Having been involved in change management programmes in a clinical setting for a while now, there always a few recurrent themes that tend to come up and ones that I always get asked about.
Here’s just a few thoughts and lessons learnt from undertaking, project managing and evaluating clinical change programmes that we are contracted to deliver in primary care.
Clinical change is always meant to be transformational and are described as such. (And what a nice word it is!)
The definition of transform is to make a marked change in the form, nature or appearance of and entity.
In a healthcare setting, this can also be taken to mean that the existing status quo could be improved. Given the huge variation in localities for even QoF related outcomes, transformational programmes are important and help to improve healthcare provision and reduce variation and health inequalities.
This is not to suggest that existing services are inadequate, but to adjunct them to gain better outcomes. This brings us nicely onto the next topic….
Undertaking a change management programme at scale across a healthcare economy is no easy task and to expect a large improvement in healthcare provision in short time frames is again not easily achieved.
Incremental gains added to change management projects is a useful approach in healthcare settings. This is also an approach to change and influence clinician behaviour as small incremental changes implemented in a step wise manner, underpinned by evidence is a sure way to get buy in from the multidisciplinary teams now prevalent in primary care settings.
Any clinical change management programme needs to be underpinned by robust evidence and this then needs to able to translate into routine clinical practice. This isn’t always the case with the evidence base and therefore the use of guidelines, formularies and pathways can help simplify this process.
4. Data Collection
We are increasingly becoming interested in, and collecting, real world data and improving our understanding of how trial data and trial populations express themselves in real world populations.
Pilot programmes can inform larger scale transformational programmes however, the effectiveness can only be determined with adequate data collection processes through out the project and undertaken in a consistent manner. Only then can such projects demonstrate their impact (or not) and inform good practice or further commissioning.
We are now working with a team of healthcare economists to evaluate the data we collect and to show the benefits of pharmacist led interventions in primary care settings.
5. Learning and development
Each clinical change management programme should be supported by relevant learning and development.
Across healthcare economies, there are a number of HCPs and multidisciplinary teams. Each type of professional within these teams will have their own learning gaps and needs. Is it right to assume the GP will have the same learning needs as a ANP who in turn will have the same learning needs as a pharmacist? Definitely not!
Yet the learning programmes attached to clinical change management programmes are a ‘one size’ fits all and non-clinical team members are not even included in these at all.
Segmented learning sets can and should be developed to support these programmes and may contribute to successful project implementation and outcomes.
6. The patient
Ultimately, the project should be focussed on patient centricity. Is what we are doing having meaningful outcomes that improves and progresses patient care, if not then all of the above becomes redundant.
Healthcare professionals are in privileged positions of making every contact count and making a positive health impact for patients and these programmes can augment core services.
I hope you found this useful and thanks for reading.