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How to move to a maintenance and support stage

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Getting to the maintenance and support stage of a digital system roll-out in healthcare is important.

lesley jones

lesley jones

Here staff can see how far they have come – they should now be able to see the benefits both for patients and for staff.

If this phase is well managed then you should be able to set the agenda and vision for future systems. This way staff can see that there is a systematic approach not a reactionary approach. They can also see that they own and play a role in the process.

This phase of a digital roll-out is the stage people often forget about. There is often considerable thought to the preliminary stages and the ‘go-live’ stage.

But if the maintenance and support stage are managed badly, staff can lose heart and enthusiasm. They may even revert back to a paper-based system as they stop trusting the digitalisation process.

“Leadership needs to be handed over at this stage”

Leadership needs to be handed over at this stage. The digital nurse leading may have been the project manager and needs to hand the project over to the maintenance and support team. 

The team needs a 24-hour contact system – enabling queries to be managed. This sort of system can offer useful general information which may also be provided online.

After the ‘go-live’ stage, all job descriptions of nursing staff will need to have a digital competency section. You need to prepare your new recruits so they know this is now an expectation.

The maintenance and support team need to evaluate the hardware and software and modify the system as users identify issues. This can be managed quicker at a local level. But if the organisation has gone live with an external company this may take longer and require prioritization internally first.

You will probably need more hardware and software than you may have originally thought. You need flexibility at this time.

Show the business intelligence in real time to staff, the executive team, patients and carers as appropriate. The data needs to be presented in board papers, fed back to departments, and used for performance management and quality improvement.

This needs careful monitoring as data migration can cause concern about data accuracy. Always remember that if rubbish data is put into the system then you will get data that is rubbish coming out.

Training and education needs to be well established in induction sessions – don’t forget about bank and agency staff. Ensure that senior nurses undertake training to be able to use the data to discuss performance and monitoring with staff.

“Communication remains key to the roll-out”

Organisations would benefit from establishing an e-documentation group to standardise nursing documentation. A group that straddles the whole organisation can help with implementing changes and standardising patient outcome plans.

Communication remains key to the roll-out. If this is managed well then other system roll-outs can follow the same process. It is important to have a patient and carer stakeholder to conclude any issues. Share the experience regionally and nationally in events or meetings, and write about it – especially from a professional perspective.

Nursing forums are crucial places to share the process, otherwise we run the risk of many areas repeating mistakes. Ensure digital nurses involved with the roll-out join the Digital Health network to share their experiences. These are skills and insights we have to grow.

It is important in organisations to build resilience with an expert nursing team that can be deployed for a digital roll-out while still remaining clinical. Nurses of all bands can find this an exciting career path.

Lesley Jones is nurse fellow (digital) at NHS Improvement

This series of blogs has been co-produced with help from trust staff looking at and introducing systems: Arran Rogers, Royal Berkshire NHS FT; Jane Benfield Gloucestershire Hospitals NHS Trust; Sam Neville, Basildon and Thurrock NHS Trust; and Dr Natasha Phillips, University College London.

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Readers' comments (1)

  • I resent the roll out of digital information, my reason, when a patient has had or has a mental health history that appears to be more important than the current reason they are attending hospital
    Having been sent to Southend hospital with extremely worrying breathing the problems, the 'wannbe' doctors' first question was did the patient feel suicidal? The patient had mental health problems some 47 years ago but has never been readmitted / treated and actually went on to to qualify in both mental health and general nursing.

    Southend hospital is obsessed with any minor mental health issue failing to see the patient before them fro what they are today, it breaches the Caldicott Guardian guidelines with constant reference to it and makes reference to issues that the patient has never ever had any treatment for.

    The patient spent five hours in hospital, was offered not treatment / relief for the very distressing breathing problems, was prescribed indigestion tablets and sent home, followed by a report that is full of lies.

    Patients mental health records should not be shared without the patients consent and doctors at Southend hospital are in serious need of education around mental health issues. When the patient complains, the PAL's officer rewords the complaint to allow him to give a much simpler but dishonest response.

    Southend hospital has one of the highest death rates in the country, maybe because they worry so much about issues the patient is not attending hospital for, as the patient suffocates struggling to breathe, for which they attended hospital for in the first place, but were denied any help!

    If the NHS wants to share records digitally, then is seriously needs to address the issues of out of date records, make sure the information they have is actually correct, and to update records periodically. Sharing information can be very useful, but only if it is correct i n the first place!

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