Silence is golden – when technology works we don’t hear about it.
Emma Arrowsmith, Digital Matron, County Durham and Darlington NHS Foundation Trust, discusses driving innovation and digital adoption in the NHS. She details how Imprivata’s single sign-on solution supports their mobility workflows on hand-held devices, providing the simple, secure, and auditable access to their EMR systems wherever staff are working.
Our digital journey
We began our digital journey at County Durham and Darlington Trust in October 2022 when we went live with our Cerner Electronic Medical Record system (EMR). Alongside the EMR, we also introduced a hand-held solution from Medanet, which enables staff to access the clinical applications available through the EMR.
The process taught us a lot about how to manage organisational change, get user buy-in and how continuous learning helps us moving forward. We also learnt that no-one talks about technology when it works!
Managing change successfully
Our Trust includes two acute sites, a sub-acute site and five community hospitals – a large organisation where any change can be a massive challenge. It can be a stressful time for staff, with a lot to learn and a lot of change going on.
Like all other organisations across the NHS, we had been facing numerous workforce challenges as we moved out of the COVID-19 pandemic. Our existing systems were not connected which was adding to the pressure and frustrations.
While mobile devices were being deployed to help nurses at the point of care, without a single interface to the EMR and other clinical systems, workflows were not streamlined for clinicians or patients. These inefficiencies meant staff workloads increased as they had to log in and out of multiple systems many times during shifts and the possibility of errors and data inconsistencies multiplied.
Our staff were already working under significant pressure throughout the organisation and we needed to do what we could to make the journey to the new system as smooth as possible. Imprivata’s single sign-on was the tool that helped us reduce that burden.
A practical solution
On average, we have about 600 users of hand-held devices per day, recording things like vital signs, completing admission and ongoing assessments and placing orders. This means that staff are logging into their devices multiple times throughout their shift.
Having used mobile solutions since 2016, the nursing team was adamant that single sign-on had to be part of our new integrated system enabling ‘tap and go’ access to all the applications. The Imprivata solution has made this a reality, providing the right level of simple, secure, and auditable access wherever staff are working.
It has reduced the need for staff to use multiple passwords for different applications, saving time across the organisation. They now simply tap the hand-held device on the back with their badge and enter their PIN or password that they have set, which logs them into the rest of the applications. It means they can pick up a device and get going with what they need quickly.
Supporting our multi-disciplinary teams
As well as the mobile devices, we installed single sign-on across on desktops and laptops. The Trust’s wards and departments are incredibly busy with multi-disciplinary teams coming and going from patient to patient. This means staff can now quickly tap on, access records, do what they need to do, then tap off and move on.
We also have a big cohort of staff who are not registered but are highly valued within our system, such as our healthcare assistants or maternity care assistants. They provide excellent care every single shift, but they were unlikely to log into an EMR or go onto a desktop and document what they have done.
We really value the mobility workflows because now our staff, regardless of grade, are comfortable with using the mobile solution. It’s easy to use and it gives them that secure place to document their care.
Collaboration and teamwork for project success
From the outset, our end user clinical and technical staff worked with the team from Imprivata, Medanet and Cerner. Success came from collaboration. We had a great deal of trust and looked to each other for help and support and in doing so we were able to define a solution from the outset that really worked for us.
We completed training for the new EMR system online, with an opportunity for staff to follow through with face-to-face training. The Imprivata element was straightforward - it was just a case of going out, getting everyone familiar, and signing them up. It has been viewed as the easiest component of the whole project, as it is simple to understand and intuitive to deploy and use.
Silence is golden
We introduced the Imprivata solution on hand-held devices just before we went live with the EMR, so that we could embed the ‘tap-on, tap-off’ working practice. Now it’s like it’s always been there. The Imprivata solution has become so embedded that it is now almost invisible to clinicians.
No-one talks about it because it’s quick, it gives them access at the bedside as they need it. The silence from end users is a good thing – when something isn’t working we certainly hear about it!
Lesson from the frontline
We planned the go live on the community sites over a couple of days, focusing on acute and sub-acute sites to begin with. Continuous learning has played an important part in the whole process. Lessons from previous projects were useful - and we will use experiences from this go-live for the future.
We also did lots of user testing to make sure that the solution that we were going to deploy was fit for purpose and easy to use, and that the single sign-on process was straightforward. Involving digital champions played an important role from the point of user acceptance testing, bridging the gap between IT health informatics and clinicians on the frontline.
What the future looks like
We now do as much on our mobile devices as we can; it’s a case of hand-held devices in staff pockets and work being done on the go. We have successfully pushed the limits on what can be done through our mobile solution and it’s still work in progress. We can see from the data that there’s more to be done, but it does show that the mobility workflows are working very well, thanks to the Imprivata solution.
We are continuously evaluating how to make existing clinical workflows more efficient and how we can introduce new technology to support them looking forward.
Watch the webinar with Imprivata and County Durham and Darlington NHS Foundation Trust