As most NHS Trust’s advance in their commitment to deliver high quality services such as those illustrated by the Service Improvement Programme, it is essential the organisation is able to support good quality services through well informed decision making for services users and carers.
This whitepaper looks at ways in which Trusts can improve how they share knowledge and work collaboratively towards the main goal; quality patient care.
2. Business Case
Executive Summary
As most NHS Trust’s advance in their commitment to deliver high quality
services such as those illustrated by the Service Improvement
Programme, it is essential the organisation is able to support good
quality services through well informed decision making for services users
and carers.
This whitepaper looks at ways in which Trusts can improve how they
share knowledge and work collaboratively towards the main goal; quality
patient care. Amongst other things we will show how SharePoint can
meet the following QIPP objectives:
• Quality and Recovery
Ensure staff have access to the latest, legitimate information
informing better decisions on patient care, leading to quicker
recovery times.
• Improving Outcomes
Improvements to outcomes can be achieved through numerous
means, which can include ensuring staff have access to the latest
policies and procedures, guidance on best practice, and
outcomes from research.
• Process Automation and Audit
Process automation is a great way to improve productivity and
ensure compliance and auditability. We will show you the
relevant features in SharePoint 2013 and the latest versions of
Nintex Workflow.
“All those who work on the frontline should be thinking carefully, and
imaginatively, about how we can do things differently. The QIPP process is
a home for this in the NHS and the way that we can implement the best
and brightest ideas across the service. As the Prime Minister said: ‘Don’t
hold back – be innovative, be radical, challenge the way things are done.”
Andrew Lansley, Secretary of State for Health – 2 July 2010.
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SharePoint; Quality, Innovation, Productivity, and Prevention
Q
3. Business Case
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• Electronic Document Management (EDM)
Version control and robust security for access are mandatory
requirements for any healthcare organisation. SharePoint
includes document management, providing you with a secure
way to manage your sensitive information
• Sustain and develop new services
Place your Trust in a strong position with respect to
commissioning, paving the way for the future.
• Workforce
Productivity gains must be made to ensure Trusts can
demonstrate value for money for the services they provide. One
of the greatest advantages any collaborative tool offers is its
ability to automate manual processes.
• Knowledge Management
Sharing of information and knowledge is a critical success factor
in any Trusts commitment to the Service Improvement
Programme. We’ll look at new collaboration tools to facilitate
team work and improve patient care.
Why Healthcare leaders
need to move away from a Silo mentality
There are three main sources of information currently existing in most
Trusts, the Intranet, network file shares and e-mail. These three disparate
applications are used independently of each other, resulting in silos of
information, no real means of verifying the integrity of documents,
laborious processes to search for relevant information or people, and a
lack of modern technology whereby information can be presented
according to relevance.
In line with the QIPP (Quality Innovation Productivity and Prevention)
challenge, Trusts are committed to lean working. That is, removing
unnecessary administrative overheads to optimise the Trust’s workforce
and thereby enable staff to focus their time and energy towards client
care. Much of this can be achieved by providing ready access to relevant
information and knowledge, building clinical networks to allow sharing of
best practice, and by using technology to support efficient ways of
working.
NEW
4. Image Source: http://www.improvement.nhs.uk
Business Case
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This strategic outline case for SharePoint covers three main sources of
information currently existing in most Trusts, namely the Intranet,
network file shares and e-mail. These three disparate applications are
used independently of each other, resulting in duplication of information
across Trusts, no real means of verifying the integrity of documents,
laborious processes to search for relevant information or people, and a
lack of modern technology whereby information can be presented
according to relevance.
Moreover, lack of integration across current information systems
prohibits staff from sharing information and knowledge across the Trust,
that is, across directorates and professional groups. There is also a
“boundary” around Trusts’ existing information sources, in the sense that
partner organisations who work collaboratively with the Trust such as
GPs, CCGs, PCTs and Local Authorities have no real means of accessing
key Trust information relevant to them for example policies and
procedures, or updates on key programmes or initiatives, other than
through e-mail.
