New technology can bring immediate efficiencies but after a few years “the picture changes”, writes Matthew Little, chief nurse information officer (CNIO) at Gloucestershire Hospitals NHS Foundation Trust
The NHS has made tremendous strides in recent years, harnessing technology to enhance how we deliver care, even in complex areas like theatres and emergency departments.
But working within the NHS means managing public funds — and that comes with a deep responsibility. We owe it to patients and staff to ensure that every investment is maximised. While this does not mean that we stop innovating and pushing boundaries to make healthcare better, we really need to fully leverage the systems and technologies we have already invested time and money in.
Many technology rollouts, for example with electronic patient records (EPRs), have been staged over a set time, maybe two or three years. We see immediate benefits — improved efficiency, better documentation, enhanced patient outcomes. However, a few years down the line and the picture changes. Healthcare continues to evolve and so too must the software and the technology that we use to support it.
While EPRs have made great improvements in how we work, it’s important that we keep records up to date with current clinical knowledge, changes in policy and best practice. If our digital system stays static, then we can’t move forward.
Focus on value
Most digital tools are scoped and costed based on an initial business case. Once implemented, that business case is technically fulfilled — but that doesn’t mean the system has reached its full potential; this is where we need to start optimising what we have.
It’s essential to shift our thinking away from ‘productivity’ or ‘efficiency’ and focus on value
Optimisation will always be challenging. True optimisation may not bring dramatic new benefits, but it does enhance the existing ones. It’s essential to shift our thinking away from just ‘productivity’ or ‘efficiency’ and focus on value.
We often talk about productivity or efficiency gains, but focusing on what gives most value can make the most difference – and is a more appropriate way of demonstrating benefits.
An important benefit that cannot be quantified easily, for example, is the freeing of a member of staff’s ‘headspace’ to focus on the patient in day-to-day care. Being able to provide improved care is highly motivating and increases staff job satisfaction, which also reduces turnover. You end up with a happier workforce because the systems that they’re using really work.
This approach also has real traction with future technology, for example the world of ambient AI. If ambient AI could be used to capture the care that a physio delivers on a ward, where there is significant electronic or paper documentation, this could free up the physio’s ‘headspace’ as well as allow them to spend time with more patients. This in turn could have an impact on flow within the organisation. Getting more patients up and moving could result in shorter stays in hospital, freeing up bed space in the wards.
Of course, ambient AI is still in its early stages and processes would need to be put into place to check the information captured, plus there is the issue of a patient’s right to access data collected.
However, the principle remains that small changes in working methods could have bigger impacts across the organisation.
Small frustrations, big opportunities
Sometimes, it’s [resolving] the little frustrations that make the biggest difference. Take logging into a computer during patient care. At home, we all know how slow it can be. Now imagine doing that repeatedly, under pressure, during a packed clinical shift.
Having login processes replaced with ‘tap and go’ cards or facial recognition reduces these irritations. Importantly it also allows the healthcare professional to focus and deliver care, without being distracted as they try and log in to a computer.
Engaging the workforce
Optimisation is not just about the tech. It’s about people.
When we talk about optimising it’s also about the importance of engaging the workforce. In my experience, successful projects don’t rely on a few enthusiastic individuals. They bring in the whole workforce — nurses, doctors, physios, occupational therapists and more.
It is very easy when you want to start bringing in change with any digital system for a small group of people to get excited about that change and start moving forward on their own.
What is more effective, however, it to bring in the wider workforce – understanding how documentation is used across roles, removing duplication, and creating workflows that truly reflect team-based care. Ultimately, we are talking about multidisciplinary teams accessing patient data and our documents need to work in the same way.
Currently, I’m working on an optimisation project focused on nursing admission documentation, risk assessments, and wound care. We’re working to capture the right information, streamline the process, and ultimately improve care. But this only works because we’re designing with everyone in mind.
An evolution in healthcare
There are some exciting things going on with technology at this moment. It’s almost like a jump in evolution in healthcare, where the software and the hardware have caught up to a level that presents real opportunities for change.
We are seeing people using AI tools to design predictive algorithms on falls prevention or pressure area care, or length of stay to help estimate date of discharge, which has always been a challenge in healthcare organisations. These new approaches should improve care, reduce harm, free up beds and improve patient flow throughout the organisation, from admissions to ward care. But to release the full benefits of these tools they will need to be optimised over time, as healthcare evolves.
The future is exciting. Now is the time to build on the progress we’ve made by optimising and innovating in equal measure.
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