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									PERFORMANCE AND INFORMATION DEPARTMENT
RiO CONTINGENCY (CONTINUATION) PLAN




                                                                     January 2008
                                                            Author: Jonathan Stanford
                                                          Review date: January 2009
                 Approved by: Information Governance and Clinical Documentation TAG
                                                Lead Director: Chief Operating Officer
              PERFORMANCE AND INFORMATION DEPARTMENT
            RIO CONTINGENCY (CONTINUATION) PLAN / PROTOCOL

1.0    INTRODUCTION

The Performance and Information Department are responsible for the delivery,
maintenance and upkeep of the Trust-wide Clinical Information System – RiO.

In order to ensure the continuation of this service, in the event of a major incident, the
Trust has developed this protocol.


2.0    DEFINITION

A major incident resulting in an emergency and contingency need is defined as:

               “any incident or accident which causes massive disruption to service
               delivery and which could result in loss of systems / delivery of
               information services”.

These may include, for example:

              The sudden loss of power or other utility to a building or buildings
               causing severe disruption to services
              A fire or security incident involving the forced evacuation from a
               building / buildings over an extended period

This plan / protocol (hereafter referred to as ‘plan’) is designed to ensure that the
Trust maintains a service, in relation to the financial systems, as near normal as is
possible in the event of a major incident, with minimal impact on both clients and
staff.

Critical systems are:

System            Functionality
RiO               Clinical Information System




3.0    SCOPE OF PROTOCOL

This plan will cover all areas / staff groups having access to RiO, irrespective of site /
building. This plan is designed for the Trust’s internal contingency only, although it
may involve the co-operation and collaboration between shared services on sites.
This plan should be read in conjunction with the Director / Senior Manager on call
policies and the Trust Major Incident Plan.
4.0    RESPONSIBILITIES

It will be the responsibility of the Director covering the Performance and Information
department to ensure that this plan is held at each relevant site / building and that
staff are made aware of its existence.

It will be the responsibility of each member of staff involved in the administration of
the IT systems to ensure that they are familiar with this plan.

The Health Informatics Service will be responsible for ensuring that all necessary
support is provided in the event of a major incident and for any linkage back to the
users.


5.0    IMPLEMENTATION

The RiO system is hosted at a remote data centre by CSE-Servelec. Connectivity to
RiO from Trust PCs is gained via local network infrastructure and the national N3
computer network.

The application is web based and access can be gained by the use of a web
browser. Any PC connected to N3 at SWYMHT or elsewhere can access the RiO
login screen.

Connectivity from the Trust COIN (Community Of Interest Network) is gained on a
locality basis, with staff in South Kirklees and Calderdale using a different N3 link to
staff in North Kirklees and to staff in Wakefield.

CSE-Servelec are responsible for the recovery of the RiO infrastructure in the event
of a disaster. A disaster recovery server is based at Fieldhead Hospital should the
RiO infrastructure fail for an extended period of time. Arrangements are in place to
recover data to this server and provide staff with limited access to RiO in the interim
between a disaster and full recovery.

Should one of the N3 data circuits or part of the COIN network become unavailable, it
would be possible to transfer staff to alternative PCs on the COIN should emergency
access to RiO be required. Should there be a problem with the N3 computer network
or the CSE-Servelec hosted infrastructure, the disaster recovery plan would be
invoked and the backup server at Fieldhead Hospital would be made available with a
copy of the RiO application based on the last good backup. A roll back plan to the full
live system from the disaster recovery server is also included as part of the disaster
recovery process.

The following table details a series of tasks which should be undertaken by Trust
staff and monitored by the Performance and Information department in the event that
RiO should become unavailable:

Timescale                  Action taken
0-72 hours                 Notify CSE-Servelec that RiO is not available and request
                           feedback as soon as possible as to the estimated
                           recovery period. All RiO users to be notified as well as
                           director level representatives.
                     Consider invocation of the RiO Disaster Recovery Plan. A
                     standby RiO server is available at Fieldhead Hospital
                     which can be used to restore a backup copy of the RiO
                     databases and provide continued access to RiO on a
                     limited user basis. This action will depend upon an initial
                     estimate of downtime.

