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Person-centred Records

Exploring the potential of in-patient electronic working in NHS Grampian

 
This is a key piece of work to get Grampian to where it needs to be in terms of innovation and person-centeredness. It’s not just about the record, it’s about the culture that we’re trying to create: that we’re all in this together.
— Caroline Hiscox, Acting Director of Nursing, Midwifery and Allied Health Professionals , NHS Grampian
 

‘Person-centred Records’ is a collaboration between Scotland’s Digital Health & Care Institute (DHI) and NHS Grampian, running from April 2019 till April 2020.

NHS Grampian has committed to the implementation of in-patient electronic record keeping in order to provide a safer and more effective service for patients admitted to their hospitals. The DHI and NHS Grampian are collaborating across a year-long programme of work, and employing design innovation methodologies, to ensure that the recommended solution is achieved with the Person at the centre.  

The DHI Design Research Team is working with hospital staff across all disciplines to design a single, person-centred, multi-disciplinary, electronic record that will follow the patient on their journey from admission to discharge.

The Person-centred Records (PCR) project builds on the DHI’s work with NHS Scotland and the Open Innovation Programme in 2017, which resulted in a streamlined one-page nursing record that has since been implemented in NHS Grampian and has been shown to save nurses time and support them in their focus on the patient.  The plan to digitise and innovate this record continues and forms part of our remit for PCR.

Once for the Patient.

The Innovation School within the Glasgow School of Art (GSA) are experts in design-led innovation research, and through our role in the DHI, in addressing complex and challenging needs across the health and care contexts.  From April 2019 through to April 2020 we will be working with staff across NHS Grampian undertaking a series of interviews, focus groups, co-design workshops, prototyping and simulation to explore preferable futures for multi-disciplinary record keeping practice and systems.

In the first quarter we have been working with staff to understand the current context, co-produce initial design concepts and to develop guiding principles for multi-professional record keeping.

In the latter stages of the research project, we will validate the opportunities identified, generating a rich resource of multiple perspectives upon which to test, refine and demonstrate possible new futures.

To view our quarterly reports please click the links below:


Person-centred Records: A high-level review of use cases. Dr Sanna Rimpiläinen, Digital Health and Care Institute. July 2019.

The DHI have produced a systematic review of published literature concerning person-centred records and similar topics. The key points from the review are:

  • Placing the patient as the central point of their health record, and coordinating data, communications and actions around that patient.

  • Giving all stakeholders (different medical and health professionals, carers, the patient) access to the relevant patient data. This will help pull down disciplinary siloes.

  • Supporting seamless communication between the professional groups involved in caring for the patient.

  • Keeping the patient and their contribution to their own care at the fore of care planning. Giving patients access to their own data and enabling them to add to their own data helps empower the patient to contribute to their own care planning and is crucial in supporting self-management and the delivery of patient-centred care.

  • Identifying the workflows, information sources and information needs of each party involved in the patient’s care is a good starting point for the development of a Patient-Centred EHR.

  • There is evidence that top-down, off-the-shelf implementation of large-scale EHR does not work well.

  • There is evidence that bottom-up, agile and incremental co-design approach, with flat decision-making structures is a more constructive approach to designing, adopting and implementing EHR.

  • Aim high – the future is in the comprehensive patient-centred, patient-owned records, cloud-based and mobile health records.

  • Investing in data automation and Clinical Decision Support systems would be prudent.

Rimpiläinen, S. (August 2019). Person-Centred Records. A high-level review of use cases. Digital Health and Care Institute. Glasgow: University of Strathclyde. https://doi.org/10.17868/69249


Images credit: Louise Mathers, No Middle Name


Digital Health and Care Institute

The Digital Health and Care Institute (DHI) is a partnership between the Glasgow School of Art and the University of Strathclyde. The DHI aims to bring together health, care and third sector professionals, academics and industry partners to work together to develop innovative ideas to overcome health and social care challenges.

 
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Authors: Jay Bradley, Angela Bruce and Cate Green from the Innovation School at the Glasgow School of Art

NHS Grampian project sponsor: Caroline Hiscox

NHS Grampian project team: Marian Taylor, John Thompson, Jill Ferbrache, Ben Dobb, Audrey Steele-Chalmers, Jon Eilbeck and Linda McCorkindale