Many procedures are still largely manual; they are reliant on people
remembering to submit information, in the right place, at the right time,
and to the right person. Examples of these are audits, recruitment,
payroll, Human Resources, Finance, I.T. etc. This reliance on manual
processes inevitably leads to errors, carries an administrative burden, and
can result in poor use of manpower.
5. Business Case
While most existing intranets will offer some opportunity for staff to
obtain information from a known location, chances are it has either
approached the end of its useful life or has grown uncontrollably,
becoming unstructured, unreliable and performing badly.
In summary, if a Trust wants to make the required efficiency savings,
develop and deliver new ways of working to support best quality care,
and position itself for the future by demonstrating and promoting its
achievements, it must work towards the following:
In 2013 many of our clients’ intranets will become powerful
communication and collaboration tools for connecting users with
information, and users with other users. A new concept of intranet
beyond the mere management of documents and processes. Traditional
static and centralised intranet is evolving to become both decentralised
and collaborative.
We must also talk here about the concept of “social” intranets. Far from
this referring to staff posting funny pictures and comments all day, Social
Intranet has been proven to increase staff productivity and teamwork.
To help address the above, Raona believe that Trusts would benefit
from a platform such as Microsoft SharePoint
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• Improving access to, and sharing of, knowledge and information,
both within the organisation, and externally with its partners
• Automate and streamline processes to collect and process data
and information with minimum effort to support lean working
• Deploy good collaboration tools to encourage participation
and harvesting of new ideas
Your Intranet can change with SharePoint 2013
1 to 1
Static Intranet
1 to "many"
Dynamic Intranet
"many" a "many"
Social Intranet
6. Business Case
At Raona, we are ready to help our clients evolve their intranets from static
or dynamic intranets to intranets which inspire teamwork and inform
better patient care. As always, the success is not just in applying the
adequate technology, but also consists in how it is applied.
The purpose of this document is to highlight technological and functional
features that will make meeting the QIPP challenge possible. The contents
of this document are the result of analysis carried out by our experts
during the early adoption programme of these technologies to which only
a few privileged Partners have had access. We will see many important
changes and new features in the world of intranets thanks to the launch of
the new version of SharePoint, Windows 8 and other complimentary
solutions provided by Raona.
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User experience
A totally new look & Feel, more
visual, clean and simple, in line with
the new Windows 8 operating
system. Compatible with most mobile
devices and browsers.
• Mobility.
• Multi-device - Multi-browser
• MyCo.
• Components and viewers.
"made by Raona"
Web Content Management
New tools for facilitating information
management when you use your
SharePoint as a web platform.
• Multilingual.
• Cross-site publishing.
• SEO strategy.
Collaboration Spaces
New tools are appearing for site
level collaboration to facilitate the
exchange of information and
working in teams.
• One Note Integration
• Project Newsfeed
• Task Timeline
• Site Mailbox
• Areas & Workspaces
My Social Intranet
SharePoint 2013 incorporates
powerful social communication tools
to connect users to the information
on your Intranet and with other
users.
• Follow.
• Microblogging.
• My Newsfeed.
• Communities.
• PiuPoint. Compliance & Governance
New tools are incorporated to assist
compliance with legal regulations and
to facilitate SharePoint management.
• Centralised management of policies.
• eDiscovery.
• Self Service Site Creation.
• Sharing.
• Governance Plan.
Applications and productivity
A new marketplace is created
SharePoint Store from where users can
download countless applications.
Important improvements are
incorporated into the BI, search and
workflow area.
• SharePoint Store.
• Skydrive-Pro.
• Search.
• Workflows in SharePoint .
• Business Intelligence.
• Nintex Worklow for SharePoint 2013.
