Learning and Improvement
Why is this important?
“We went out and discovered for ourselves, oh it’s really good for that type of patient and that type of patient, and we were able to say oh I wonder if it would be useful for this patient as well.”
“It’s very difficult to do much work with what we’ve got at the moment. We can go out and do training on what we’re using but it’s limited in its application and that makes it a barrier in itself.”
What are the key steps?
If you are implementing telehealth for the first time, a period of experimentation can help to identify why and how you are using it, and give staff time to adopt telehealth and gain confidence.
Having telehealth champions to support staff during this time can help to promote adoption during what can be a difficult phase of the service.
Creating regular opportunities for ALL stakeholders to share experimental learning and practice-based knowledge can be an important part of on-going evaluation.
Shared learning can help to identify barriers that are limiting success, and spread positive experiences and successes about what works and why.
There are various tools that can help to structure how you improve your telehealth service by targeting what to improve and test different ways to improve it.
Action Research and Plan Do Study Act are useful tools that enables you to run cycles of improvement over time to address barriers to success.
Learning from the MALT study
MALT conducted four case studies to learn about how telehealth was being used for community nursing, and to identify key barriers and enablers to successful telehealth. Click here to download a summary of the factors affecting telehealth adoption.
Findings from the case studies were used to run action research to improve the telehealth service in each site and address key barriers to staff adoption. Although telehealth was being used differently in each site, staff chose common improvements to make:
- To develop a service pathway for telehealth, e.g. establishing clear referral criteria and considering options for effective discharge
- To improve assessment and review of telehealth patients, e.g. reviewing current caseload of patients to establish goals for use
- To streamline delivery of telehealth, e.g. improving monitoring and triage of telehealth patients
- To improve information sharing and access to telehealth data, e.g. opening up data channels, improving electronic patient record systems
- To raise awareness and adoption of telehealth, e.g. staff training, championing, events
- To establish processes for evaluating the success of telehealth, e.g. capturing telehealth activity on electronic patient record system
- To secure investment for telehealth technologies and roles, e.g. working with commissioners, scoping out equipment needs for a future sustainable service
Although staff were able to make some improvements during the research, it was difficult to achieve change without additional resources or key stakeholder involvement. Please see the key messages from our work to find out more.