                     All staff groups will be notified via the IT Service Desk as
                     soon as an initial assessment of the unavailability of RiO
                     has taken place, not more than one working day after any
                     disruption. Email/ telephone/ fax will be used to contact all
                     staff affected. This communication should provide staff
                     with an estimated recovery time and with advice on
                     whether it is appropriate to revert to the use of downtime
                     forms.

                     Staff should revert to paper based records and use the
                     downtime forms in the appendices of this document. All
                     completed forms should be retained locally for manual
                     entry when RiO is available again for up to a period of one
                     week.

                     Should the disaster recovery plan be invoked, staff will
                     have limited access to RiO via the disaster recovery
                     server. The Performance & Information department will
                     coordinate access to this service and will prioritise this
                     based upon clinical requirements.

                     Inform external stakeholders where relevant.

72 hours +           Emergency meeting of Trust Board/Senior Managers to
                     be convened.

                     All RiO users should be updated via the IT Service Desk.

                     Staff should revert to paper based records and use the
                     downtime forms in the appendices of this document. All
                     completed forms should be retained locally for manual
                     entry when RiO is available again for up to a period of one
                     week.

                     Inform external stakeholders where relevant.

                     Critical reports to be prepared on a best estimate basis,
                     including all assumptions.

By end of 1st week   Staff should forward all completed downtime forms to the
                     Performance and Information Department should RiO
                     remain unavailable for one week or more. Attention
                     should be paid to the confidential nature of this material.
                           Any urgently required clinical information should be
                           obtained from the Performance and Information
                           Department

                           Critical reports to be prepared on a best estimate basis,
                           including all assumptions.

                           Review bank/agency staff requirements

                           All RiO users should be updated via the IT Service Desk.



6.0    POST INCIDENT

Following any major incident, and when normal operations have resumed, the Trust
will review the performance of the plan and highlight any aspects where
improvements can be made, should a similar incident re-occur.

Assessing the effectiveness of the plan should take place immediately following the
major incident and again after six months when any longer term implications have
been identified.

Lessons from the major incident should be built into any review of this plan.


7.0    REVIEW

This plan should be reviewed every three years and / or after any major incident
occurs and / or when any changes to the RiO system are undertaken.
APPENDICIES INDEX

Downtime forms:

Please note that in the event of a disaster, up to date code sheets will be
distributed to staff to allow the completion of the downtime forms.

The Downtime forms contained in this document make up part of the portfolio
of documents which change over time as RiO is developed. See the following
link for a complete set of up to date documentation:

http://nww.swyt.nhs.uk/organisation/rionews

In the event that the intranet is unavailable, the performance and information
department will distribute this documentation should it be required.

Appendix 1:   RiO Patient registration form

Appendix 2:   RiO Change of details form

Appendix 3:   RiO Referral form

Appendix 4:   RiO Discharge form

Appendix 5:   RiO Appointments form

Appendix 6:   RiO Activity form

Appendix 7:   RiO Medical records procedures

Appendix 8:   RiO Medical records enquiry form

Appendix 9:   Disaster recovery and business continuity contacts
           APPENDIX 1

                       Performance and Information Department
                   RiO DOWNTIME REGISTRATION FORM - Register a new patient onto RiO

                           Please complete this form should RiO become unavailable.

           The form should be retained by each service for local re-entry when RiO is back online.

            Should downtime exceed one week, please forward all completed downtime forms to the
            address below for central RiO updating/entry. Please refer to the Safe Haven Policy when
                                   transferring Person Identifiable Information.

           Team Name………………………………..
           Staff Name …………………………………
           Staff ID No …………………………………

                               All sections marked with * MUST be completed

*Title: (Mr/Mrs/Miss/Ms)
*Surname                                                 *Forename(s)
NHS No:
(If known)                                               Marital Status                         *Sex
(Example: DD/MM/YYYY)
*Date of Birth                       Ethnicity                              Religion

Occupation                                               Language

*Address

*Town                                                    *Post Code

*Daytime Phone No.                                       *Evening Phone No.

