Standards as yoga practice – reaching for improvement

A guest blog from Taffy Gatawa, CICO at everyLIFE Technologies.

Yoga is a practice where improvement is continuous and incremental, and which contributes to a broader goal of wellbeing and betterment. It’s the best way to describe the journey taken by everyLIFE Technologies on the route to PRSB standards conformance. And it’s one upon which all system suppliers across social care should consider embarking.

Before joining PRSB’s Standards Partnership Scheme, we noticed that the market was changing with a new, national focus on integration between health and social care, coupled with an emphasis on digital as the key method for getting us there. Demand was growing for standards to be taken more seriously.

Taffy Gatawa on the rising awareness of PRSB standards in care.

As digital tools become increasingly essential in helping social care adapt to daily challenges, there is a vital need to ensure that information across the sector is collected in a standardised way, so that the quality of the data recorded can be relied upon by care providers and care receivers alike. With consistent information-sharing, professionals can work together across sectoral boundaries and facilitate joined-up care. We realised that, as a supplier, it was not enough to simply send our products out to market; it was now essential that our products conformed with recognised standards before going out to customers to enable this.

As such, we joined PRSB’s Standards Partnership Scheme at the beginning of 2021 and through desktop research, clinical reviews and critical engagement with PRSB and our customers, successfully implemented two standards into our digital products: About Me and the Personalised Care and Support Plan. The conformance process not only benefitted our digital products in ensuring information is consistent across services but also improved our engagement with our care providers and supported them in administering safe, high-quality care.

Taffy Gatawa on the PRSB standards conformance assessment process.

Over time, we refined our methods based on PRSB and customer feedback and as the process matures, we will continue to reflect on best practice and lessons learned. PRSB standards are available for use on their website so we could have taken the standards directly and implemented them on our own. The benefit of the conformance process however, was that it presented the opportunity for mutual dialogue around the standards and discussion regarding the changes required to facilitate full alignment of the standards with our products. These conversations and reviews ensured that the standards were fully applicable to social care settings and resulted in a solution for social care rather than a health solution made to fit social care.

A significant portion of the conformance process was targeted at refining our digital product but more importantly, we needed to ensure that the product was usable for our care providers and that the standards fit their daily requirements for administering care. The time taken in this regard paid dividends as we were able to engage with our care providers at every step, and they could validate product changes as being compatible with their workflows on the ground. We had the opportunity to raise care providers’ views with PRSB’s clinicians and in turn, this created a new learning experience for us with our customers. It meant customers were able to raise requirements directly with us at the product development level, which in turn informs our future product strategy.

Taffy Gatawa on the outcomes and benefits of PRSB standards conformance assessment.

Yoga is not just about building physical skill, but also about improving our lives more broadly.

The same is true of standards. We wanted to implement standards not just to say that we are conformant with them, but to make sure our product meaningfully supports the safe transfer of information that allows our care providers to administer care safely and efficiently.

Since implementing the Personalised Care and Support Plan, our 1,000 care services are all using the standard, the use of the About Me standard is steadily increasing, and our care providers are now reaching out to us to ask for more standards to be implemented into our products. There is no doubt that the development of industry-wide standards will help to create a safer environment for care receivers through the use of digital technologies in care delivery. Not only does this mean greater ease of interoperability between the health and social care sectors but, crucially, it means improved care outcomes at an individual level too, allowing for incremental improvements to future data management.

Taffy Gatawa on lessons learned and next steps from PRSB standards conformance assessment.

Allowing for seamless communication between digital systems beyond organisational boundaries, will ensure that interoperability can have a positive and lasting effect on standards of care. With the creation of universal standards, not only will there be a reduction in duplicate data entry, but critical health information will be passed between professionals more quickly, more accurately and more safely, at the care receiver’s point of need. Once implemented, these improvements will very quickly be evident in patient outcomes overall.

Read more news
Read more blogs

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.”