If what you don’t know can’t hurt you, some folks are practically invulnerable: http://news.bbc.co.uk/2/hi/health/7887438.stm
I am concerned about some of the statements in this article regarding the failure of the Royal Free Trust to adequately re-engineer its business processes to take advantage of a new computer system. Were these the work of a CEO or a journalist? Lets have a look at some:
“technical problems had cost the trust £10m and meant fewer patients could be seen”
The “technical problems” were that a new computer system that the Trust spent many months planning to implement did not work in the same way as the old one. It wasn’t “worse” per se, it was different (and actually better in many ways).
So, if one gives you an electric oven and you choose to light a fire in it do you blame the fitter because you didn’t use it properly?
Process and organisational change is not easy, it is not a job for the IT Department, it is the job for managers and organisational leaders.
What did the management team at the Royal Free do to focus staff on the extent and nature of the process change they would need to lead?
Did they identify that the key objective of the project was reengineering processes?
Did they enlist staff in identifying how they would contribute to change and the harvesting the benefits that would accrue from success?
“I have personally apologised for the decision to implement the system before we were really clear about what we were going to receive… I had been led to believe it would all work.”
Automating processes is never simple as plugging in a computer system and it “works”. Success in implementing any new tool (which is what a computer system is) depends upon understanding what that tool does, and doesn’t do, and then working out how you are going to use it.
In 30 years I have never seen a computer system solve a problem caused by bad process. Computer systems always enable us to perform bad processes faster and increase the magnitude of the impact of those poor processes.
Those same computer systems enable us to perform good processes faster and reap the rewards of doing so. The key to success is to identify the difference between a fundamentally good and a fundametally bad process.
A chief executive, in a sector that is driven by information and the technologies that enable its collection, sharing and dissemination; needs to understand that a computer system designed to support reengineering of a large percentage of his organisation’s processes will need to be implemented professionally.
He also needs to understand that the implementation should be driven by health care professionals from day one. Not by IT personnel or a government department.
Computer systems of course should not drive process, process must be sensible, efficient and above all effective. However if a process must change because a computer system can’t support it then that change must be carefully planned and executed by those who must make the change.
And the National Programme for IT?
How can a government department attempt to impose, on multi-hundred-million pound organisations, one-size fits all computer systems that are designed to automate their processes?”
Was there an assumption that each of the organisations involved could all operate processes the same way?
Did the DoH honestly believe that different local cultures, work patterns, patient demographic profiles, speciality profiles and funding profiles could all be automated under one standardised hospital process regime?
Did the government, through the “National Programme”, seriously think that they knew better than hospital-Trust management teams how a hospital should run?
Or did they think that involving a big telephone company (oops, “consultancy” firm) or a big Japanese computer company (oops, thats right they are known for leading best practice in hospital management processes, aren’t they?) would result in a better outcome than letting their management teams (thats right the management teams that they employed) get on with it?
Sometimes I despair…
Tags: hospital trust, National Programme, NPFIT, Process Change, Royal Free
