Transfers of care
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About this toolkit

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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

Taking stock and planning

Before embarking on a change programme to implement the standard, organisations need to understand their starting point, including readiness of the workforce, any current or planned systems and the local priorities for change.

This will help inform a route map where changes can be delivered in small, achievable steps, building confidence and momentum, and increasing chances of successful change. Progress can be measured against the priorities and goals agreed by local stakeholders.

This section provides tools to help:

  • Understand the current local context
  • Assess your readiness: The current state from clinical, technical and operational perspectives
  • Agree how you will measure and evaluate the change programme
  • Plan the changes.
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Current state analysis

These downloadable tools can be used to give a comprehensive analysis of the current state in your workplace.

Process mapping

Process mapping allows for the identification, visualisation and analysis of existing workflows relating to transfers of care, pinpointing areas that may need improvement.

Data flow mapping

Data flow mapping can help to show the current journey of the data information required by the standard within and between IT systems, shedding light on data sources, transfers, and potential vulnerabilities.

Systems audit 

An IT systems audit is useful to evaluate your existing technology infrastructure, identifying strengths, weaknesses, and compatibility with the eDischarge Summary Standard. 

Organisation readiness

Assessing the maturity of your organisation evaluates its readiness for digital transformation, including factors such as leadership support and staff training. 

Planning a stock take

Follow the steps below to start planning your stock take.

Schedule events and meetings to tell people about your standard implementation plans as part of digital transformation and encourage them to join in the project.

Check your understanding of the problem you might be trying to fix and consider how your sense of the situation is different from the view other stakeholders might have based on their different knowledge and experience, for example as point-of-care professionals.

Offer an opportunity to bring representatives from different stakeholder and professional groups together to find out what they might have in common, how they are different in their approaches, culture, and language, and how they can work towards a shared objective.

Remember that the implementation of the standard is a people-based cultural endeavour and cannot succeed without the hearts, minds and professional expertise of all your stakeholders.

Holding a stock take workshop

The table below illustrates how you might plan a stakeholder workshop to take stock of your local system’s readiness to adopt the standard. It outlines your potential participants, the purpose of the stock take and what materials/questions you may want to include in the sessions.

Activity metrics

When embarking on this project, you should begin by establishing the baseline or starting point. The measurement of a set of metrics over time will be the key indicators of successful improvement. Criteria for the metrics must be agreed by the project representatives from both settings*. 

Think about metrics that evidence the scale of activity, the measures that can be used to track improvements and also any qualitative measures.

Download: Hospital discharge metrics spreadsheet

 

Understanding governance requirements

It is important to engage the local care system Information Governance team early in the project. They will confirm what activity must be done prior to any data sharing.

Regardless of the system being used for sharing information, Information Governance is a key requirement. If your area has a shared care record in place you may find an over-arching Information Sharing Agreement (ISA) has already been signed by the data sharing partner organisations.

Data Protection Impact Assessment

If the sharing of eDischarge processes and information involves a new set of data about a person or significantly changes the way in which the data is processed, you will need to carry out Data Protection Impact Assessment (DPIA). The DPIA is a structured assessment of the potential impact on confidentiality, privacy, and data protection. The data items to be shared or processed are included. Your Information Governance team will have a DPIA template for you to complete.

Clinical safety and risk management

It is recommended that you make contact with your local care system clinical safety officer or clinical safety management team early in the project. They will be able to advise you on the clinical safety management process that is in place and advise on the development of the clinical safety management process and fulfilling DCB0160 (see below).

Organisations embarking on deployment of health IT systems are required to apply clinical risk management for the deployment, use, maintenance or decommissioning of health IT systems within the health and care environment NHS England standard DCB0160 expands on the DCB0129 clinical safety standard applied by the manufacturers of the health IT system.

Health organisations must establish a framework within which the clinical risks associated with the deployment and implementation of a new or modified health IT system are properly managed.

See NHS England’s Clinical risk management guidance

Building a roadmap

Taking all the baseline evidence and material gathered, develop your local roadmap for change. Focus on all aspects of change including staff readiness.

Work with key stakeholders to develop the plan to ensure commitment and buy-in. 

Here is an example roadmap that you may want to follow as a guide.

Assessing conformance

The PRSB team work closely with system suppliers and health and care providers to implement the standard and also provide robust and independent evidence of their implementation with the award of the PRSB Quality Mark.

Systems which have undergone this process can be found on the Conformant Partner section of our website.

Download: The PRSB Conformance Assessment Methodology

Your can ask system suppliers to provide evidence of their level of compliance including whether they have been independently assessed and achieved the PRSB Quality Mark. Even if the supplier system is compliant, you will still need to check that your local implementation is compliant. For help and support with assessing compliance with standards, please get in touch with the PRSB help desk.

If a supplier system is unable to reach compliance, a procurement exercise may need to be undertaken.

Set improvement goals

Prioritise the pain points to be addressed Рuse working group members to categorise and prioritise the categories. 

This will populate your driver diagram and support further refinement of the scope and support the planning of your implementation phase.

Download: Example driver diagram

Checklist and questions to consider

The following checklist will help you determine whether you have the right leadership, governance and controls in place for a transformation programme to succeed. The set of questions that follows will help you gauge your readiness to take stock and plan your transformation programme.

CHECKLIST

Clear senior management ownership and leadership

Appropriate skills for the programme/project team

Clear roles and responsibilities

Effective financial control

Success criteria that clearly link objectives to outcomes, and clear links with the organisation’s key strategic priorities

Effective risk management

Sound commercial knowledge of the supplier marketplace, linked to the requirement and management of the supplier over the contract term

Involvement of key stakeholders throughout the programme/project

Breaking development and implementation into manageable steps

Effective project team integration between clients, the supplier team and the supply chain

QUESTIONS TO CONSIDER

What are the ‚Äėfixed‚Äô points ‚Äď e.g. system upgrades, procurements etc.?

What activities must take place to achieve change? Awareness raising, training, information governance agreements, clinical safety assessments, system changes, testing etc.

What have stakeholders identified as the biggest priorities for them and when could those changes be delivered?

What are the dependencies? What must happen before other changes can be achieved?

Which changes could be achieved relatively quickly and achieve tangible benefits for staff and patients?

What are the opportunities for piloting the new system (or parts of the new system) on a small scale and who needs to be involved?

Should organisations join the process in a phased way? What is the preferred phasing for organisations joining in?

What needs to happen to ensure smooth running of existing systems during the transition?

What needs to happen to ensure smooth running of existing systems during the transition?

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.