Articles

Maintaining High Quality Consistent Care

Welcome to the third article in the series; “Addressing the Challenges of Service Delivery”. Following on from our article that considered ways to reduce the burden of administration, this article focuses on some of the many challenges of maintaining high quality consistent care.

The Best for Our Patients

There are numerous challenges facing services in their efforts to maintain high quality consistent care. Our services are commissioned to care for the population of our defined geographical area and we strive to deliver a holistic patient centred non-judgemental approach that is sensitive to an individual’s physical, psychological, emotional, social and spiritual need.

The cultural diversity of our nation and often our local population brings new considerations when delivering care. The reality is that geographical boundaries of healthcare are clearly not a consideration of our population when choosing sexual partners. This means the diversity and often complexity of delivering care is increased, as we now need to face the challenges of caring for patients from outside our “defined” areas and even our nation, all of which presents services with a new range of challenges.

There are quite a few national standards relating to the delivery of sexual healthcare. There are also many examples of best practice highlighting how, over the last few years, services have developed and adapted locally to improve the delivery of care. As new evidence and standards are released or updated, locally services take the time to reflect these changes in their own services through service guidelines, protocols or standard working procedures. These changes in practice then have to be rolled out to staff, be it through the regular service meetings or by training for staff.

Standards of best practice and guidelines are essential to guide your staff on how they should be delivering the best quality holistic care to patients. In the real world of sexual health service delivery the difficult job of creating comprehensive guidelines and standards of practice is only the starting point to delivering high quality care.

By far the greatest challenge lies in converting these standards into practice, utilising these best practice guidelines in a manner appropriate to the diverse yet individual needs of each and every patient and ensuring efficiency of the service as a whole. Delivering the highest standards of patient centric care requires great dedication and the passion shown by the healthcare professionals (HCPs) that continually strive to care for each and every patient in this way is testament to the true importance of our population’s sexual health. This dedication can be seen throughout sexual health services in their drive to truly improve our population’s sexual health and wellbeing.

How do we Improve?

Maintaining the highest standards of care is not easy, even with a team of committed staff. The high demand, incredibly busy clinics and pressure on patient / staff time all add to the challenge. In addition to this, there is a need to promote a patient’s own awareness, understanding and knowledge. Whilst caring for a patient’s presenting requirements, there is an overarching need to increase prevention of sexual ill-health and ensure each patient’s risk through history taking and risk assessment is established.

Services are therefore reliant on each member of staff to deliver the highest standard of service, in line with local guidelines. Only through audits, which are mostly manual studies, is a service able to identify areas for improvement and be able to take the necessary actions to address any weaknesses. This problem is compounded by the need to deliver services at multiple times and locations in order to provide easy access to sexual healthcare, which requires a diverse mix of full and part time staff with varying skills.

When attempting to improve standards, in order to measure the effectiveness of any improvements, a re-audit is required. This unavoidable, labour intensive, slow and lengthy process is a barrier to delivering timely improvements to standard working practice across the whole service.

So what methods can be used to overcome this problem when sexual health services deal with such a diverse and sometimes complex range of care requirements from such a diverse range of patients? And how can you obtain the same level of staff performance from a full time member of staff and those who only work a few hours per week? What are the solutions to rolling-out new standards of working practice, which have been identified as essential for delivering high quality, cost efficient care, in an effective and timely manner?

Support Staff to Deliver the Best Care

Utilising the technology available can benefit sexual health services in a number of ways and one of the most valuable benefits to be sort from clinical software is it’s ability to support staff to consistently deliver a high quality service.

There are a whole range of ways in which technology can support services in this area. As already discussed, most services have invested considerable time creating service specific guidelines. The use of technology should enable these guidelines to be implemented and maintained supporting all staff delivering services.

Direct illustration

In a similar yet much more powerful way technology can do what paper pro-forma were designed to do. If we take for example a sexual history taking proforma or template, on paper it can be a great way to encourage a healthcare professional to collect from the patient the information your service feels necessary in order to take history. However the information your service deems “necessary” for a comprehensive history taking may differ based on the patient that is in front of the HCP, be that due to gender, age or sexuality. Paper has very limited ways in which to deal with these different types of patient.

