PM Healthcare - Summer 2022

PM Healthcare Journal 23 22 PM Healthcare Journal 2. Approach to project delivery Adopting a project management approach was pivotal to delivering a project across a large system with varying needs. Arden & GEM established a project team with experience of working across multiple stakeholders and who understood the systems in place. Team structure We utilised a combination of remote and peripatetic team members, with the remote team focusing on back-office functions, while the peripatetic team provided onsite visibility and were able to ‘walk the floor’ of the relevant Trust departments to gain a true understanding of the situation (see Box 2). The delivery of ward-based, one-to-one training and troubleshooting enabled Hospital teams to continue with their core duties. This helped to drive engagement while allowing the team to deliver training and provide more practical and responsive support to Hospital staff. Baseline assessment findings The project team arranged to undertake site visits, which included completing an assessment tool in conjunction with the relevant Trust staff, to gather a baseline understanding of the current state of DMS provision. The assessment tool acted as a prioritisation framework through its ability to score and RAG rate each descriptor, which allowed the Arden & GEM team to tailor support to meet the individual needs of Trusts. The results were organised into common themes hindering the success of the service and action plans were developed and agreed with the Trust: • Variations in processes: For example, the process for referrals was based upon the previous TCAM model, however since then, Trusts had implemented differing digital systems which meant that previous ways of working were no longer appropriate. In some circumstances the original procedures were no longer practical and new ways of working were required • Training: Training requirements for clinical team members were identified by Trust clinical team leaders and these varied depending on the degree of change to processes, and the level of existing experience with referrals within the team • Business intelligence and performance monitoring: To understand their individual DMS CQUIN indicator target, Trusts needed to identify their target proportion of discharges referred to DMS, in relation to their total number of in-patient discharges. It was also important for them to understand the proportion of referrals made that were completed, rejected or unactioned by Community Pharmacy Box 2 – Key roles of project delivery team Remote team • Governance arrangements • Developing bespoke action plans • Project research • Business case development support to allow Trusts to access NHS England and NHS Improvement funding for DMS support roles • Development of training tools • Liaising with EMIS Health • Development of webinars • Managing stakeholder queries • Managing internal and external meetings. Peripatetic team • Understanding systems and processes through discussions and onsite visualisation of systems • Identifying barriers and opportunities for efficiencies • Delivering onsite training • Providing hands on support for processing referrals • Provide onsite troubleshooting and query answering service. • Communications and engagement: It was necessary to raise the profile of DMS and remind teams involved of the value the service brings and encourage them to consider this element of patient care as a priority, whilst recognising the demands on the existing workforce capacity 3. Tailored support model Our initial scoping exercise enabled us to identify the baseline position at each Trust, and it was decided to pilot the new support model on the site with the most embedded infrastructure for DMS referrals, namely Dudley Group NHS Foundation Trust. Tailored support focused on the common themes identified in the service baseline assessment and included: Standardising processes: Arden & GEM updated Standard Operating Protocols and information leaflets, identifying efficient processes that reflected the needs of the Trust, while ensuring national and local best practice was captured. Training and coaching: Training was undertaken on DMS, ensuring DMS support teams were aware of its benefits and the process required to make a referral. Group training was delivered to clinical ward-based teams and further 1-2-1 coaching support was also provided where required. Graph 1: Dudley Group NHS Foundation Trust – Weekly DMS Referrals, March-May* 2022 *incomplete month, data only available until 26/05/2022 Table 1: Monthly DMS referral activity for Dudley Group NHS Foundation Trust Jan- May* 2022 Month Total DMS Referrals January 83 February 67 March 116 April 100 May* 181