10% Technology, 90% Business Change - Recently Updated Pages

Emerging issues

davemiller — Fri, 14 Nov 2008 04:07:01 CST

What should be done to make a socio-technical approach to the delivery of technology projects in health and social care in the NHS the norm?

A Socio-technical approach considers the technology change alongside and as part of all the other aspects of work, and people's attitudes to it. This recognises that people will not always use systems in the anticipated way, and that this can be a good thing. Healthcare as a very complex system was mentioned (though complexity theory was not), and the need for the technology to meet the needs of the users, and to develop with them, rather than just to provide a rigid set of workflows which may not match preferred or efficient ways of working.

The following issues were raised during the discussion part of the event - please, please add comments, add content, challenge statements, amend our use of headings, reference other material ...

The question itself was challenged! It was suggested that we should not be considering a socio-technical approach, nor that we deliver technology projects, rather that this is about improving healthcare using mechanisms that promote the value of informatics.

The recommendations below have been grouped around 5 main areas where delegates felt change could be effectively implemented. These include:

Engage Key Stakeholders, have Clinicians in the Lead

Engage clinicians in the change process
Get a clinician to lead the change project *
Use a clinically led decision making panel *
Incentivise clinicians and those that need to engage with the change
Give clinicians protected time to participate in change projects
Provide bank staff to backfill when clinicians asked to participate in change projects
Use the clinician’s contract to incentivise / influence
Don’t forget the nurses and other health professionals

Develop new, flexible processes – including planning and project management, contract and supplier management

Need to align local business objectives with IT drivers coming from the centre
Start with small pilots and work with the enthusiasts *
Get the technology working before committing to its extensive use
Develop standards, not standard systems
Build in realistic timescales / relax targets
Bring together clinicians, managers, academics etc.

Base activity on service / service user benefits

Develop an ‘upwards’ approach to change rather than ‘downwards’
Clearly define objectives / care benefits of the change project
Focus outcomes on the needs of the users *
Focus on the care benefits, not on technology ‘button counting’
Move away from contract and contract dates driven change
Pull managers away from the target driven culture within which they work
You cannot simply transfer the risks – take rather than off-load ownership of the business processes
Ensure that IT is the servant not the master in Health Policy
Influence the politicians!

Encouraging local ownership

Identify the right stakeholders at the outset, or you will get what you “think” you need rather than what is actually needed
Build a consensus of the need for change – it is a gradual process
People need to see the longer term benefits of change
Develop a deeper understanding within the organisation(s) of why change is needed *
Change is evolutionary rather than revolutionary

Developing the Health and Social Care Workforce to embrace “socio-technological change” / use vibrant and interactive communication media to improve and promote knowledge sharing and experience

Have the right capability (skill mix) to deliver the change
Offer training or other support for clinicians to ensure that they know how to influence the use and development of technology around patient and clinical needs
Share lessons learned – there needs to be a structured knowledge sharing process
Benchmarking *
Clinical Leaders Project (e.g. action learning sets )
Provide a business change award scheme

What can be done to use the opportunities that the Darzi Next Stage Review and the National Health Informatics Review implementation plan offer?

Resources, references, links

KatherineChristensen — Mon, 03 Nov 2008 05:16:09 CST

Add any suggested resources, references and links to this page, or attach them to other sections where appropriate.

Summary Care Record Independent Evaluation (UCL, May 2008)

King's Fund - Technology in the NHS - Transforming the patient's experience of care

PowerPoint presentations delivered at Masterclass on 20 October 2008:

Answers to Questions discussed within the group: see attachment below.

What's the aim?

KatherineChristensen — Mon, 27 Oct 2008 08:28:55 CDT

The outcomes of this wiki will be incorporated into a Faculty Briefing Report, along with contributions from the event speakers, Professor Trish Greenhlagh, Professor Chris Clegg, Ian Herbert and Dr Bev Ellis.

In addition we hope that we can produce a paper designed to provide recommendations from the cross section of Health Informaticians working across healthcare organisations that were represented at the event, with the hope that it can be used to influence key developments in the NHS such as the implementation of the National Health Informatics Review in England.

Your input is invaluable!

10% Technology, 90% Business Change Home

davemiller — Thu, 23 Oct 2008 13:50:25 CDT

What should be done to make a socio-technical approach to the delivery of technology projects in health and social care in the NHS the norm?

This was the question posed to delegates at the end of the UK Faculty of Health Informatics master class held on 20th October 2008 at the Emirates Stadium entitled: “10% Technology, 90% Business Change - Maximising the added value of new technologies for the NHS”.

To build up our response to the question we have created this wiki and hope that you will now use it to contribute your knowledge, thoughts and inspiration to some issues we collated from the discussion part of our event.

Read the pages attached to this wiki so that you have the full context, then use the Emerging issues page to make your contributions, or use the Discussion Forum to throw around thoughts/ideas.

For help using this wiki contact Bruce Elliott (0113 397 4286; bruceelliott@nhs.net) or Katherine Christensen (0113 397 3266; katherine.christensen@nhs.net).

Event agenda

davemiller — Thu, 23 Oct 2008 13:42:01 CDT

9.30am Registration, arrival and refreshments

10.00am Welcome, overview of the issues and outline of the day - Dr Bev Ellis (Chair)

10.15am Maximising the added value of new technologies for the NHS: some reflections on theory and practice - Professor Trisha Greenhalgh

11.35am Break

11.50am Factoring people and process change into technology developments in Primary Care: 30 years of learning and inspiration - Ian Herbert, BCS HIF and Independent Consultant

12.40pm Lunch

1.25pm Socio-technical thinking and practice: applying lessons from elsewhere - Professor Chris Clegg, Leeds University Business School

2.10pm Discussion (tea will be served):

"What should be done to make a socio-technical approach to the delivery of technology projects in Health and Social Care the norm?"
"What should the Faculty’s role be in making this happen?"

3.00pm Plenary discussion: key issues for the Faculty’s briefing paper

3.20pm Summary & conclusions

3.30pm Chair’s closing remarks and departure