Palliative and End of Life Care
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About this toolkit

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End-of-Life-Getting to grips with the standard

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Getting people on board

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Taking stock and planning

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Putting the standard into practice

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Shared resources and learning

Putting the standard into practice

Having agreed your roadmap with stakeholders, you can now begin making the changes and putting the standard into practice in your organisation.

From piloting the information standard and developing a training programme, through to monitoring and measuring its successful adoption.

Develop a detailed timetable

Based on your high-level roadmap, develop a detailed timetable for change with dates and responsibilities clearly identified. This will signal to stakeholders when the change programme will begin, how long it will take and prepare them to fulfil their role in making it happen.

Consider the following when pulling together your timetable:

Phases – a phased approach to implementation is often helpful to manage systems and stakeholders. It also reduces the risk of issues accumulating, as you can address them at each phase.

Piloting – a small scale trial at the start of a project can help to refine your plan and test systems and requirements.

Stakeholder management – share your timetable for change as early as you can and provide regular updates to stakeholders, so they are engaged in whether progress is being made with implementation and how they can contribute, as needed.

Plan and procure system changes

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Procure the system changes needed ensuring that systems will be delivered that are conformant with the standard. See NHS England procurement guidance.

Agree how the team will be involved in testing the software to ensure it is conformant and meets local requirements.

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Technical message standards (to enable translation of the standard into machine readable formats) can be accessed on GOV.UK – The Technology Code of Practice.

Piloting

We recommend piloting a small-scale trial; implementing the information standard for a small number of users or in a small locality. After these users have been trained, the project team can make charts of the processes involved – these charts will form the basis for training all users to access and utilise the information standard.

There are several advantages to running a pilot:

Reduces the risk of a full-scale implementation as adjustments and modifications can be made as a result of the pilot

Improves processes through evaluation of the process charts produced during the pilot
Develops training materials through conversations with users from the pilot who can share their learnings.

Training

When you are ready to implement the information standard on a wide scale, you will need to develop training materials. You can use our example slides and training schedule as part of your training initiative.

Your training plan

Make a list of stakeholders who will need to be trained and produce a timetable of training

Work through the example training schedule to develop your plan.

Multiple training sessions can be helpful for your staff to engage and have a greater lever of understanding

Different groups of users will have different learning styles. Take this into account when designing the type of training you offer.

Safety case and hazard log

Every information standard built by PRSB includes a safety case and a hazard log. These additional documents are written based on the NHS guidance – PRSB, as developers of the data model, use DCB0129 guidance (for manufacturers of health IT systems).

Why use a safety case and hazard log?

The purpose of the safety case and hazard log is to identify the hazards which could cause a person harm because of using the standard, along with how that hazard can be mitigated. There are different types of mitigation – through system design, testing, user training or business control processes.

When implementing the Palliative and End of Life Care Information Standard you should consider and mitigate hazards using the documentation. Any suppliers you work with must:

  • Develop their own safety case and hazard log, using NHS guidance DCB0160
  • Have registered clinical safety officers to ensure the systems implemented are safe for use and person care
  • Run risk assessments to determine the likelihood and consequence of a risk happening.

As part of ongoing clinical risk management, it is recommended that regular clinical risk assessments are undertaken. This can be done using a recognised tool e.g., SWIFT or BOW TIE.

 

Resources

Monitor, measure and adjust

Once you have implemented the Palliative and End of Life Care Information Standard, you’ll want to measure the success of your implementation. For example, how often the elements within standard are being used and whether it is improving care and/or patient experience. Use the current baseline metrics you have developed.

 

Analyising the results

  • Are the expected benefits being achieved?
  • If not, why not and how could this be improved?
  • What has been learnt that would improve the process and outcomes?
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You should expect to go through iterations to get your implementation right over time. This gives you a chance to review data on the effectiveness of the changes and course correct as needed in iterative cycles:

Define clear roles and responsibilities

Reflect on the data you have gathered

Make adaptations to your system or processes

Celebrate and publicise successes

Repeat

PRSB Standards Explained

Why we need standards to record our health and care information in a consistent way so that it can be made available whenever it is needed.

Making change happen

Transformation programmes need clear goals, the right leadership and engaged staff and stakeholders. Get started by reading our information on transformational change.

PRSB Support Available

If you have a question for PRSB, please contact our support team. We have an expert team who can help you find the answer, or direct you to the right place.