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:
Piloting – a small scale trial at the start of a project can help to refine your plan and test systems and requirements.
Plan and procure system changes
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.
Technical message standards can be found in the NHSE API catalogue. New APIs will be required for sharing data generated by the person as part of their self-management with electronic records.
If you have a bespoke system it needs to be updated to comply with the PRSB Diabetes Record information standard. If your system is purchased off the shelf, you are responsible as a provider to check that it complies with the standard.
Example data definition templates
PRSB has created example data definition templates to be used by suppliers or providers in the development of screens and forms for systems compliant with the diabetes record information standard and to help enable consistency across applications used by healthcare professionals in healthcare settings handling information relevant to the care of a person with diabetes.
The examples are set out in the table below with accompanying downloadable templates:
Example | Description | File download |
|---|---|---|
Diabetes front sheet | For both the display and collection of the data that a GP would expect to see on a diabetes summary page for an adult (over the age of 18) with type 1 or type 2 diabetes.
|  |
Glucose, insulin and hybrid closed loop summary sheet | For display of diabetes medical device summary data and based on published international consensus papers for continuous glucose monitoring (CGM), blood glucose monitoring and automated insulin delivery systems. |  |
DigiBete school care plan | For the data items required in a school care plan for a child or young person with diabetes.
|  |
The methodology established for defining the data definition templates is outlined in the project report. If you are considering using any of these example templates in your system (or want to develop your own conformant templates), we would like to hear from you. Please get in touch with us by email or via our support form.
The PRSB Standards Partnership Scheme was established to support providers and suppliers in demonstrating compliance with PRSB standards. Further information on requirements can be found in the information standards notice (ISN) and PRSB standards conformance guide.
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
The short film below looks at some of the next steps PRSB has been taking to pilot and test the standard.
Pilot: Gestational diabetes management
Overview
Gestational diabetes (GDM) is rising in the UK, and those affected have a 60% higher risk of developing type 2 diabetes later in life.
Patients with GDM often receive care from both secondary maternity and diabetes teams, as well as primary care, so effective communication between these teams is essential. This ensures medication and glucose monitoring continue, and that patients are recalled for HbA1c testing to detect type 2 diabetes early. They should also be referred for structured education after pregnancy to reduce the risk of progression to type 2 diabetes.
The pilot
The pilot, conducted by the Health Innovation Network, focused on using the Diabetes Record Information Standard to improve communication to drive up recording, recall for tests and referral to the NHS Diabetes Prevention Programme. A GDM diagnosis letter template (see figure 1 below) was developed collaboratively with primary and secondary care clinicians and piloted with clinics within three south east London hospitals. The template includes the code for GDM alongside medications, follow-up testing and follow-up education requirements.
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 Diabetes Record 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 Diabetes Record Information standard, you’ll want to measure the success of your implementation, e.g. how often the elements within standard are being used and whether it is improving care and/or patient experience.
Analysing 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?
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.