Mobile Phone No.                                         Email Address

Date Registered

*GP Name                                                 *GP Practice

Practice Address

Town                                                     Postcode

Practice Phone No                                        Date Registered with GP

Carer(s)                                                 First Mental Health Contact

           Performance and Information Department,
           Trust Headquarters, Fieldhead,
           Ouchthorpe Lane, Wakefield.
           WF1 3SP.
           Tel: 01924 327000

                                                                            Version 1 – January 2008
     APPENDIX 2

                  Performance and Information Department
                           RiO DOWNTIME CHANGE OF DETAILS FORM
                               Update existing patient details onto RiO

                      Please complete this form should RiO become unavailable.

      The form should be retained by each service for local re-entry when RiO is back online.

       Should downtime exceed one week, please forward all completed downtime forms to the
       address below for central RiO updating/entry. Please refer to the Safe Haven Policy when
                              transferring Person Identifiable Information.

     Team Name………………………………..
     Staff Name …………………………………
     Staff ID No …………………………………

             EXISTING DETAILS                                  CHANGED DETAILS
RiO ID                                                 NHS NUMBER

SURNAME                                                SURNAME

FORENAME                                               FORENAME

SEX                                                    SEX

DOB                                                    DOB

ADDRESS                                                ADDRESS

GP                                                     GP

DOD                                                    DOD

OTHER                                                  OTHER
INFORMATION                                            INFORMATION




     Performance and Information Department,
     Trust Headquarters, Fieldhead,
     Ouchthorpe Lane, Wakefield.
     WF1 3SP.
     Tel: 01924 327000

                                                                       Version 1 – January 2008
APPENDIX 3

              Performance and Information Department
               RiO DOWNTIME REFERRAL FORM – record a patient referral

                   Please complete this form should RiO become unavailable.

The form should be retained by each service for local re-entry when RiO is back online.

 Should downtime exceed one week, please forward all completed downtime forms to the
 address below for central RiO updating/entry. Please refer to the Safe Haven Policy when
                        transferring Person Identifiable Information.

Team Name………………………………..
Staff Name …………………………………
Staff ID No …………………………………


Patient Name

NHS No.                                           RiO No.

Time                                             Date

Service                                          Care Setting

Referral Source                                  Referrer
                                                                   +
Referring GP*                                    Referring HCP
Referral Reason:




HCP Referred To                                  Referral Urgency
Administrative Category                          Referral Comment




Referral Received Date                           Referral Accepted Date

*Only to be completed if referral source is GP.
+
  Only to be completed if referral source is NHS Hospital Staff.

Performance and Information Department,
Trust Headquarters, Fieldhead,
Ouchthorpe Lane, Wakefield.
WF1 3SP.
Tel: 01924 327000
                                                                       Version 1 – January 2008
APPENDIX 4

            Performance and Information Department
           RiO DOWNTIME PATIENT DISHARGE FORM – Discharge a patient

                 Please complete this form should RiO become unavailable.

The form should be retained by each service for local re-entry when RiO is back online.

 Should downtime exceed one week, please forward all completed downtime forms to the
 address below for central RiO updating/entry. Please refer to the Safe Haven Policy when
                        transferring Person Identifiable Information.

Team Name………………………………..
Staff Name …………………………………
Staff ID No …………………………………


Patient Name

NHS No.                                       RiO No.

Discharge Date                                Discharge Time

Method

Destination
Destination Address




Postcode
Comment




Performance and Information Department,
Trust Headquarters, Fieldhead,
Ouchthorpe Lane, Wakefield.
WF1 3SP.
Tel: 01924 327000
                                                                 Version 1 – January 2008
  APPENDIX 5

                 Performance and Information Department
             RiO DOWNTIME APPOINTMENTS FORM – Record patient appointments

                     Please complete this form should RiO become unavailable.

  The form should be retained by each service for local re-entry when RiO is back online.

      Should downtime exceed one week, please forward all completed downtime forms to the
      address below for central RiO updating/entry. Please refer to the Safe Haven Policy when
                             transferring Person Identifiable Information.

