How to get involved

Multi-professional digital team just like we see in clinical practice

A 'team' of professionals and non professionals supporting each other to fulfil the needs of the service/specialism - see further notes

Senior position e.g. B7/8 nurse/midwife, supported by B5/6, obstetrician/specialist doctor, with enough staff to cover leave/sickness etc. Admin support and close links with other specialities for MDT working, and other teams such as IT/Informatics CNO/board level/directors, robust and supportive regional LMNS/ICB(S) and national relationships. For digital maternity - leadership, informatics and business analyst training, QI, Clinical Safety, relevant clinical experience/mandatory updates, communication, RCA. Support and buy in required from wider leadership team and clinical staff - change army, winning over hearts and minds

Many jobs for nurses doing virtual health need to be a prescriber. If the companies don’t offer in-house training they will use up nhs staff

Digital Links for each speciality

Having anaesthetists, maternity support workers, ward clerks et al being able to represent their speciality when developing new ICS, as well as being able to deliver cascade training. When the people who are going to use the system are part of the development, the training and interface that will be used would be created with the people in mind.

A generic model is needed to assure a SOCIO-technical approach, facilitate public, patient, and carer access, and professional values.

Several decades of IT use demonstrate the importance of the need for inclusion of users - both staff and the public. This requires an approach that is not just process-centric (key as this is), but SOCIO-technical to encompass purposes, practice and policy. Accessibility of the public, patient, carers is vital - especially for sustainable health systems. As another idea points out, technology should not become a barrier - (a surrogate gate-keeping method). Hodges' model - a generic conceptual framework - can facilitate critical thinking, reflection and engagement in a socio-technical manner, preserving and assuring due regard for the patient and nursing's values. The model can be used across healthcare professions, educational pathways, and forms of literacy and informatics. The model is also open - Creative Commons with a small but growing bibliography: https://hodges-model.blogspot.com/ Thanks and best to all. Peter Jones, Lancashire, UK @h2cm

Work in progress - refinement needed for data processes

Data is currently used for communication in practice, to aid clinical decision making, to report for assurance, governance, auditing, highlight trends and deficits in service provision, highlight areas for improvement including through research. Data capture is not consistent across providers - paper vs digital, digital = different suppliers, different users (digital literacy vs time available vs availability of digital systems), different levels of digital support within each provider... Work required to streamline processes, making data input less arduous and data collected easily accessible to all who need it - clinicians, service users, regional and national groups, associated services. More guidance required around what data we need to capture - standardise processes through MSDS and PRSB. Make guidance maternity specific - informed consent, personalisation and choice, WGLL, etc. In future - more of the same but better! More efficient use of technologies, less duplication of effort, less errors, more AI, more accountability

Improvement not assurance

Common observation is that nursing data is used for assurance, is often clunky and manual and reliant on the person collecting the data/doing the audit being consistent in their approach. We need the ability to look at data, use tools to inform opportunity for improvement and benchmark across organisations and systems

All local and national maternity dashboards should flow from the data we have to enter and submit into the Maternity Services Dataset (MSDS)

Make the data relevant to those adding it

Relating how and why the data is used and the reciprocated impact on practice, resources and finance might help to drive a sense of improved entry by practitioners; show people why what they are doing is important and how it will impact citizens

Digital Literacy and data driven education for Nurses

We currently have a staff level data application that allows us to see how often each nurse is using the trust core documentation and workflows such as risk assessments, escalation of care and closed loop medications. The data allows us to see how many times a piece of documentation is completed in the last month/2-3 months/4-6 months and > 6 months. This allows us to draw patterns on why engagement is improving or declining (i.e. education need, new workflow introduction or ward pressures at times of high clinical need) This is used by educators and managers to analyse training needs and provide education to staff, in a supportive environment, that is tailored to them. This also reduces the need for blanket education that is not relevant to all. In future it would be good to map this to national standards for documentation.

