Implementation is in many ways just the beginning. Often only a subset of benefits can be fully realised during the initial implementation period, which leaves a lot of scope for future improvement. Optimisation, through system iteration and developments, should be a constant feature of any implementation strategy to ensure you utilise the full potential of a system in the long-run and that you take advantage of new technology and functionality that emerges along the way. Read through our suggestions of what on-going optimisation activities you should consider.
The team you need
BAU for all teams!
What to do
This includes upgrading/developing of software and hardware, medication and knowledge databases, and the provision of on-going support to users.
Customisation/refinement of the installed system (e.g. relating to clinical decision support, re-use of data, reporting and ‘rule-breaking’) and further improvements in interoperability.Tip:
For ‘rule-breaking’ see: Position Paper on electronic decision support within Newcastle upon Tyne Hospitals and Sample interaction rule 2 Ciclosporin linked within the tools listed below.
Continued engagement with end-users
Continued engagement with end-users will maintain motivation and allow you to monitor any existing and anticipated workarounds that users may employ to overcome difficulties with the system. It will also help guide the continuous process improvement journey, allowing you to identify how to rethink existing process and practice.
Measuring Training Needs
Identifying ongoing training needs (for different roles such as nurses) and developing human and technological capabilities to support optimisation is vital.
Monitoring and evaluation of progress
Monitoring and evaluating progress over time is imperative to assess whether anticipated benefits for both end-users and patients and the forecast return on investment have been realised. The evaluation strategy should acknowledge that, due to continuous and iterative development, different benefits will likely be realised at different moments in time. Conducting data quality monitoring, critical incidence reports, analytics, clinical audit, periodic reviews of progress, and assessment of changing requirements will help you to evidence when and how successfully you have realised your predicted benefits.
Developing relationships with other hospitals, particularly benchmark sites such as University Hospitals Birmingham who have been using ePrescribing systems for a number of years will enable the sharing of transferable lessons, particularly in relation to continuous system improvement (e.g. introducing barcode medication administration) and data reuse.