Taking that same example technology can use your guidelines to control what questions are asked and what data is collected from the patient by steering the HCP along a protocol driven pathway.

The more intelligent the technology, the more likely it’s ability will be to react to any number of known facts already recorded in this patient’s Electronic Patient Record (EPR). At the most basic level an example would be that the system will ensure it only asks “female” questions to patients that are known to be female.

It is however now possible to achieve a much greater level of intelligence and manage more complex examples. For instance, if you have a service defined rule stating all patients between the age of 16 and 25 should be offered a screen for Chlamydia, where a patient fits the rule, the right technology can highlight this requirement to the HCP and further to this raise an alert if a HCP tries to send a patient home with services still outstanding.

Specifically designed to support the staff delivering care, this type of technology ensures all patients are consistently cared for in line with service guidelines. Controls don’t have to be restrictive, if your HCP deems it not necessary to perform a suggested task or collect a certain piece of information from a patient, technology can allow the HCP to proceed and where required, can also ask the HCP to state a reason for not carrying out this task.

In more important areas, technology can be used to enforce certain actions. For example, if your service defined rule states all patients under 16 year of age require a Fraser competency assessment prior to certain items of care, technology can make this mandatory for staff to complete.

Safety can be increased by using technology to highlight to an appropriate member of staff, clinic manager or clinical lead, if a user attempts to continue without prior completion of this or a similar rule based requirement.

Make a Real Difference

Appropriate use of technology can make a real difference to the quality of the care delivered. Clinical alerts and context sensitive support materials are also now available through the use of technology, further supporting the HCP in the delivery of care.

Clinical alerts provide a safety net against a whole range of potential incidents. If we take as an example a patient with an allergy to penicillin, when this patient presents at service, visual warnings can be displayed when viewing the patient’s details. More advanced technology based on pathways is able to work to protocols and service defined rules and is able to support staff to a much higher level preventing them from continuing, whilst at the same time, highlighting the allergy in context with the action they are attempting to perform at that time.

Informed Care

The wealth of information that is available to inform sexual healthcare delivery is a great asset to those delivering service and its value is increased all the more if it can be accessed in a quick and efficient manner.

Alert illustration

By providing staff with the right support materials, be that service guidelines or access to online resources in context to the care being delivered, productivity is increased and staff are supported to confidently provide the best quality care. Services know the best way to deliver care and they need the ability to facilitate the delivery of the highest quality care right across their service. Further to this, services need the ability to quickly roll out new adjustments to working practice. By harnessing the advantages technology can offer and integrating best practice rules into the technology in use in the day to day delivery of care, the service will gain the ability to adapt and develop as needed.

Clinical software has the ability to support both new and existing staff, for new staff it can re-enforce the best working practice as defined by the service and for existing staff it can support them in adapting to new guidelines while also providing competency logbooks for re-accreditation.

Combining technology with clinical expertise, results in services that can finally control the consistency of care delivery, whilst at the same time gain the flexibility to rapidly adapt working practice across the entire service. This brings an opportunity to address service delivery weaknesses in real time - a world away from the slow change of labour intensive manual audit.

Rather than being considered a drain on resource, the use of the right technology can be rewarding when it truly supports patient care. Chosen and implemented in the right way, technology has a very definite role to play and is a real asset to services facing the challenges of improving the health of the population, within the financial limitations of the modern day NHS.

Like to know more?

If you would like to find out in more detail about how INFORM can support services in this area please get in touch.

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More than just Software?

We don’t expect you to be experts in IT so when you need support we strive to make sure you get that support as quickly and easily as possible, communicated in a way that you and your staff understand.

What makes us different?

Not only is the INFORM software at the cutting edge of healthcare IT, it is our understanding of how technology can address the challenges facing Services and our continual commitment to keep in touch with the issues being faced by both management and those delivering service.

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