Evidence Based Nursing

It is the commitment to Evidence Based Nursing that drives the demand data, which requires the processing of the data into information that helps the frontline deliver care, and the Board to assure itself that care is compliant and delivering its strategic goals. It is the data processing and communication of the information that requires technology. We should not buy technology because it is fashionable.

Time spent inputting clinical data into patient records feels to be increasing, reducing face to face contact.

Multiple benefits currently conflict with areas for improvement

If used effectively, it can improve communication and streamline processes, whilst simultaneously identifying and monitoring areas for improvement. Constantly evolving digital landscape means that currently users are frustrated with inefficient systems and the burden this can place on care offered - interrupting person centred and place based care. Technology can widen access to services, removing physical boundaries to care and reducing inequalities, but only if used correctly and efficiently - still a work in progress in many areas and often a source of frustration, especially for those used to practice pre digital era. Once refined, digital processes have the potential to improve person centred care, freeing up time to have more contact 'with woman/person' and reducing the burden of documentation and communication

Succinct data capture when F2F

Making systems more "pick up and play" while capturing essential data would enable us to be more interactive with the woman while documenting her care

Unclear the value of added data ? At times it is to fulfil some other gap in data collection.

In HV services multiple data collection items requested by commissioners, but purpose and use unclear

Ensure competencies achieved prior to use

A lot of training is now self led with no assessment component - ensure staff are confident using the system as you would any other clinical skill, it is just as important and can pose just as serious a risk to the public and themselves. Difficulty lies in freeing staff to complete training - face to face best but only if led by people with a good knowledge of the systems, and the speciality (i.e. maternity - if a training session for midwives is led by someone with a basic understanding of the system and little to no knowledge of maternity/obstetrics, it has no benefit - staff become disengaged and lose faith in the digital solutions/whole process). If self directed, ensure staff are PAID for their time as they should be any other essential training, and ensure there is a robust assessment process within the self directed modules

Placement

We offer focus weeks for our student nurses to work with the digital nursing team

Digital Champions ( not keen on word champion)

We are establishing a group of self selected digital champions across our organisation who will be 'upskilled' and supported with 3 hours per month to support colleagues on their wards/departments with digital issues. we are also using them to test new products and be involved in the design

Inclusion of digital in post-reg education and training

Inclusion of digital in post-reg education and training

Should we be teaching transformation not digital?

Digital is the golden thread running though all we do now, not only in healthcare but most of our society, the challenges we face are often legacy issues that come from patients changing needs, societal changes, population health, evidence based knowledge, improvements, new technology and systems - as we innovate and build we transform. Would the fear of digital being out of a nurses remit be removed if we built into nurses education the skills to manage transformational change, with this include digital skills and literacy?

By patients recording their vital signs and symptoms remotely and a nurse monitoring the dashboard means patients are prioritised by need

Innovation must not widen inequalities gap

When bringing in a digital tool or solution to improve pathways or to care or remote monitoring/health consideration must be given to groups that may have limited access or no access to technology such as forensic/prison populations, homeless etc as well as those that already face health inequalities. There must also be innovation and improvement to support better healthcare for those that can not access digital when a digital solution is implemented - we must not only innovate in a digital space

Freeing up time for the people who need it most

Use of virtual and remote technologies can reduce travel time to static clinics etc., for both service users and staff. It also allows staff to 'triage' those who need that face to face time most - some queries or care can be offered virtually, and save multiple face to face appointments for others in the process

Contingency for the digitally disengaged service users, there must be strategies in place to accommodate this issue

expand the use of 'wearables' within healthcare to support patients taking ownership and being involved in their own care

digitalise remote monitoring and increase patient engagement through wearables and XR

Genetics Competence for N&M

Booking visit questionnaire to be adapted to include further prompts for midwives to assess whether a referral is required.

Digital record of discussion

A digital record of discussion for genomic testing linked to NHS spine and EPR