The increased adoption of new technologies across the NHS during the COVID-19 pandemic has been widely covered in the media over the past months. The sharing of care records at scale, the implementation of remote consultations, and the use of data and analytics to support decision making and protect the most vulnerable are only a few examples of technology-enabled achievements we have seen in different parts of the system.
While the technology elements used for these remarkable accomplishments can be quite diverse and complex, there is a single crucial ingredient that has underpinned each one of these successes: collaboration.
In this edition of our Cerner blog, James Bird, chief nursing information officer at Imperial College Healthcare NHS Trust, reflects on how trust-based collaboration has boosted the UK response to the pandemic, and how some of the main shifts he’s seen in the way the NHS operates will have a permanent impact on the way health and care organisations work together.
It’s been nearly four months since lockdown was declared by UK government in an effort to reduce propagation of COVID-19 across England and help our healthcare organisations and workforce cope with the pressures brought upon by this pandemic.
The magnitude of the crisis we’ve been through has forced everyone in health and care to come together in a way that many of us didn’t even think was possible. The pace at which things have been done across the NHS is unheard of – we have basically completed a decade’s worth of transformation in just a matter of weeks.
The golden key for successful collaboration
When I try to think of the recipe that has led to some of these successes, the first thing that comes to mind is that for the first time in my NHS career we had a clearly defined overriding goal – a very clear and shared ‘why’, and that has been absolutely key.
The complexity and the size of the NHS mean we often find ourselves firefighting and reacting to address the day’s top priorities, usually guided by what has come down from NHS England or what’s been published in the press. Whilst this often results in progress in addressing individual issues, sustained transformational progress can be hard.
But this time it was different. There was a defining moment in March, when we saw what was happening in Italy, that made us all tacitly commit to doing everything we could to avoid going through that. And whilst we knew that conditions and resources are different from one organisation to another, we also knew that we were all trying to achieve the same thing.
Collaborating in times of crisis
When Public Health England announced at the beginning of the pandemic the symptoms of COVID-19 that we needed to look out for, I immediately realised we needed to find a way to record this information in a standard way in our electronic patient records (EPR) system – and we also needed to make sure that what we built could be rapidly adapted as national guidance evolved.
Creating a COVID-19 pathway was absolutely necessary for us to be able to standardise our care and the treatment we were giving to people across the seven hospitals and two organisations in our EPR domain.
Having attended a care pathway training session at Cerner’s Collaboration Centre only a few weeks before, I knew the basics of how a COVID-19 pathway could be created. Relevant colleagues from Imperial and from Chelsea and Westminster Hospital NHS Foundation Trust were brought together to design the pathway, based on the Public Health England guidelines.
Being in the early stages of the pandemic, time was of the essence, so we needed to keep the pathway and the process around the creation of the pathway as simple as we possibly could. That meant ensuring we got just the right amount of people involved in the process, and that we kept the pathway and the set of questions limited to the essentials.
Cerner were quick to offer their technical support and, whilst we could’ve done it ourselves, by leveraging our existing partnership with Cerner and their knowledge and experience from the work done at Royal Free, we were able to accelerate the implementation. It was the most rapid and effective collaboration I’ve seen between us and Cerner in recent years – the pathway was designed and implemented within just eight days.
We did not get it 100% right the first time – four days after go-live we implemented version two of the pathway after feedback from staff who were using it, but the end result was a useful and usable pathway created in partnership with teams from all three organisations that was then quickly built upon by other NHS Trusts and other Cerner clients as they armed themselves to better respond to the pandemic.
When I look back and realise the level of cross-organisational collaboration that we’ve seen in the first half of 2020, I can’t help but thinking that none of this would’ve been possible just a year ago.
Throughout this pandemic, organisations have been forced to learn how to trust in one another. We have completely broken down barriers and we have successfully formed trust-based partnerships that simply were either not there, or were very limited in nature before.
Looking beyond COVID-19, we have already started discussing the potential for elective hubs and scheduled admissions to ED, for example. We have already started thinking more on a system-level, and that is a massive shift. If we can carry that mindset into the future and keep it as we re-start non-COVID-related activities, then that’ll be a huge win and an invaluable lesson we will have learnt from what has been a very lamentable situation.
Cerner clients are all part of a community – one where they can collectively learn, share and advise in a range of ways to ensure they can deliver best practice and address common challenges. Explore our variety of special interest groups (SIGs) and make sure you follow us on Twitter to be notified of upcoming collaboration events and opportunities.