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Practice comment

“Technology can transform the quality of clinical practice”

Nurses must embrace technology as part of ensuring high-quality care

Innovation is increasingly viewed as a key behaviour for high-performing leadership teams throughout the NHS. The growing significance of long-term conditions, fundamental changes in the nature, age and skills of the healthcare workforce, persistent challenges in relation to quality and safety, as well as concerns about cost, all underline the urgent need to change clinical practice.
Yet, as we know from the well-evidenced understanding of the diffusion of innovation, there are no quick wins to successful and sustainable innovation.
Successful innovation requires interaction between many parts of the system and you frequently see a “clash” between managerial and professional innovation agendas. This can lead to contrasting approaches to innovation, for example, never events versus professionally generated empirical evidence.
This can be seen clearly in relation to introducing new technologies and approaches to the use of information in the system. However, what seems to be missing is the adaption of this innovation for frontline staff and patients. The information prioritised for collection and made available is not necessarily what frontline staff would prefer to gather to address their own quality concerns.
Recognising this tension is a good step forward, but also presents us with a strategic leadership challenge. That is, a need for us to take a transformational view, and to think in multiple time frames; identifying what we are trying to achieve not just now but in six months, a year, and five years across a complex system.
New technologies are critical to healthcare. The opportunities for technology and the use of social media to support and transform the quality of practice are truly exciting. And there are already pockets of great practice: nurses are listing their clinics on choose and book, using mobile technologies to boost care in the home and supporting patient choice via the timely provision of high-quality information.
But how do we spread these pockets to achieve system-wide change? By making more use of the information we have available. We need to use information to our advantage so we can enhance decisions at the point of care, improve our skills, and develop the talents of our workforce. We also need to have accurate patient records that can be safely shared in care settings.
We know how to do this and do it well - as nurses we are experienced change managers. However, we must make sure we have a seat in the room - don’t walk out when the technologists walk in. We must persist in asking for the information and technology that supports the sort of innovations we want to see, and to stop automatically saying “yes” to collecting more data. And we need to articulate our ambitions for our patients and work with them to design a future that is closer to what they want.
This is the leadership challenge. It’s one that’s both urgent and important, and one that we need to be actively networking our ideas about. So let’s get started.

Dr Susan Hamer is director of nursing, midwifery and allied health professionals, NHS Connecting for Health

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Readers' comments (4)

  • Great comment by Dr Hammer. However, I would have liked her to end the note with words other than "lets get started'. Rather I would argue we need to continue and celebrate nursing and its innovative use of technology for optimal patient care!

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  • Please visit www.institute.nhs.uk/armchair for more information on exactly this topic!

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  • I must say that I have been surprised at the fear and lack of acceptance of such new technologies as computers and electronic patient records.
    Since I returned to practice after an absence of 20 years I have been teaching / supporting / showing other members of the ward team how to do very basic computing tasks such as saving a file with a different name!
    I am surprised at the reluctance to allow themselves to learn technology when they are generally good and caring care givers.

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  • Most nurses I work with are willing to embrace technology and have innovative ideas. The problem comes in making technologies work together. Since TCS our Acute Trust and PCT Trust merged and we have experienced lots of issues in security "mismatch". Most services have problems with IT service, we currently have a 12 week back log to get a scanner installed which was delivered 3 weeks ago! New PCs wait weeks for installation. We were promised new a software program which would speed up areas of work, reporting etc. and was purchased over 1 year ago; it has never been of use due to the problems getting Trust security systems working together with Tablet PCs of which IT are trialling the 8th model still with no success! We, the nurses are still waiting for the technology systems to catch up with what we want to do. Our nurses are more than willing to embrace technology we just need reliable IT infrastructure promised years ago to revolutionise healthcare-as the starting point!

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