P81 IMPLEMENTING THE RENAL INNOVATION PROGRAMME: IMPLICATIONS FOR OUTPATIENT SERVICE DELIVERY Anson R, Bravo F, Hudson C, Helliwell P, Darking M, Goldberg L Sussex Kidney Unit BACKGROUND: The Renal Innovation Programme (RIP) is a regional programme of patient centred, information technology enabled service redesign that includes the implementation of an upgraded electronic clinical information system (ECIS), regional laboratory results integration and the use of video clinics. PROBLEM: The Renal Services Information Strategy 2004 emphasises the importance of ECISs in the development of renal care and management. However, understanding the precise nature of these developments and their implications for improving patient safety, reducing costs and improving the quality of care in renal services remain under-explored. We reviewed the impact of RIP to date on the management of renal outpatients. PROCESS: A multidisciplinary Action Learning Set was established in order to carry out the implementation of RIP which includes representatives of the multidisciplinary team at our Kidney Unit (KU), an expert patient representative, representatives from the ECIS technology vendor and an academic socio-technical evaluator from the university. Clinical Vision 5 (CCL) was the selected ECIS and an external project manager was contracted temporarily to oversee procurement and implementation. A Superuser strategy and cascade model of training was used to ensure that 100 current staff at the KU and satellite regional centres were given role-specific training. Video-assisted remote clinics were piloted. Each modality process-mapped their department’s work in advance of implementation. Concurrent to these activities, video clinic trials were conducted and carried out from distant outreach clinics. RESULTS: Clinical Vision 5 was successfully implemented in December 2010. In the outpatient (OP) department process mapping identified an excessive use of clerk and nurse time in pulling nursing folders and handwriting clinical observations and laboratory results in flow sheets before and after OP clinics. This has been replaced by the electronic recording of weight and urinalysis which has led to easier identification and analysis of trends. Initially for CKD 5 pre-dialysis patients, then for stages 3 and 4 CKD patients, nursing folders became redundant saving staff 15 hours per week in pulling and filing folders, and charting results. In June 2011 integration of CV5 with Renal PatientView was achieved resulting in fewer patient phone calls to request results. Two pilot video-assisted clinics for patients based to the east of our catchment area were successfully conducted, saving 9 patients an extra 70 mile journey to the main KU clinic (further development of this service is ongoing). CONCLUSIONS: The ECIS was successfully implemented into the Sussex Kidney Unit as a result of the collaborative, user-led project approach and has changed working practices in the outpatient department to the benefit of staff and patients. Despite increasing patient numbers, there has been a reduction in staff time required for running these clinics, allowing staff roles to be changed to support the anaemia management and transplant clinic. Future developments will include the application of this methodology to other clinics, the development of interfaces to allow the automatic transfer of laboratory results from remote trusts in the network into Clinical Vision 5, and the introduction of an analytics module.