Learning from the experiences and successes of our NHS Trust partners over the years, Cerner’s approach to working with Trusts has evolved over time. This has been evidenced by a significant change in Cerner’s approach to helping Trusts deliver change and realise benefits. While technology remains a significant enabler in the delivery of meaningful change in healthcare, the transformation work is most successfully delivered and sustained when a coordinated focus on the ‘people’, ‘process’ and ‘environment’ aspects of the change is applied, as well as the ‘technology’ itself.
The embedding of Performance Improvement tools and techniques within the Cerner Consulting Framework aims to optimise workflows, remove variance and waste, and increase patient outcomes and satisfaction. The approach involves the collaborative (Trust and Cerner) use of selected tools from methodologies like Lean and Six Sigma, as well as from behaviour change methodologies like ‘Influencer’. Our team obtains baseline measurements of current state workflows, and identifies opportunities for improvement that are in-line with benefits the Trust is pursuing. This in turn informs the system design and the transition plan which contains all aspects of the planned change, (people, process, technology and environment). Post-live measurements are then captured in order to evaluate the improvement, and measures are put in place to enable the Trust to monitor and control the improvement thereafter.
The implementation of ePrescribing at some of the London Trusts has highlighted the benefits of this approach. Trusts sought to implement a system that complemented the way clinicians work, delivering benefits to patients and the hospital while making clinicians’ jobs easier, faster and more effective. Performance Improvement tools were used to measure workflows before and after the implementation of the Cerner system, in order to measure the impact of the system on nursing processes. These observations and measurements, carried out over six weeks, allowed the Trusts to realise that the implementation of Cerner ePrescribing had enabled a reduction in time of 16 seconds per medication administered. This change becomes significant when extrapolated across 28 beds per ward for instance - with patients frequently requiring combinations of multiple medications – and six drug rounds per 24 hours. This equates to a reduction in time per medication of about 13 percent, and thus a release of nursing time to care for patients.
It is measurable benefits like these that the incorporation of Performance Improvement into the Consulting Framework is helping our clients to achieve across a spectrum of workflows.
These tools and techniques are also embedded within Cerner’s range of stand-alone Performance Improvement packages which help Trusts to tackle key health and social care challenges like discharging inpatients earlier in the day, improving ED patient flow and more.
This blog post was written jointly with Gavin Cater, Director for Performance Improvement at Cerner, and Pete Hughes, Pharmacist and Consultant for Performance Improvement at Cerner.