Digital Skills Implementation The Good, the Bad and the Ugly Miriam Watts Hospice Manager Marie Curie, Glasgow

Things we could get better next time

Marie Curie 9 Hospices 2 Scotland 1 Northern Ireland 1 Wales 2 systems EMIS System One (Bradfpord & Newcastle) 4 Inspectorates

Starting Point - and where did we want to get to? Move away from paper based patient notes Eliminate or dramatically reduce the use of fax machines for clinical correspondence Improve overall efficiency and reporting Positively impact on patient care

PATIENT Hospice Care Clinical Nurse Specialist Allied health professionals Outpatient Care Day Therapies Counselling Services & Spiritual Care

Practical Problems Single use Out of Hours access to information Locating notes Timeliness of clinical advice Information security Filing errors Etc, Etc, Etc

Accessibility in Multiple Areas Ward Offices Outpatients Community

Implementation and where to start? Positives Challenges Centralised implementation team Local implementation team – clinical/non-clinical Benefitted from not being first! Dedicated training room Multiple IT workstations Staff culture Mechanics of laptop management Training – time and staff capability Timeframe Template planning and design “Too Many Cooks”

It’s all in the name! Computers on Wheels (CoWS) v Workstations on Wheels (WoWS) Guess which stuck?

Clinical Nurse Specialists Day Therapy and Outpatients And so it began….. Phase 1 Clinical Nurse Specialists Mobile teams Signal dependent via SIM cards DSE implications Information security Phase 2 Day Therapy and Outpatients Appointment length - contemporaneous recording Staff skills Template management Phase 3 Inpatient unit Communication barrier Charging of COWS Infection control Cleaning!

Where are we now? 15 months post implementation Ongoing upgrades and changes Revision of templates Revision of training as coding becomes more important Monthly review meetings Continued central support Reporting development

If we could start again……. Ditch the staff capability assessments Engage IT and Facilities Manager at the start As much lead time as possible! Don’t be afraid of templates Start as you mean to go on – do everything Delegate control locally – train for template building Swipe entry for EMIS Tablets in patient rooms Training – role based Role play training User training focus rather than process maps Train everyone – employees and volunteers

Ongoing Reports Coding What do you need to get out of it? Minimise options Patient Identification use EMIS rather than DOB and name Upgrades BCP testing Dongles v Sim Agency staff access Don’t underestimate the time it takes to fill in electronic forms Legalities- does it evidence the care

Benefits Communication Accessibility Investigation made easy Audit – trail and planned Skills development Internal referrals AWARDS