Electronic care plans - Are they relevant for residential and nursing homes?
With the high demographic pressure, spending cutbacks and staff shortage taken into account we experience an increased demand for efficiency. Here digitalisation is considered an important part of future social care initiatives.
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Digitalisation defined as “the process of leveraging digitisation to improve business processes” should aim higher than the 1-to-1 translation of physical papers onto a computer. Digitalisation must add an edge to the entire value chain. Consequently, it is taking on many shapes and sizes improving essential aspects of social care. In specific assisting with two focus areas. Quality of care and efficiency of care delivery. Including not having a paper documentation burden hanging over your head end of shift.
The UK population is both increasing and ageing. Current projections show a pattern set to continue. By 2037 we are reaching a population landmark of 73 million. Meanwhile, longer life expectancy is resulting in a growing older population. People working longer will increase the size of the workforce, but a further pressure will develop on services.
Add to the increasing percentage of people over 65, the drastic decrease of European nurses registering to work in the UK, it is evident that both health and social care faces challenges. The number of nurses joining from EU countries dropped by 96% a year after the Brexit vote, with the care sector already suffering recruitment and retention woes.
While the above-mentioned reasons are mostly external, there are other more direct reasons to go digital. Retaining and attracting staff remains a key challenge for most care providers. Digitalisation will help sex up the care sector and pump up the dated image, for more people to (re-)join. In the actual job, more face to face time will influence on employee satisfaction levels, as no one ever joined care to complete heaps of paperwork. Further to that, proper digital care planning will serve as an incentive when nurses are choosing their workplace.
Efficiency and cost savings are other very specific reasons to digitalise. Freeing up care workers represents a significant business potential. Like Quinton House, where end of shift documentation has been reduced by 1,5 hours per carer per shift. Amounting to a very attractive business case. Turning a seemingly comprehensive investment into a low-risk operational decision. Who would not want to save £1,4 million annually like Odense Municipality does across its 31 residential, nursing and LD homes?
A final reason for embracing the transformation has a more audit like character. With strong financial arguments. When linking single observations and activities to their care planning context in a tagging regime you’re turning documentation and evidencing into a by-product of care delivery. Rather than a time-consuming task of its own. This means that care providers are now generating CQC proven audit trails by default. Utilising data already available in their organisation when inspected. Information no longer hidden in floor to ceiling binder walls.
Being able to evidence care impacts big time on ratings! This again impacts highly on any providers’ service valuation. Ultimately, the motivation for being good or outstanding should be clear.
Depending on the magnitude of the project the challenges will of course differ. However, since this article assumes a profound shift in the way organisations act and people work, we are pointing at culture.
Culture, as in the meaning beliefs, behaviours, rules and rewards collectively. Formed over a longer period. If you apply these same beliefs, rules and rewards repeatedly you are bound to get more of the same. This goes for all industries. History repeating itself. It is almost like a company DNA. And for this to change a strong and continued focus is needed.
In relation to such a cultural change, it is important to get the employee buy-in. Why are we digitalising? Getting to that point can only be achieved by articulating the immediate benefits that staff will experience from going digital. Without real incentives, staff will not sincerely support the journey as they could. And will. When given the right prerequisites.
Initially, the investment may seem prohibitive, but considering the immense potential of digitalisation, cost should not be a deterring factor. However, since digitalisation is a blurry, broad term it’s important to pick the right suppliers and tools. These will vary from care provider to care provider. Mainly due to respective strategies. Pointing to the one thing that creates the most blasting digitalisation ever. The powerful linkage between digitalisation and any organisation’s overall strategy. This is a winner!
There seems to be a lot of hype and excitement associated with the possibilities of going paperless. On the other hand, we have observed some common concerns. Here are the 3 usual suspects:
1st Concern: “It is too difficult to learn and use”
Maybe fueled by lesser fortunate stories in the news about costly public digitalisation, some people have a go at user-friendliness or the general tech-savviness of care homes. As if it was a bad combination? Perhaps. But this is not our experience. Quite the contrary. It is the prerequisites that are missing or simply in too poor a condition to pave the way for a change. How is that?
Obviously, there will always be negative outliers, but today’s care technologies are from a time where user demands are in focus. Take the iPads for example. 2 year olds are learning how to operate these with ease. So, to say that digital isn’t for social care…
Design and interface should be self-explanatory and accessible. Other than that, what is needed has to do with training, allocated time and a sense of purpose.
In other words, implementation is a key factor. The important thing is not the technology itself, but what it allows the user to do. Technology will most likely serve as a support function. It is tough work for an organisation to learn a new way of working, which is why a good implementation plan incorporates change management.
2nd Concern: “It doesn’t pay off”
One of the concerns our network is flagging is that the cost can delay or blur the benefits of going digital. This is only natural as the care sector is under heavy financial pressure and we are still in the beginning of its digital transformation. Over time this will naturally change. When product categories have settled and it has normalised using VR, AI or even something as straightforward as digital care planning. Like nobody questions the efficiency of e-mails compared to letters. And so on.
When addressing the core questions and pains of the sector, the benefits will emerge clearer and clearer. At first it requires the visionaries. Later others will follow. This is a key trade of any digital (market) transformation.
Digitalisation covers a lot of technologies that each support their users and organisations in providing better care. Why would they be there if not? Caretech will only last a single boxing round with carers if they do not provide value. Poor performers go quicker to the canvas than they were ever made. This is a brilliant trait of social care; picky and delicate – nobody’s fool.
3rd Concern: “What if we lose valuable data?”
Digitalisation includes transferring data or documentation from a paper version to a digital one. For many, this switch comes with some reservations. What if the system fails? What if we get hacked? System failures and data flaws do happen. Only naturally these are two essential themes needing tackling by every supplier. Although most solutions born today are cloud based, a stern process for GDPR issues and data security is a must.
When it comes to data security, it is arguable that a transition from papers in the filing cabinet and servers in the basement to a cloud set-up will fix a lot more than it will damage. Also in terms of data storage cost and flexibility. Top companies like Microsoft operating the cloud data-centres are way ahead of onsite server companies when it comes to keeping trespassers and viruses out. Their requirements of redundancy and backup services are top of the market.
Going through some of this article’s topics where is it then a good place to start? One thing stands out. From the fully digitalised care homes to those purely scratching the surface: It all begins with a why. Management sets the direction and communicates to the rest of the team, where you are heading. Including what role digitisation will play. Whatever this end-goal might be, it cannot be understated how important a clear vision is. Since technology is so diverse in its applications, it is easy to become enamoured with benefits that are not essential to your business.
Our advice is to focus on the “need to have” benefits rather than those “nice to have”. This advice may seem trivial, but countless examples of clumsy tech projects confirm the summary. Focus on essential outcomes will maximise the chances of realising the benefits set out from the beginning.
To sum up, here are our suggestions for the best way to start digitalising:
- Ensure your clearly stated premises for why you are going digital
- Recognise that technologies are supporting people, rather than the opposite
- Focus on “need to have” rather than the “nice to have” benefits
- Acknowledge that digitalisation is a profound shift in the way your organisation is working. Give your staff the time and space to learn
- Do not regard the implementation process as done when the technology has been unwrapped. It takes a bit more effort