In October 2002, the NHS in England embarked on a modernisation programme following the publication of a series of White Papers: The initiative, labelled the National Programme for Information Technology (NPfIT), was to modernise the NHS through the use of IT (Wanless 2002). NHS organisations were under increasing pressure to deliver efficiencies and business benefits from projects as early as possible and show value for money or a return on investment. The implementation of electronic health records (EHRs), is one strand of the national programme and successful implementation would result in compliance with both NPfIT and the need to improve services whilst cutting costs. The implementation of an information system into any large organisation will present numerous challenges, data security, data migration, information sharing and timely staff training to name a few.
A community mental health trust at which I was previously employed embarked on the implementation of an EHR, my part in this was to programme manage the project portfolio which was created to support a successful output. I am a PRINCE2 qualified project manager and an MSP (managing successful programmes) qualified practitioner, this methodology was used to manage the projects and programme of the EHR.
PRINCE2 is a traditional methodology with the disadvantages that many traditional methodologies bring (Lau 2022), for example, full delivery at the end of the project instead of incremental delivery and iterative refinement which enables organisations to benefit from early delivery of solutions. The pressure on staff and management of an instant cut-over to a new system/product, the implications on training where early delivery can lead to a need for refresher training and late delivery means staff who lack confidence to use the new system/product. It can be argued that the lack of user feedback means refinement is undertaken on the live system, organisation wide, rather than in those areas affected compared to other project methodologies (Wideman 2002). Testing or data validation is undertaken by staff who are unfamiliar with the system, casting doubt on how robust such activities are.
4.0 Project Implementation
For the purpose of this assignment I have elected to look at the implementation of the EHR into the Child and Adolescent Mental Health Service CAMHS. Each CAMHS site utilised a different data capture system and information was only be shared by staff (with appropriate permissions) at individual sites, the Service as a whole are unable to share information.
My focus in this instance is the provision of training as this was considered to be problematic for the following reasons:
• The Trust did not employ a system trainer.
• A suitable training environment was available, yet proved to be ineffective, as it was not synchronised with the live system. • An assumption was made that staff had a basic level of IT skills however, this proved incorrect and the poor standard of IT literacy of staff caused delays in training delivery. • Managers expressed concern regarding their ability to release staff for training due to lack of backfill resources.
The initial work package in the training element was the development of training materials such as a training manual, a quick guide and a system ‘do and don’t’. The work package was to create a corporate training manual, the manual was to be checked and approved/amended by the System Leads Group (SLG) and the documents should have been tabled at the Project Team Meeting for quality checking and to ensure ‘fit for purpose’, then returned as complete to the Project...
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