Process Change is the Most Difficult Challenge


3rd Feb 2009

In 3rd quarter 2009 our Trust plans to go-live with its new electronic patient record (its eRecord).

The Trust has engaged the xxxx to assist it in building an electronic patient record. The Trust’s key focus is on supporting staff in making further improvements to patient care, enhancing the patient journey and improving work practices.

A second key focus of the programme is putting in place a central patient record which will eventually replace paper records as the core source of information about a patient’s care and history.

The new eRecord will initially be used to gather patient demographic and visit information, results of investigations such as radiology and laboratory reports, medicines administration records, and operating theatre booking information. It will also be used to automate and speed up processes in the accident and emergency department and to ensure that hospital staff are better informed when a patient is admitted from A&E to one of our hospitals.

Trust managers have, since April 2008, been reviewing and improving processes involved in booking appointments, scheduling theatre activity, managing beds, ordering investigations, and prescribing medicines. This is in preparation for a higher degree of automation and more effective data capture.

Process-change is the most difficult and certainly the largest component of any major information systems implementation. It is critical that new processes are communicated, understood and standardised. It is also important that the people who need to use the new systems understand their roles and have been engaged and empowered in designing how they will work.

The Trust is aware of the difficulties inherent in such a project and have engaged two senior managers with extensive experience of leading meaningful process change programmes in the New Zealand and US health sectors. In addition the Trust’s partner, xxxx, brings to the Programme experience building and deploying the yyyyyy applications in more than 17 hospitals. This experience has put the organisation in a strong position to advise on getting the most from yyyyyy products, clinical engagement, and opportunities for process reform.

The Trust sees the challenge of unifying its electronic patient records as an essential first step to providing an up-to-date and coherent view of a patient’s history to other providers in the NHS. The long-term plan for the eRecord is that nursing notes, theatre records, and specialist information systems used within the Trust will be integrated so that summary information is available to all clinicians with access to the eRecord.

The eRecord Programme management and the Trust’s IM&T Department are working closely with Connecting for Health to ensure that Choose and Book will be thoroughly integrated and that the development of the eRecord at our Trust is in-line with plans to integrate health information systems on a wider scale in the future. The Trust has also had significant engagement with CfH in designing the local electronic prescribing module which will be the first implementation of yyyyyy’s electronic prescribing in the UK.

Presentation given to Cerner User Group, UK. 2008. By André Snoxall. NUTH Cerner User group

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