When disruption is good for healthcare

Authors:
Clair Sullivan, Andrew Staib, Stephen Ayre, Michael Daly, Renea Collins, Michael Draheim and Richard Ashby

What’s the research –
This paper describes the challenging digital transformation of the Princess Alexandra Hospital (PAH) into the first integrated digital tertiary hospital in Australia.

Why it’s important –
There is no doubt that digital healthcare is the future. It will completely change the way care is delivered. Going digital was disruptive but it was more than just replacing paper with technology. Establishing Australia’s first tertiary digital hospital was a difficult task. Strong executive and clinical leadership was essential. While disrupted workflows and reporting structures required refinement; few staff members expressed a wish to return to paper. Disrupted workflows need to be expected and managed. The true return on investment will be delivered when the data collected can be used to improve the quality and efficiency of healthcare delivery.

What have we learned –
A traditional IT-led approach to the digital transformation of a large tertiary hospital was unlikely to be successful. Practising clinicians — rather than IT staff with clinical backgrounds — joined the leadership team to ensure that the project remained patient and staff centred. Clinical leadership was critical to the change management efforts. They were able to meaningfully describe the potential long term benefits — particularly, the promise of a rich database of clinical information that could be used to improve the care provided. Clinicians were concerned about the adequacy of the project-prescribed training. Additional training, such as dress rehearsals using mock patients in clinical settings with the new technology, was organised to practise scenarios such as deteriorating patients and outpatient workflows before digitisation. The executive and senior clinicians, who balanced this disruption against the long term clinical benefits, articulated an acceptance that care would be temporarily slower and less efficient. There were concerns about patient safety during the digital disruption. In response, a patient safety team, independent of the digital hospital project, was deployed to create a patient safety watch to monitor for adverse events. Although adverse events continued to occur, there was no significant harm directly attributable to the digital transformation.

Who should read this paper –
Clinical leaders and Information Technology Leaders of healthcare organisations contemplating investment in digitisation and thinking about their project teams must learn from the lessons learned at the Princess Alexandra Hospital.

To read the entire journal article, click here.