Embracing an era of technology

Protecting patient care while needing to do more with less has become part of working life for all of us, with organisations the length of the country looking at what positive changes can be made to meet this challenge.

At Oxleas Foundation Trust, we’ve been able to go some way in meeting this challenge through some simple technology implementations; moving from a paper-based staff rostering system to using a fully computerised, e-rostering tool.

This has helped us better manage the complex rostering demands of our 3000-plus members of staff who are dispersed over a number of sites. They now work in a way which has helped protect standards of patient care while making more effective use of staff time and reduce expenditure on agency support staff.

Cultural challenge

While new technology was a key factor in helping us improve the efficiency of the way we manage staff time, the challenge in delivering positive change and driving adoption of new systems, wasn’t a technology-based challenge, but a cultural and people-based challenge, where our job as project leaders was to change the collective mind-set of our staff.

Based on my experiences at Oxleas, I’ve prepared these tips, which provide some practical advice I’ve picked up over the past 18 months when it comes to bringing about this kind of change.

Clarify your aims and ambitions

Senior buy-in is key to any project and while I benefited from having a good, existing relationship with management, the key to obtaining support for our project was to have real clarity in terms of our goals and objectives. We also needed to ensure we had thought our vision and changes right through to know how they would benefit and affect our patients and service users.

Knowing what you want to do and how you mean to achieve it will not only make your project and proposition more ’sell-able’ internally but help you keep in touch with your ultimate objectives throughout the duration of your project.

Know your staff and services

It is essential to appreciate that every trust and clinical area is unique. This maybe because of the geographic layout, the demands of the local community or personalities and dynamics of the staff. 

Even if you have implemented the same technology elsewhere it is rarely a ‘cut and paste’ job as you will need to tailor both the technology and the implementation to fit the specific staff groups and scenarios. This means that you need to be as much of an expert on your own staff and services as you need be an expert on the technology itself.

Understanding the nuanced needs of our staff helped us better appreciate the impacts of the changes we were asking staff to make

Understanding the nuanced needs of our staff helped us better appreciate the impacts of the changes we were asking staff to make while promoting the specific benefits the new technology would have for different staff and patient groups.

For example, continuity of care is key for our mental health service users, where we need to ensure patients are always seen by the same doctors and carers – which is a particularly tough challenge when working across 110 locations.

In other clinic areas, the workforce challenge was quite different and we would rely upon the new HealthRoster system more for ensuring we have the right staff numbers and skills and were making the most efficient use of staff numbers. 

Another instance, which helped sell the benefits of the new platform, was among community staff who we knew found it hard to get requests for leave approved, as the managers required for the sign off process were never in one place. They can now have requests approved quickly and simply online.

Even though in each scenario we were deploying the same core technology, tailoring the way in which we sold and deployed the system and trained users ensured the system was tied as closely as possible to supporting the working demands and needs of staff.

Deliver the right kind of training

Like any other NHS organisation, planning training sessions can often be an uphill battle, but it really is important that as a project manager you champion the benefits it can provide. It’s all good and well getting this kind of technology to improve productivity, but if no-one knows how to use it, it is pretty pointless.

Some nurses at Oxleas were quite sceptical when we first introduced e-Rostering, which was in some ways down to the fear of the unknown. It’s not uncommon for new technologies or systems to result in resistance, even though it often comes from the right place, with staff worried that making a mistake with new technology could unintentionally damage patient care, or that they would show themselves up by not knowing exactly how to use it.

In our case, it is easy to see how someone who had managed their rosters and timesheets for 20 years on pieces of paper, and worked specific shifts could be alienated by being ‘told what to do’ by the new computer system. We tried to make sure that our users were never afraid to ask for help or had any shame in not knowing how to use the system, so our project team focused on being available, accessible and open to all questions.

Create a network of advocates

Initial training programmes are rarely just “initial”. At Oxleas we identified and trained a number of key advocates or “power users” who could specifically encourage and support their colleagues in using the new system once staff had received initial training, helping people discover new features and to try and avoid forming bad habits. 

Having successfully rolled out the e-Rostering project, we have created a positive precedent for being able to roll out future technological innovations

Given that staff regularly change and that many software platforms are frequently updated with new features, having a specific network of advocates helps us maintain good skills among staff. Most third-party providers will offer training throughout the contract, and not just at the implementation phase, so do make the most out of that.

At Oxleas, we’ve been able to successfully modernise working practices by taking a measured approach, ensuring that staff were on-side with the project and understood their roles in delivering positive change.

Having successfully rolled out the e-Rostering project, we have created a positive precedent for being able to roll out future technological innovations.

It took some time, we faced several challenges and had to make sure we took the right approach. We ensured that the emphasis was on changing attitudes and behaviour rather than focussing solely on the technology as the be all and end all for delivering improvements.

It’s no secret that the adoption of technology in the NHS will continue to be an uphill struggle, however, I feel that if we’re open with each other and share advice on these experiences, then at least we’re not completely fighting in the dark.  

Yvette Knight is a project manager at Oxleas Foundation Trust