patient flow and continues to increase. Actions taken in OPEL Two have not succeeded in returning the system to OPEL One.
- OPEL Four – Pressure in the local health and social care system continues to escalate leaving organisations unable to deliver comprehensive care. There is increased potential for patient care and safety to be compromised. Decisive action must be taken by the local A&E Delivery Board to recover capacity and ensure patient safety.
More information about the Operational Pressures Escalation Levels (OPEL) Framework can be found here, which goes into a vast amount of detail, outlining the flowchart, status triggers and incident guidance around the relevant OPEL levels.
The System is delivered as a responsive web application which can be used on any number of devices within the hospital or trust, such as Operating room monitors, laptops, tablets and mobile phones. It’s important that the most up to date information is available – which is why changes to the levels automatically update the view on the portal so the most up to date information and data is always shown.
The heart of the system is the collection of measures which are used to calculate the OPEL levels for metrics, categories and ultimately the organisation. The primary visualisation for the application shows metrics around the outside that feed into categories and an overall organisation level. The side panel shows the data for any of the elements, in this case, the number of resus bays occupied.
The metric levels are calculated using a variety of methods; ascending thresholds, descending thresholds or direct level entry. The calculation for categories and the organisation is by weighted thresholds which allows the calculations to be fine-tuned to prioritise metrics within a category or categories within the organisation.
In addition to the levels shown in the chart, the overall OPEL level is calculated by taking the calculated level (in the centre of the chart) and applying configurable time delays before escalating or de-escalating. This ensures the overall OPEL level doesn’t change too rapidly. An OPEL level 4 is declared manually because it is a significant step and there may be outside factors influencing the decision to go to level 4.
In addition to calculating and displaying the OPEL levels, the application can also send notifications (emails, SMS and Microsoft Teams) which are completely configurable:
Messages – Message content is templated and can contain OPEL levels, time declared etc.
Recipients – Message recipients belong to configurable groups (for example, Silver command).
Events – Messages can be sent to recipient groups, using specific templates, in response to level changes in any of the metrics, categories or organisation and also any changes to the overall OPEL level. Notifications can also be sent on a schedule.
When Megan joined us for a week’s work experience, we set out to provide her with a series of software development challenges and learning activities in order to help her develop her understanding of technical requirements that can arise in a real world working environment. These activities and this project in particular also helped her develop an understanding of how to approach potential challenges and issues, and overcome them through sound problem-solving techniques.
We set Megan a project task in which the end goal was to use a device in order to update the status code of an online portal, drastically improving the efficiency and effectiveness of how this could be done. A key objective of the project was to have a solution in place in which a hospital worker on a specific ward could use the OpelBox to set the OPEL level of a given node in the System to update the online portal. The aspiration was to provide an effective, tactile and convenient way for hospital workers to update the system, and therefore help improve the response to the changes in System levels.
To begin with we created a hardware device, codenamed “OpelBox” with coloured lights and buttons that would be the key component for Megan’s Project. This OpelBox is made up of a microcontroller with input and output capabilities, along with switches that can invoke actions on the microcontroller, including interacting with other systems over a bluetooth or wifi connection. As Megan’s prior experience was limited, she spent a day or so getting an understanding of the hardware and how it reacts when changes are made to the code.
The OpelBox can also be programmed to display the current EMS capacity levels of the ward or section of the hospital it represents, allowing those operating within that space quick and effective methods of understanding the real time OPEL levels.
With the System and the potential future use of the “OpelBox”, there is a great opportunity of increasing the ease and efficiency of OPEL level reporting inside hospitals and across other NHS Trusts.
This is a relatively inexpensive solution, as other than the EMS application licence, which would vary depending on the topology and needs of the hospital, the physical OPELBox (Pictured above) can be produced at a relatively low cost as was the case with our MVP (Minimum Viable Product) version, which came in at around £25.
- A) As shown in the diagram component “A” is a small 2000mAh battery that allows the device to be placed anywhere within the Wi-Fi network.
- B) Component “B” is a ESP32 Micro controller with Wi-Fi and Bluetooth capabilities. This allows the user to set and control the OPEL levels of the trust via the dashboard.
- C) Component “C” shows the lights and buttons that are used to set and show the current OPEL levels at the hospital/trust.
The process of using the OPELBox to adjust or represent the current Operational Pressures Escalation Levels has proven to work well in its early testing phase, thanks to Megan’s work and help in getting this project up and running. We were even in a position where we could showcase some of the functions and abilities of the OPELBox to one of the key stakeholders of The Rotherham NHS Foundation Trust.
The feedback we received from key stakeholders at The Trust after this demonstration was extremely positive and scenarios in which the OPELBox and system had potential uses were discussed. And whilst work on this device and system is still needed to improve the quality and effectiveness, it’s clear that Megan has done a great job at creating an MVP with a large amount of potential, especially considering this was achieved in a week with limited to no background experience or knowledge with the project.