Month: July 2022

Challenges to widespread adoption of standards

Lorraine Foley, CEO, PRSB As the mercury spiralled, we knew it was going to be a tough week for health and care services, already under pressure from another increase in numbers of people with COVID-19 and the battle to restore services after the last two extraordinary years. It is now widely accepted that there is […]

New information sharing standards to support diabetes management

There are approximately 4.8 million people living with diabetes in the UK and this is expected to rise to 5.3 million by 2025. PRSB has published two standards that will help to ensure the right information flows between services and from medical devices and tools to the professionals that need it, to support better care […]

A welcome plan, but delivery is key

In quick succession in recent days, the Government published two strategies for digital transformation and use of people’s data for health and care planning and research (A Plan for Digital Health and Social Care and Data Saves Lives). The digital agenda is central to plans for the future of the NHS and social care, and […]

System C & Graphnet Care Alliance joins PRSB Standards Partnership Scheme

The System C & Graphnet Care Alliance has joined the Professional Record Standards Body’s (PRSB) Standards Partnership Scheme. The Alliance brings together five of the UK’s most innovative and experienced health and care IT providers to create integrated solutions for the health and social care market. The Standards Partnership Scheme connects the PRSB with digital […]

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.”