Humans, not technologies, transform healthcare
The human side of technology
A recent event, jointly hosted by BT and health policy think tank ‘The King’s Fund’, featured a talk on delivering higher quality healthcare at lower cost. That talk drove home the message that technology only enables transformation in an organisation — it’s the human systems around the technology that deliver it.
When big IT programmes run into difficulties, it’s often because there’s been so much focus on the technology that the human side has been marginalised. Too little thought has been put into understanding the culture that underpins the current way of working, and what has to be done to change it. Crucially for the NHS, clinicians often feel that systems are being imposed on them rather than developed with them to make their work more efficient and effective.
Getting the leadership right is crucial. The King’s Fund chief executive, Professor Chris Ham, argued that if the NHS is going to build services around the needs of patients and deliver higher productivity, it needs three things: a clear vision for change, systematic measurement of progress towards its goals and leadership at all levels of the health system.
Technology companies often like to think that their systems provide the opportunity to take a big leap forward. But, drawing on a wide range of international examples, Chris stressed that sustainable improvement is about “the aggregation of marginal gains”, built on the motivation of staff.
At the same event, Glen Burley, chief executive of South Warwickshire NHS Foundation Trust, said it took him three years to win the trust of clinicians, which he and his team achieved by talking to them about patient care — not targets and budgets. Managers helped staff understand the patient journey through the whole hospital system, encouraging them not to just focus on the service in their own department. He said his most important performance indicator is the annual NHS survey of staff satisfaction.
Winning the hearts and minds of clinicians
When we teamed up with Nottingham University Hospital’s NHS Trust to equip its 4,000 doctors and nurses with mobile devices, clinicians played a major role in designing the system.
One of the reasons the implementation was so successful was because the E-observation team have been at the heart of NUH’s technological journey to a paperless system. Clinicians worked hand in glove with the IT team, with a senior nurse from the E-observation team aligned to them. As a result, the nursing teams feel that the solution has been designed by one of their own, the senior nurse was able to demonstrate empathy with the demands of the ward and find workarounds to deal with any challenges.
Now all the staff can see the same information about a patient and share that information across the trust wherever they happen to be. This is hugely powerful in terms of patient safety and rapid response to immediate problems. This is the first time that they’ve been able to share information in real-time.
Developing the workforce alongside the technology
Humber NHS Foundation Trust has implemented a mobile solution designed to transform patient care as well as the working lives and productivity of clinicians. The new solution ensures that clinicians have the most up-to-date information at their fingertips, whether in the office, on the go or at the patient’s home. It streamlines the Trust’s existing processes, reducing the need to return to base, saving time and money travelling and allowing more time to be spent on patient care. Staff can access patient records, view schedules, appointments and update notes while on their rounds — all using a mobile device of their choice.
The team have made a significant step change culturally; completely changing the way they work. As a result, the clinicians have more time back in their lives.
Allowing people to become agile workers and manage their day remotely doesn’t just happen overnight; it requires significant change to working practices. They need training in how to use the devices and their new ways of working. And, importantly, those that manage the services need training too, so they don’t insist that their teams return to the office throughout the day.
We had a similar experience in our collaboration with Peninsular Community Health in Cornwall to deliver a telehealth system. Again, a combination of building the system around the needs of patients — providing them with kit at home which they could use easily — and demonstrating to clinicians that it would help them almost as much as it would help the patients, went a long way to ensure the project succeeded.
The same lessons apply in all our work, no matter what the industry. We need to take people with us and work with them to dismantle old ways of working in favour of new approaches. Technology is the enabler, but it’s the skills, planning and passion of the people that make the difference.
To read some of the stories from across the NHS where clinicians, managers and commissioners alike have shown leadership and direction and are delivering projects which are succeeding in delivering real changes that deliver better care at lower cost, visit www.bt.com/health
By Ian Dalton, President Global Government & Health.