7. Business Case
The Structure of the NHS is changing. Some organisations such as Primary
Care Trusts (PCTs) and Strategic Health Authorities (SHAs) will or have been
abolished with new organisation such as Clinical Commissioning Groups
(CCGs) taking their place.
These changes mean that more organisations need to work together, in
some cases these are newly formed groups who know nothing about each
other. For example, local authorities will be taking on a larger role,
assuming responsibility for budgets for Public Health. Health and
Wellbeing Boards will have to encourage integrated working between
commissioners of services across health, social care, public health, and
children. They will also be encouraged to work more closely with other
health and care providers, community groups and agencies, using their
knowledge of local communities to tackle challenges such as smoking,
alcohol and drug misuse and obesity.
It seems that not a day goes by where there isn’t some new initiative to
engage on a wider scale to improve Public Health. No bad thing, but
historically, interdepartmental communication and collaboration has
proved challenge enough without expanding this to the public, public
health bodies, other healthcare professionals, local government, the
voluntary and community sector and many more.
There are many examples of NHS Trusts and partner organisations working
in new and innovative ways to improve their communities’ health and
reduce health inequalities, however the overriding message seems to be
that is difficult to spread good practice into new areas because people say
their area are “too different”.
Now that we have looked at some of the new features around “sharing”
and working in a new way, please allow us to look at some context around
using SharePoint to meet the QIPP challenge
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The Importance of Communities
Community 1
communityResources
Community 2 Community 3
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Area Area Area Area
Workspace Workspace
Workspace
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8. * http://www.nhsconfed.org/Documents/1000697_QIPP_final_report_101208.pdf
Business Case
The QIPP agenda remains high profile within the NHS, i.e. Quality, Inno-
vation, Prevention and Productivity. A publication * (Kike, pon un asteris-
co aquí, y abajo de la página pones el link que hay abajo en azul), by the
NHS Confederation on Back Office Efficiency and Management as part of
the QIPP challenge reported the following:
With developments in commissioning GPs (CCGs) will hold a much
stronger role in this arena. Trusts will need to collaborate and engage in
dialogue with multiple interested parties, effectively, and efficiently. A
demonstrable means of promoting its achievements to ensure existing
services are sustained and new business secured is crucial.
Freedom of Information (FOI)
Current filing systems are disparate across directorates, with few stan-
dards for version control. An orderly filing system, enabling easy identifi-
cation of documents, with true version control and good search facilities
will help the Trust to meet FOI requests efficiently, within statutory time
limits, and with integrity.
Care Quality Commission (CQC)
All Trusts must comply with the requirements of the CQC, and as such,
requires a tool that will support:
• Robust data gathering for evidence to support compliance with
core standards.
• Compliance with policies and procedure
“Workflow - Workflow is a process tool which delivers the right work to the
right people at the right time and, in doing so, optimises the processing
time within your operations. Workflow solutions manage, distribute and
monitor work as it progresses through pre-defined business processes and
therefore assist with the efficient running of an organisation’s operations.
Workflow enables a range of benefits including process visibility – which is
essential for tracking progress and improvement. The benefit of workflow
technology is that it streamlines and simplifies clinical and business proces-
ses, connecting providers directly to the information they need – where,
when, and how they need it. By managing care transitions and information
gaps between diverse systems, departments and facilities, workflow techno-
logy can deliver crucial patient information with speed, efficiency and logic.
It bridges the gap between the business and the clinicians.”
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Strategic case - National context
QUIPP
9. Business Case
Currently, much of the above is accomplished using manual processes. A
tool that enables automatic notifications to be issued to relevant staff
when a document is near expiration will help ensure policies (or indeed
any documents) are kept up-to-date. Similarly, automating some of the
steps associated with action plans and the ability to prompt and track
actions on-line will go a long way towards strengthening governance.
The Information Revolution
Liberating the NHS - An Information Revolution published recently,
highlights the need for good quality information, that is relevant and
accessible, and establishing an environment where using information to
build knowledge becomes the norm.
