The Newcastle Programme

Presenter: André Snoxall, Programme Director

Our Programme

• Engage Trust leadership to review and overhaul the following processes:– Management and treatment of patients in A&E– Admission, discharge and transfer of patients– Booking, scheduling and management of out-patients– Management of waiting lists– Ordering of investigations– Review of results– Prescribing of inpatient medications– Administration of medications to patients

• In doing so; develop a single, central, patient record that will replace the existing paper records

• Use the Cerner Millennium™ suite of computer applications as core tool and a catalyst for change

Our Objectives

• Better, safer, more effective patient care• Better patient experience• Less stressed, more innovative, happier and more

effective staff• Improved value for money through less low-value

effort• Less paper, less security risks, less lost records, better

understanding of cause and effect for continuous improvement

• A single, well understood, source of patient-centric information to support our care providers

What We Were NOT Planning To DO

• Become pariahs to the National Programme• Ignore the lessons learned by others• Reinvent any wheels• Solve all the Trust’s IM and process problems in one

fell swoop• Drive or manage process change

The Team

• Our Chief Executive• Clinical Leaders• Programme Nurses• Programme Manager

– Extensive experience in the NZ and US markets– Ex Lab Manager, Quality and Risk Manager and CIO

• UPMC– A major US healthcare system– Nearly 40 hospitals

• Cerner– Experienced in the UK market– High calibre consultants

• Connecting for Health

The Challenges

• UK vs the US– They don’t do waiting lists in the US– Clinical practice is not vastly different

• Project management– If you don’t know where your going then no one can blame you

when you don’t get there– However….. FTP = PTF– Strategy and tactics need to be defined and understood before

you start– Getting PIDs was like pulling teeth– Good quality Boards are essential

• Management engagement and ownership

Progress

• Our Chief Executive, Executive Team, Directorate Managers, and Clinical Directors own this programme

• Our approach now to challenges thrown up by: The Cerner Way Vs Our Current Way has changed

• Accountability is becoming far better understood• The terms “Informatics Professional” and “Process

change” now have real meaning to our managers• The eRecord team are providing the leadership that

the IM&T and Estates Departments needed to deliver on such a major programme (allowing their managers to keep the other wheels turning in a large Trust)

Some Observations Regarding Cerner• Cerner is a software company

– Not a management consultancy– Not a business process engineering– Not a change management consultancy– Their approach reflects this

• Millennium is a large, complex, and comprehensive toolset

• In my view Millennium is not significantly better or worse than many of the other offerings in the market

• Assume that it has been built to automate processes in the most widely accepted (and likely “best”) way

• Don’t expect miracles

Some Observations Regarding Cerner• Cerner needs to develop its capability to engage with

the UK market and provide for the needs of that market• Currently there are too many disparate messages

reaching this vendor• As a sector we must work out how to engage

consistently unambiguously and cleanly with Cerner• If we, as a sector, are to realise some of the benefits

that can be achieved then we need to determine how we will engage with vendors to:– Identify priorities– Driver change– Manage vendor delivery