When I walk through the doors of a supermarket, I usually have a very good idea of what I want to buy. When NHS trusts are looking to procure an IT system however, they will often only have a basic knowledge of their specific requirements. One example of this is when clinical and IT teams do not have a common understanding around what is needed from the technology.
This can cause difficulties, as IT suppliers may misinterpret goals or encourage implementation of IT software and products that do not fulfil, or fit with, a trust’s needs. Precious taxpayer money can be wasted and everyone loses out, including the clinical staff, managers, IT suppliers and, most importantly, the patients.
Some of the most rewarding IT projects I have been involved in my role at Leicester’s Hospitals were around improving our clinical and medical handovers. We recognised that digitising our core nursing documentation and providing up-to-date, accurate patient information to healthcare staff could reduce transfer times, delayed discharges and risk for potential patient harm.
When we asked staff what could make their working lives easier, technology was right at the top of their list. Nurses said they wanted less paperwork and IT systems that reduced repetitive data entry and supported their day-to-day schedule. They pointed out that it was taking too much time to log on to different systems to complete tasks like discharges and transfer letters, which was a real source of frustration on the wards.
To overcome these challenges we needed intuitive software that shared data between different information systems and was bespoke to our specific requirements rather than a ‘one size fits all’ product. Another key consideration was the ability to use mobile devices. Our nurses and doctors were taken back by the practicality of mobile technology: less inconvenience of logging onto main PC-based systems, and the ability to meet Sir Bruce Keogh’s new clinical standards around seven-day working.
When you are responsible for a major IT project and entering new territory, it comes with some sleepless nights. You continuously ask yourself: will the IT infrastructure support the software? Will staff find the mobile devices convenient and accessible? Are there security risks we have failed to cover? The excitement at recognising that we could change our processes to improve patient outcomes is coupled with extreme anxiety about letting the clinical teams down – it can be your biggest fear.
It is therefore very reassuring when you have an IT supplier who can speak the specialised ‘clinical language’ of the NHS – it instils confidence and credibility that they can deliver. For the clinical and medical handover projects we opted to work with a mobile technology software supplier called Nervecentre who has an in-house team, including qualified nurses, with vast NHS experience.
They understood and grasped our trust’s goals, and were aware of the many pressures our busy hospital regularly faces.
We looked for a partnership approach with our supplier for technology deployments. The wealth of NHS experience available to us was invaluable, particularly when we were introduced to other trusts and managers who have learnt from past challenges and have come through the other side. We were actively encouraged to visit another trust which had deployed the same technology, ask questions and see how we could take the software forward for our trust.
Everybody always thinks that every trust is different, but there are some great similarities. Plus, by seeing with our own eyes how the technology worked for one trust, we could understand and create a picture of what the technology could deliver for us.
From our perspective, it was crucial that we knew what we wanted to achieve from each project. There were things we learnt along the way which meant being flexible in our approach and strategy.
Clinical engagement is imperative when implementing a major change to working practice. We achieved this by selecting five ‘pioneering wards’, to work closely with our project team to provide suggestions and feedback in how best to use the software for their needs. You can never underestimate how good it makes people feel to be involved in projects that are going to make a fundamental difference to providing care.
By acting upon their feedback and demonstrating our commitment to them, we have an incredibly powerful message – we have listened and have acted. That simple change in culture to focus on better support for our staff, has helped us boost morale and as a result has had a positive impact on patient outcomes.
By focusing on getting the implementation right within the pioneering wards, we anticipated the roll out across other areas of the hospital would be very rapid. Staff from these wards act as ‘champions’ for the new system. Nursing and medical teams on some wards are ‘buddying up’ with our champions to draw on their knowledge and experience of deploying a new system whilst they themselves go through the implementation.
This is a very powerful way of working which has produced strong advocacy for the new system. We have also been proactive in our formal internal communications activities and together the results have been staggering – the number of system users is continually increasing in frequency and I have found consultants and nurses knocking on my door asking when they are going to get the software.
There are lessons to be learnt from any IT implementation, however, healthcare and IT are two very complex areas, and thus, shopping for the right software and hardware can be riddled with obstacles and a great deal of uncertainty. Implementing the right IT system that meets a healthcare organisation’s goals will only be truly realised if it is fully aware of its stakeholders’ needs and its specific requirements and by partnering with the right technology supplier.