  Team Name………………………………..
  Staff Name …………………………………
  Staff ID No …………………………………

                 Appointment     Appointment
HCP                                                Patient/Client Name          NHS No           RiO No.
                    Date            Time




  Performance and Information Department,
  Trust Headquarters, Fieldhead,
  Ouchthorpe Lane, Wakefield.
  WF1 3SP.
  Tel: 01924 327000

                                                                      Version 1 – January 2008
        APPENDIX 6

                                                  Performance and Information Department
                                           RiO DOWNTIME ACTIVITY FORM – Record patient contacts/activities
                                                 Please complete this form should RiO become unavailable.
                                 The form should be retained by each service for local re-entry when RiO is back online.
         Should downtime exceed one week, please forward all completed downtime forms to the address below for central RiO updating/entry. Please refer
                                         to the Safe Haven Policy when transferring Person Identifiable Information.

        Team Name………………………………..
        Staff Name …………………………………
        Staff ID No …………………………………

                                                *Use codes on crib sheet for activities, location and outcomes.

                                                                                                  Date
              NHS       RiO                                                                               Duration                Activity   Activity   Activity
Date   Time                             Patient Name                       Address                 of                Location*                                     Outcome*
              No.       No.                                                                                (Mins)                   1*         2*         3*
                                                                                                  Birth




        Performance and Information Department,
        Trust Headquarters, Fieldhead,
        Ouchthorpe Lane, Wakefield.
        WF1 3SP.
        Tel: 01924 327000
                                                                                                                                 Version 1 – January 2008
APPENDIX 7

                   Performance and Information Department
           RiO MEDICAL RECORDS PROCEDURES – to be used by Medical Records staff

Business Continuity Procedure for Clinics during RiO downtime:

      Ensure clinic lists are printed one week prior to clinic date. This will provide a list to work from
       should RiO be unavailable.

      Ensure all additions/cancellations to clinic are written on clinic lists

      On the day of the clinic, photocopy the list for each doctor and for the receptionist to use in clinic
       reception.

      Record ‘arrival’ and ‘seen’ times and the outcome of the appointment on the clinic list to be
       entered on to RiO at a later stage.

Business Continuity Procedure for accessing case notes during RiO downtime:

      Case notes are filed numerically and it is essential to obtain the RiO number in order to locate the
       case notes

      Ask the person requesting the case notes if they can provide the RiO number

      Determine whether the notes are required urgently or whether the request can wait until RiO is
       working again

      If they don’t have a RiO number, take down the name and date of birth of the patient and the
       name of the Health Professional involved

      Ask the relevant secretary or any department with which the patient has contact (e.g. CMHT,
       Crisis etc.) if they have a record of the RiO number

      If a RiO number can be found, locate the case notes and inform the requester. If not keep the
       requesting person up to date with your progress

Business Continuity Procedure for dealing with enquiries during RiO downtime:

      Inform the enquirer that the system is down

      Determine the nature of the enquiry by completing the Enquiry Form (Appendix 9), which includes
       space to record contact details of the enquirer

      Explain that medical records will contact staff once RiO is working again
APPENDIX 8

                     Performance and Information Department
        RiO MEDICAL RECORDS ENQUIRY FORM – to be used by Medical Records staff only

 Please complete this form should RiO become unavailable. Please refer to the Safe Haven Policy when
                              transferring Person Identifiable Information.


Team Name………………………………..
Staff Name …………………………………
Staff ID No …………………………………


Name of requester                                  Telephone No.
Reason for request




Details of enquiry




Patient name                                       Date of Birth

RiO number                                         NHS Number
Address


Performance and Information Department,
Trust Headquarters, Fieldhead,
Ouchthorpe Lane, Wakefield.
WF1 3SP.
Tel: 01924 327000
                                                                            Version 1 – January 2008
APPENDIX 9



Disaster recovery and business continuity contacts
In the event of a disaster resulting in the partial or total loss of connectivity to the RiO application, the
following staff or a nominated representative working on their behalf will make up a working team to
ensure that a restoration of service is achieved as quickly as possible.

Senior Portfolio Manager – Performance & Information
Portfolio Manager – IM&T
Portfolio Manager – Information Governance & Health Records
Service Manager – Medical Records
Estates Manager – On call manager
Assistant Director – One of four possible clinical leads
Service Manager – The Health Informatics Service

								
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