Strategic Case Local context
With the QUIPP headings in mind, Trusts objectives must be to:
Quality and Recovery
Collaboration is a critical success factor in any Trusts commitment to the
Service Improvement Programme.
Implementing a new recovery model will require colleagues to readily
communicate with each other across a variety of professional groups, and
geographical boundaries, share latest ideas and examples of good
practice, and obtain feedback quickly. Using familiar means of
communication that is web-based with the ability to search for the right
How does SharePoint help support Trusts objectives?
• Improve the quality of the services, we deliver, underpinned by the
recovery approach (Quality and Recovery)
• Develop and deliver a modern model of service provision within
appropriate building environments (Modern services)
• Support existing services to thrive and become more competitive to
encourage participation and harvesting of new ideas
• Develop the capacity and capability of the workforce to deliver our
vision and strategic objectives, while operating efficiently and effectively
(Workforce)
• Grow and develop mental health knowledge and practice and its
application for current and future generations (Knowledge Management)
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10. Business Case
people and engage in dialogue for example through blogging, along with
the capability to push information targeted to the relevant audience will
make a significant contribution to this requirement, while allowing the
momentum of new and innovative ideas to be retained.
Improving Outcomes
Improvements to outcomes can be achieved through numerous means,
which can include ensuring staff have access to the latest policies and
procedures, guidance on best practice, and outcomes from research.
The use of dashboards can also help support improvement in outcomes by
highlighting progress with particular initiatives, and alerting staff to
changes required in the configuration of services if certain areas are shown
to be weak. The Trust is in the early stages of developing an in-house
dashboard solution. Ideally, these would be available from a common user
interface, reducing the need for additional training, while taking
advantage of the ability to push information that is relevant to staff.
Audit can also be a valuable source of evidence which can demonstrate
both the strengths and weaknesses of services. Electronic forms and
workflows, and on-line surveys can both be used to support audit.
Electronic Document Management (EDM)
The primary objective of any EDM project is to convert paper documents
to an electronic format, which in turn, requires an efficient document
management system to maximise the benefits electronic documents can
offer. Version control and robust security for access are mandatory
requirements for any document management system. SharePoint includes
document management, which in turn can provide access to historical
documents which can inform the best way forward for the future.
Sustain and develop new services
Noting the innovative nature of the Service Improvement Programme, the
Trusts would benefit from the capability to publish its services and
outcomes both internally and externally to its key stakeholders. In turn, this
would improve transparency, placing Trusts in a strong position with
respect to commissioning, paving the way for the future.
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11. Business Case
Workforce
A standard and consistent document library available through a web
browser, together with excellent search capabilities, not only releases staff
time to find information, but will widen access to relevant documenta-
tion, which can further support training and encourage cross fertilisation
of ideas without overwhelming staff through information overload.
Productivity gains must be made to ensure Trusts can demonstrate value
for money for the services they provide. One of the greatest advantages
any collaborative tool offers is its ability to automate manual processes.
For example, intelligent forms can be created, with users being prompted
to select data from drop down lists, and through business rules, the form
is passed to the correct person for processing. The status of the process
can be monitored through audit trails, and staff can be confident they
have submitted the correct information, and to the correct person.
Electronic workflows can also help reduce mistakes, and reduce the time
taken to chase after and correct errors; and taken one step further, can
facilitate the electronic uploading of information to other systems (e.g.
Electronic Staff Record (ESR)) thereby removing the need for manual
transcription.
It should be noted that this concept of automating workflows can apply
to both standard procedures, and to actions resulting from meetings,
workshops or consultations.
As with any development programme, new proposals inevitably involve
documents, discussions and approvals, often over a large population
dispersed over a wide geographic area. Strong version control will help
ensure consistency and currency of information with clarity on the status
of the document (including approval status) thereby avoiding risks
associated with miscommunication, while the ability to review documents
collaboratively can reduce travel, and offer staff far greater flexibility and
more time in their working day to focus on the true nature of their job.
