When it comes to digital transformation in healthcare, the journey is as important as the destination.
The last two years at University Hospitals Coventry and Warwickshire NHS Trust (UHCW) have demonstrated 'why' and 'how' transformation in digital and data is important and feasible, at a time when the NHS is faced with operational and financial challenges.
As an organisation, we have managed to achieve a good balance between addressing operational priorities, by utilising our continuous improvement methodology, and exploring innovative and constructively disruptive ways to doing things. We recognised early on that doing more of the same and expecting a different outcome is pointless, whereas using our clinical curiosity and innovative mindset to explore change, is the way forward.
Strong leadership was a catalyst for change, from board sponsorship to championship at ward level.
There are three key components of leadership where the board's role is critical for a successful digital transformation, as follows:
- Reverse engineering failure by asking 'what could go wrong?'
- Investing in people leadership and digital teams.
- Having a bold vision that is shared amongst all staff groups.
Reverse engineering failure by asking 'what could go wrong?'
As a learning organisation, we always try to create the space for people to reflect on what could have been done better and disseminate learnings. When it comes to digital transformation, we should be collaborating and learning from organisations that have gone through similar journeys, so that we proactively address risks before they become issues. The board plays a key role in asking the right questions at the right time and creating a culture of psychological safety. It is worth investing time in reviewing scenarios of failure and placing mitigating solutions proactively, rather than discovering the root cause in the post-mortem programme phase.
Investing in people leadership and digital teams
One of the tools that we explored during our digital transformation journey, is the power of 'design thinking'. We brought people together, clinicians, administrators, analysts, operational managers as well as external partners with artificial intelligence and process mining expertise, to solve some 'wicked' problems impacting citizen engagement with our organisation.
Within 10 weeks and through working as one team, we went from defining the problem to prototyping and implementation of innovative digital tools that have had positive and sustainable benefits for patients. For example, the use of a website chatbot and a new SMS reminder for clinic appointments, significantly reduced calls to appointment centres and our 'do not attend' clinic rates for a subset of our patients, reduced from 10.13% to 5.92%. Patient and staff satisfaction improved as a result of those digital interventions.
Having a bold vision, that is shared amongst all staff groups
Complex innovations, such as an integrated Electronic Patient Record (EPR) implementation, which we have recently completed, are social processes and require good and continuous engagement with all staff groups. The successful adoption of an EPR in the first few days and weeks after going live relies on the 'buy-in' of staff and their understanding of 'what's in it for them', early on into the project implementation. As leaders, we need to be able to articulate the benefits of digitising care records to any member of staff, using language that can be understood and presenting use cases that people can relate to. For us at UHCW, the EPR is a key enabler to our strategic aims, our message to staff was:
Our EPR will interface with other systems to ensure interoperability, clinical access to care records anywhere in the system, seamless pathways, safer care, with patient self-management tools including a patient portal.
Internal engagement is as important as engaging external partners, including patient groups and using a whole-system change approach. The long-term benefits of an integrated EPR, in terms of rich data analytics driving population health management, intelligent decision-making and a more efficient healthcare system, relies on the early adoption of the EPR after going live.
Finally, there are various components of readiness in digital transformation. We often address well the individual level of readiness through staff training and engagement and less well the organisational and system levels of readiness. Investing in the right organisational and system infrastructure, components of which include people, processes and platforms and with such a sequence, will provide greater assurance that the journey of digital transformation will be a successful one.
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