Overcoming digital barriers in the nursing profession

Posted on 14th April 2021

Written by Sue Clarke, Clinical Lead, NHS Digital

At the time, all nursing documentation was done on paper. We used whiteboards and clipboards to document our patient’s status and manage patient flow around the hospital.

It was incredibly time-consuming, walking around the wards making notes and compiling bed occupancy. Not having real-time data made making decisions difficult. Nor were we able to share that data with other health and care organisations to make the patient’s journey, and any delays, a shared responsibility. There was enormous potential for improvement.

Welcome to the 21st century

An example of using digital technology to improve care was the introduction of electronic observations. There were many benefits: for the first time, we could digitally capture real-time data on our patients, receive alerts when their status deteriorated and view their information remotely, not just when we walked over to the bedside to check their charts.

Evidence from many organisations that have implemented this technology demonstrates that having the right information at the right time really does have the potential to improve patient outcomes.

“In the acute trust I worked in, most people welcomed the change but for some less digitally-literate colleagues, there was resistance, fear even….”

Despite the evidential benefits, its sometimes a challenge getting everyone on board. If someone has always done something in a particular way, and it has always worked for them, it may take a little longer for them to appreciate the potential benefits of doing the task in a different way.

In the acute trust I worked in, most people welcomed the change but for some less digitally-literate colleagues there was some resistance, fear even, despite the benefits. Change is hard, and for the time-pressured nurse or midwife, it could be difficult to carve out enough time to learn a new system when they already had an embedded practice that worked for them.

Most patients, in my experience, welcomed the change. “Welcome to the 21^st century” was a familiar phrase we heard when we asked for their feedback!

Winning hearts and minds

To get the sceptics to embrace the changes, it is about articulating ‘what’s in it for them’ in the right way. It’s definitely about the hearts and minds, not just the technology.

The skill of the clinical informatician is to be a translator, to help those that find digital transformation challenging to understand why it is necessary, why we can’t stand still and why we can’t do things the way they’ve always been done.

Health Education England have an ongoing programme of work to create an “uplift of digital skills, knowledge, understanding and awareness” (Digital Readiness | Health Education England (hee.nhs.uk)). I think this is a really important piece of work.

Though many health and social care workers are used to using technology in their everyday lives, it seems that technology is not always quite so intuitive in a health care setting. It’s important for nurses, midwives and other health care professionals to have a voice in this space. They understand what works and are well placed to articulate how digital ways of working can improve patient outcomes.

How the Global Digital Exemplar Programme makes a difference

After spending a few years implementing digital solutions at my local acute trust, I moved to NHS Digital in January 2018. I was assigned as a Clinical Lead to the Global Digital Exemplar Programme (GDE).

GDEs are NHS providers that use world-class digital technologies and information to improve quality of care. It really felt like a privilege to have the opportunity to visit digitally mature trusts, to find out about the progress they are making, and the difference digital ways of working are making to patients and staff.

One of the key expectations of the exemplar trusts – and their followers – is to share their learning. There are several ways they do this, but the repository of blueprints written by the GDE’s and their fast followers is a great place to find information and points of contact for less digitally mature trusts. The blueprints are hosted on the NHS Futures platform and provide a wealth of information relating to digital transformation.

I think it is important to recognise that only a handful of trusts are digital exemplars and therefore there are still many that will find digital transformation a significant hurdle. Challenges include finances, resources and a lack of digital skills.

Some trusts do not have digital leaders such as Chief Clinical Information Officers (CCIO) or Chief Nurse Information Officers (CNIO) in post; others may have them but not always in a senior enough position within the organisation to steer the digital strategy.

“Visionary digital leaders need to drive the agenda.”

Without digital leaders in senior positions there is a danger that digital strategies won’t truly address the requirements of digital transformation – it is about so much more than the technology, its also about the culture, processes, target operating models and opportunities for service improvement. Visionary digital leaders need to drive the agenda. Trust Boards need to support the digital transformation agenda, as difficult as that may be with competing priorities.

It goes without saying that there’s work still to do to have a truly digital NHS aligned to the NHS Long Term plan. That said, looking back at the International year of the Nurse and Midwife 2020, it’s really fantastic to reflect upon the progress that has been made, particularly at a time when we have faced our biggest health crisis in decades.

In 2020, nurses, midwives and other health care professionals have really embraced digital transformation with incredible resilience and determination. They’ve implemented changes that previously would have taken years, all for the benefit of their patients. There’s no turning back. Digital transformation is the only way to go.

Originally posted here

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