Equally, through the use of modern technology and collaborative soft-
ware, staff can benefit from up-to-date skill set, enhancing staff develop-
ment opportunities. Collaborative software can also support action
learning sets, allowing staff to come together on-line to share their
experiences without the need to travel for face-to-face meetings .
Finally, increased participation in Trust events and consultation processes
through the use of on-line discussion forums or surveys, can give staff
the confidence that their voice has been heard.
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12. Business Case
Knowledge Management
Sharing of information and knowledge is fundamental to knowledge
management. A good knowledge management strategy requires the
following:
• System to capture and share new ideas and information
• Ability to connect people with common interests
• Ability to find information according to relevance
• Informed decision making by integrating information into a
single trusted source
Reflecting on the current challenges facing most NHS Trusts in relation to
retrieving and using information to maximum effect, to help staff perform
day-to-day duties and to build knowledge to support the Trust going
forward, there are key areas where improvements can be made.
The key areas for improvement are summarised as follows:
• Reduce the administrative overhead to collect, store, retrieve and
dispose of information
• Access to information, that is relevant to the user, through a
common user interface, from a trusted source
• Compliance with governance arrangements through policy
controls such as retention schedules and notifications of updates
and expiration
• Ability to engage in dialogue with colleagues regardless of the
geographical location
• Managing the technical overhead to maintain information sources
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Summary of Benefits
13. 8
Business Case
For the purposes of analysis, the above are described more fully in the table below:
Productivity
Overhead in
technical support
Governance (compliance)
Isolated mobile workers
Up to date skillset for staff
Partnership Working
Effective organisation
through streamlined
processes
•Time to retrieve and maintain information such as documents through i)
intelligent and intuitive search facilities ii) single information source using a
common user interface and iii) accessing information according to relevance
•Time to find the right people through intelligent searches and a single
information source (staff directory)
•(Reduce) need to travel through on-line document reviews for MS Word
documents and MS PowerPoint presentations
•Administrative overhead through integrated information systems, and
reduced need to transcribe information
•Workload to create on-line forms (no more paper forms or programming)
•Avoidance of multiple departmental systems and databases, most notably an
Electronic Document Management System EDM (reader for scanned clinical
notes)
•Turn-around time to provide users with access to relevant document libraries
•Eliminate costs to maintain a legacy system
•Governance through true version control for documentation, and a central
repository for policies and procedures
•Compliance with procedures through automated workflow management
and alerts
•Staff are trained in use of modern technology, facilitating staff development
•Access to information, for external parties e.g. PCTs, CCGs and Local
Authorities.
•Collaboration and sharing of good practice through on-line discussion, and
communities of practice
•Standardised data collection through intelligent forms, reducing errors in data
entry and delays in authorisation
•Proactive approach through dashboard facilities and managing risks effectively
•Access to information and on-line dialogue
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Benefit Description
14. Business Case
There are potential cash savings, improved governance and improved
operation to be gained from automating business processes. Most NHS
Trusts’ administration is currently distributed across the Trust. Adoption of
a collaborative tool with automated processes will see a minimum of 2
hours of time being saved for each staff member per week and this
saving will rise considerably for those heavily engaged in administrative
duties such as processing forms and transcribing data. This cumulative
saving has the potential to consolidate and rationalise the administrative
effort across the Trust as a whole, thereby introducing potential cash
releasing benefits.
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15. About
Raona is a multinational company specialising
in custom software development and
consultancy. Wth offices in London, Spain and
Argentina, we help our clients pinpoint where
technology can really provide more value. We
considerourselvesaboutiquecompanythanks
to our high level of specialisation in Microsoft
technologies.
http://www.facebook.com/raona.uk www.twitter.com/Raona_UK www.raona.co.uk hello@raona.com +44 (0) 20 834 2960
@W
