Getting people on board
People often believe that adopting standards for digital information sharing is about ‘getting the tech right’. In fact, getting people on board is a key element of successful standards adoption and the culture change required to make it happen. This part of the transformation initiative demands thorough attention and planning.
To effectively engage people, you should start by understanding their motivations. This includes understanding who you need to get on board and why, and how important their positive involvement will be to your success.
In this section you will find a narrative that describes the case for changing how wound care management should be delivered by using the Wound Care Information Standard to improve documentation of care, what difference it will make to professionals and people using services and what each stakeholder group needs to do to make the changes happen.
It will help you map various stakeholders and assess their readiness to adopt the Wound Care Information Standard and anticipate FAQs and other needs they may have before committing to undertaking the changes we describe here.
The case for change
People receiving wound care services are supported by a range of health and care professionals and their wound management may extend over months or even years.
Health and care professionals should work together to ensure people receive well-coordinated care that promotes healing, reduces pain and discomfort, and supports preventive care.
Feeling confident to deliver the best possible care
Professionals caring for people with wounds need to feel adequately trained and supported to deliver the best possible care, this includes the creation of care plans which record a person’s goals, and strengths.
For the individual and those professionals caring for them it is vital that they have confidence in the information being shared.
Empowering people to engage in their health and care
As patients begin to engage in their health via digital tools such as the NHS App or Person Held Records (PHRs), they will be able to enter information relevant for their ongoing care. This could include information based on the About Me Standard and Personalised Care and Support Plan Standard.
This information will be visible to clinicians at the point of care via either local systems or conformant shared care record systems. As patients take control of the data they record and share, this will begin to reduce the burden that clinicians currently face of recording and updating information.
The problem
What is the current situation?
When we talk about wound care, we are focusing on lower limb wounds, pressure ulcers and surgical wound complications for all age groups including children.
At the present time, information is collected and shared about a person’s care, but it can differ by team and health and care professional. The information may be siloed in records in different care settings, it may be partial and even contradict other records, depending on when the record entry was made and who was involved in making it.
There is currently no recognised standard for a generic information record that can support the delivery of wound care (including assessment, management, or prevention) across a care pathway.
The solution
Standardising the information that should be in a person’s care record so that there is a single source of truth would resolve these problems.
The Professional Record Standards Body was commissioned by the National Wound Care Strategy Programme to produce an information standard that will support the programme’s strategic aims to:
Use clinical time and other health and care resources in the most effective way.
Reduce patient suffering and improve healing rates. Prevent wounds occurring and recurring
The Wound Care Information Standard is for all UK nations. It covers all settings including acute care and community services.
A call to action
Implementation of the standard needs to be delivered as part of a wider change programme. Implementing standards is often viewed as a technical fix but in reality, it is part of a wider service change programme to improve the experience of the individual receiving care and those professionals providing care.
If this change programme is going to be successful everyone involved must understand the purpose of the change and what a successful conclusion might lead to. This works best when the change is framed in the form of a compelling narrative, that connects with people emotionally as well as intellectually. Local health and care systems need to assess the best approach to delivering this change and identify what will motivate clinicians to deliver the change and the benefits to be realised.
The section below ‘Creating a stakeholder map’ outlines in more detail who needs to be involved and how to get them onboard with the change programme.
Resources
The following resources are available on the FutureNHS website, which requires a login to access. Registration is free, and you can sign up easily.
- Surgical Wound Complications Recommendations – Improving Wound Care: Building on The National Wound Care Programme
- Lower Limb Recommendations – Improving Wound Care: Building on The National Wound Care Programme
- Pressure Ulcers Recommendations – Improving Wound Care: Building on The National Wound Care Programme
Briefing your staff
It is critical that your stakeholders are actively involved from the start and have the chance to influence and contribute to the task of implementing the standard.
These slides provide an outline to help you brief staff on the project, the rationale for doing it and how they will be involved. You can adapt them to reflect the specifics of your local situation.
Download the slide pack
Creating a stakeholder map
When starting your implementation project, you will need to identify all the stakeholders that need to be involved in your project. The most useful thing we know from developing the standard is who your key stakeholders are most likely to be and what they are most likely to be concerned about.
The list below identifies the main stakeholders that should be involved when delivering wound care management change projects.
- The health and care system clinical leads, including the organisation’s Chief Clinical Information Officer and Chief Digital and Information Officer.
- The governance teams that support the implementation of new systems, clinical safety, and sharing of personal data
- People that support programme and project delivery and will deliver the required change management programme
- Most organisations will be members of the Integrated Care System’s (ICS) existing Wound Care Management Working/Strategy Group. If you have not yet involved this group, it is recommended you do so to reduce the burden of additional meetings on very busy clinical staff.
Here is an example list of key stakeholders you may want to include based on our research:
We also recommend using the RACI model – which identifies who needs to be responsible, accountable, consulted and informed.
Creating a commitment chart
Once your stakeholder list is complete, filling out a commitment chart can be a useful way to compare current levels of commitment to minimum levels needed from key players for effective implementation. This image shows the individuals or groups that may be involved and their current status with arrows to where their commitment level is required for the project to be successful.
You can follow the steps below to create your own chart* and determine areas of support and resistance to the project:
- Identify the essential individuals or groups for the project’s success and list them as “key players” on the chart.
- Review the commitment rating system.
- Rate the minimum commitment needed from each key player by placing an “O” in the corresponding box.
- Evaluate the current commitment level by placing an “X” in the box that represents their current level.
- Discuss strategies like personal contact, emails, or recommended readings to achieve the minimum commitment level needed for the exercise.
You can then develop a strategy to move everyone to the desired state of commitment. Below is example list of barriers for specific groups and what could be done to engage these stakeholders and get them on board.
Write your business case
To assist with your implementation, you can download and personalise this example proforma business case which includes hints and tips on the benefits and gains which you can expect.
Each organisation will need to tailor to their own unique circumstances.
FAQs
In our standard and toolkit development, we gathered many questions and our FAQs have the answers. These FAQ’s will be added to as the standard is implemented widely across health and care systems.
The wound care information standard is not a replacement for existing standards, however it does standardise the information that should be recorded during a wound care episode.
This may require the implementation of a new clinical system (or the development of a template within an existing system) which could replace existing manual form of recording information.
The standard is one of a suite of information standards that are used in electronic health records.
Information standards are used to support the recording of data in a consistent way so that it can be made available whenever it is needed such as when the community nursing team visits, when we visit our GP, attend a hospital appointment or order medication from the pharmacy.
No, historic data does not need to be updated. Once the new standard is implemented, the new codes can be used but you will need to consider the impact of using the new codes on reporting.
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.
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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.