Month: June 2017

The PRSB and INTEROPen extends partnership

The PRSB is also working closely with INTEROPen to provide a view on professional and patient priorities The INTEROPen board, a network of organisations promoting interoperability in healthcare, met for the first time this month. The inaugural meeting was held in London, to outline the mission, vision and terms of reference agreed by the parties […]

PRSB attends Royal College of Occupational Therapists conference

The PRSB attended this year’s Royal College of Occupational Therapists (RCOT) conference with a poster presentation, to raise awareness about standards amongst occupational therapy professionals. From reduced funding to the growth in population, there are numerous challenges currently facing occupational therapists. One of the key issues highlighted at this year’s RCOT conference was the changing […]

Update on PRSB projects

The PRSB updates on the key changes to four projects including child health events, the outpatient letter standard, the clinical referral information standard and the digital care and support planning standard. Child health events The second child health workshop took place this month, focussing on primary care, health visiting and school nursing routine information. The […]

The PRSB speaks to Lucy Butler

This month the PRSB speaks to Lucy Butler, who has just joined our advisory board and is the director for children’s services at Oxfordshire County Council. She talks to us about the challenges of information sharing in the social care sector, and the data that professionals need to receive to provide better care. What are […]

PRSB interview – Ian Turner

This month we published the Care Home Information Flows Report, which analyses the information gaps between care homes and health care providers. The report, which can be found online, shows that nine in 10 care homes are still getting paper records, while others are getting inadequate information. We have spoken to Ian Turner, PRSB advisory […]

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”