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PRACTICE COMMENT

'Don’t upgrade my IT system - I have patients to look after'

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When her practice’s IT system goes through an upgrade, Jane Warner feels thrown in at the deep end of the pool. She pleads for more training and smoother transitions

Information technology is supposed to help us make safe, evidence-based clinical decisions for the benefit of our patients. But please stop implementing radical upgrades to my IT system while I am trying to get on with what I do best: caring for patients!

I’m no Luddite (although I accept some people may assume I am a bit of a technophobe) but changing a complete IT system without getting clinicians on board every step of the way is verging on dangerous. If staff do not feel confident and competent using an unfamiliar system, this is likely to have an adverse impact on patient safety and wellbeing.

If you are teaching someone to swim, throwing them in at the deep end of a pool tends to be less than conducive to good health and longevity. So why is it that nursing teams, GPs and receptionists are expected to sink or swim when improved technology is installed?

As with numerous other practices, we knew in advance that our old IT system was being replaced, and we welcomed the potential benefits that would come with the new one. We listened to others’ experiences, always believing the transition to the new system would be smooth, and we could “hit the ground running” when the changeover happened.

As nurses, we should never stand in the way of progress, but we are also advocates of common sense. What recently transpired when our new IT system was installed was little short of pathetic. What is so difficult about arranging appropriate and robust training in how to use a new system before rolling it out? Why have a small army of technicians swarming all over every consulting room, office and reception desk when you know there are patients waiting to receive advice and help? Why did no one consider extending out-of-hours cover for the start of the day? And, most irritatingly, why was the sole available person brought in to help firmly telling me there were other priorities to be attended to?

I begged, pleaded and cajoled for help - I was no longer able to print my own prescriptions, my new login had been denied and it was taking six times longer than normal to make an appointment for a patient.

To my professional shame, the standard of the care I gave on the changeover day was lower than it should have been. I needed to work out every new step of the process in a painfully slow way. My focus was on the screen in front of me rather than on the patients.

With time, I am certain I will get to grips with this improved system. But what might I do differently if the same situation were to be encountered again? The truthful answer? Beta-blockers and waterproof mascara.

Jane Warner is nurse practitioner at a medical centre in Somerset.

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Readers' comments (2)

  • I worked in a trust that changed their electronic care record to a completely new system within the last year. I and my colleagues welcomed it as the previous system was slow and clunky at times.

    However the new system has taken some getting used to, despite training and support. I think one thing that irks me is there doesn't always seem to be consultation with the very people who will use a new system day in, day out. For example, with the new system we had to do twice as many clicks to open up the files of a patient. And things didn't seem to have been placed intuitively.

    On top of that the system appears to have slowed down almost reaching the slowness of the system it had replaced!

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  • Matthew  Carr

    What do you expect when it's not the end user (Nurses) who are involved in it's development... they need to wonder into any Hospital (Preferably not a 'posh' hospital, sorry but others are going to be more down to earth and result in a simpler easier to use system) Take a couple of Nurses of different ages and for three weeks have them work alongside some tech guys to create a system that works.

    I have to admit I've not heard a single good thing about the systems the Comunity Nurses are using on their Laptops. They do begrudgingly agree that it is a good thing that in 5-10 years time you'll be able to get a decade + of patient history moments after a patient comes into your care, in a case like an A&E admission this could mean the difference between life and death... knowing instantly what someone is allergic to, any medication they take or even what medication they've taken that day.

    But... Alas... we're the thick edge of the wedge... doesn't fit yet... but after a few years the systems we use should (Hopefully) be the same across the NHS and be as intuitive and easy to use as filling out sheets of paper.

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