In our latest #OurEntrepreneurs profile we meet cohort 8 Clinical Entrepreneur Julian Sonksen, Consultant in Anaesthesia, and Intensive Care Medicine.

Tell us a bit about yourself 

I am a consultant intensivist/anaesthetist at Dudley Group with an interest in quality improvement and service redesign aligned with the professional development of frontline clinicians. My previous leadership roles included Clinical Director for Critical Care and Head of Surgery, and through these experiences, I developed an understanding of the importance of regular feedback on the performance of a clinical pathway and the outcomes of patients treated along it.

Tell us about your innovation  

Multi-specialty and multi-disciplinary teams across the NHS deliver complex urgent care along the emergency laparotomy pathway, 24 hours a day, seven days a week. Despite the high-risk nature of this pathway and surgery, the patients often recover rapidly and completely. Nonetheless, there are infrequent but repeated occasions when one or more elements of care is either delayed or omitted, sometimes causing a negative impact on outcome. Delivering excellent care more consistently, requires learning from the best care delivered today. This is sometimes referred to as ‘Safety II’ or ‘Learning from Excellence’, but delivering such learning is complex. The necessary information is routinely collected but requires significant transformation before sharing with staff. When delivered, the feedback must be ‘near real-time’, at the individual patient level and include every patient on the pathway. Furthermore, to be meaningful the feedback should be presented in an easy and rapidly understandable format, available to the full MDT who are responsible for delivering care and accessible when each member of the team has an opportunity to pause and reflect. Not an easy task, but without such workplace supported professional development, we risk continuing to see the negative consequences on both quality of care and staff satisfaction and retention.

Working with my Trust, colleagues at Health Innovation West Midlands and with a small software developer (Exploding Phone Ltd), I have been developed a digital tool which I hope will overcome many of these challenges for staff who work along the emergency laparotomy pathway. The solution is called QI Notify-EmLap.

QI Notify-EmLap is a digital solution which ‘re-surfaces and transforms’ data already within clinical record into patient level ‘mini, qualitative case reviews’ for every patient undergoing a NELA eligible emergency laparotomy.  Each patient journey review includes:

• A timeline of the patient’s journey.
• A description of care delivered.
• A qualitative assessment of the care received against recognised standards.
• Access to the clinical standards.
• Opportunities for users to capture reflective writings and/or service improvement ideas.

For the first time staff within this MDT can receive regular, patient level qualitative feedback shortly after an episode of care has completed, allowing them to ‘look back’, review and reflect on what went well, why it went well, and how they and others might do the same, more often and more consistently. In a similar way QI Notify-EmLap will give insights to the occasions when outputs and outcomes are not as hoped for. Regular reflection supports small adaptions in behaviour (individual, team, and organisational), which overtime leads to cumulative improvements in care.

Why did you apply to join the programme, and what are you most looking forward to?

I found out about the CEP through the online research I was conducting to support my clinical entrepreneur journey. Having read about the programme and the reviews from previous fellows, it was clear that the support and networking opportunities it provided was what I needed to help me overcome the challenges I was facing.  

I hope the programme can support me to take the QI Notify-EmLap innovation from use in one Trust, to use across multiple hospital sites. I also hope I will receive support and guidance around the challenges I have encountered along my journey including data hosting, DTAC compliance and business model development.

I look forward to completing the whole programme, and particularly the mentoring opportunity offered.

What are your ambitions for the next year?

My ambitions moving forward are to make my participation in the programme a success, including the sharing of QI Notify-EmLap with other organisations and to conduct a real-world evaluation to assess impact. I also hope to contribute to the programme, sharing experience and knowledge of career with other entrepreneurs.

Why do you think innovation is important in healthcare?

Healthcare systems worldwide, including the NHS, are grappling with the challenge of delivering their hoped for outcomes. The combination of limited resources and escalating healthcare demands has placed our health service under unprecedented strain.

Innovation can play a crucial role in supporting the NHS for the future, sometimes through ‘big ticket’ advances such as AI, but also through multiple small innovations, including tools like QI Notify-EmLap.

QI Notify-EmLap can make the working environment more educational and developmental, leading to better motivated, trained, and experienced workforce. Finally, where successful and repeatable, innovation will lead to economic growth, which itself can generate further resource to invest in the NHS.

How can we find out more?

Please visit the Dudley Group NHS Foundation Trust website for more information.