Evidence Based Assessment of New Medical Technology Through Test of Change Case of Patient Monitoring in NICU Unit

Traditional or ‘off the shelf or out of box’ method of acquisition of medical devices and technology is currently being challenged by clinical users. Currently there is a need for flexibility in acquisition patient monitoring systems that is tailored to clinical needs of the healthcare organisation. Driven by accreditation, regulation, and technology, clinical practices are constantly changing. To align with the National Health Service Scotland (NHSS) transformation strategy, Clinical Engineering is recommending test of change prior to major acquisitions of medical devices with organisation wide clinical impact. Future technology need to be safely tested in clinical settings to gain knowledge of its capability, the innovation that are likely to have a positive impact on patient outcome and the value for money. Evidence should be provided to justify the investment. The purpose of this paper is to open up a discussion and share ideas on how test of change can predict the efficacy of a technology prior to acquisition. It provides insight about efficiency, deficiencies, current practices, changes that are required, and issues that may arise during the acquisition, implementation, go live and beyond. In this case study, Neonatal Intensive care unit (NICU) is used assess the introduction of an integrated patient monitoring system into NHS Tayside. The approach taken to conduct the test of change is discussed, documented lessons learned are highlighted. Innovative changes in clinical practices that may allow improvement in effectiveness of patient monitoring with wider impact on the entire organisation are presented. This exercise brought together a large number of stakeholders. Including those who are still interested in the old way of working, to come together and be part of the evaluation. As a result, a final paper will be presented with request for funding to the senior management for the next capital cycle.