Case Study: ERA


ERA – Emergency Role Allocation

In a critical setting, such as the delivery suite, staff are required to deal with a number of high risk emergencies on a regular basis. When these incidents occur, it is imperative that specific tasks are swiftly allocated and actioned to ensure the most positive and effective outcome for mother and baby.

It is understood from other disciplines, particularly in Emergency Departments, that allocation of tasks in advance of patient arrival can improve team performance. Musgrove Park Hospital Delivery Suite was seeking to replicate this process but in a non-verbal system that reduces medical discussion at the patient bedside as the nature of the circumstances means that the patient and their family are usually very aware of the emergency and in a heightened sense of anxiety.


Somerset NHS Foundation Trust


React Native, Android tablets, and Android Mobile Application, Tinker Board and Touch Screen Display

The Challenge

When an emergency occurs there are a variety of challenges presented as the skilled team communicate the roles and tasks required. The challenges that may present themselves include overcrowding of nurses within a delivery room, leaving other areas vulnerable and causing distress for the mother.

Musgrove Hospital Maternity Unit wanted to create a digital solution which would help overcome these challenges in a simple but effective way. Through their initial simulations the team worked out the sort of system that would work for them – they just needed a company to make it a reality.

The Solution

Our aim was to create a mobile based application which can be deployed to tablets that would be based in each delivery room. When an emergency is triggered, an attending midwife can instantly activate the screen and select an predefined emergency which will act as a shared checklist for the teams, the displaying app will act as a shared checklist for the nurses, displaying roles that need to be filled that can be toggled as completed. This enables the nurses to care for the patient in a more organised fashion.

The Outcome

In response to these challenges the ERA (Emergency Role Allocation) System has been devised built as an end-to-end system with all software and hardware delivered as a complete package which underwent stringent testing before being delivered to the unit for simulation training with members of the team.

The ERA system is an app based terminal solution which connects to a cloud based platform to coordinate, store and authenticate the ERA system. The cloud based architecture enables ERA to be trialled as a secure stand-alone system, operating in parallel with current ‘bell-pull’ systems. ERA will be deployed on appropriate devices suitable for the trial stage. Consideration will be given throughout the proof of concept stage for the appropriate screen hardware for potential installation. The content of screens and the automated selection and allocation process will be dependent on findings made at the start of and throughout the trial process.


 “The benefit of the ERA System is that clinicians arrive knowing what they are attending, their role, the equipment and response needed to safely manage the event, and what has already been instigated to optimise patient outcomes. This enhances teamwork, maintains situational awareness, and helps teams provide safe care in a calm and timely manner. ERA Systems is not intended to tell clinicians how to manage emergencies. This we are very good at already. The digital system built by One Big Circle will streamline our response and reduce those human factors which can lead to substandard communication, errors and poor patient outcomes.” 
– Caroline Lacy, Practice Development Midwife