In any given industry, if we standardise inputs and processes, we can significantly reduce variability in outcomes.
For example, there are three variables in quality manufacturing: raw materials, quality processes (identical & validated), and trained operators. Looking at healthcare in a similar way, if we cannot manipulate the variable of the ‘raw materials’ (in healthcare, cases of illness and injury) that leaves us to focus on quality processes and trained operators that contribute to standardised outcomes.
In terms of identical, validated, quality processes, care pathways have made and continue to make great strides in reducing outcome variability and overall cost.1 From NICE’s disease specific care pathways including flow charts to care pathways that include information about efficacy and cost, clinicians are gaining a broader view into how their clinical decisions impact the healthcare system and support the patient.
So what’s next? While pathways are becoming clearer, how clinicians operate can still be a source of variance. Whether it is staff trained differently because they graduated nursing school decades apart or staff trained differently based on previous experience in other regions, a key ingredient in clinical consistency is standardisation in staff education and skills. For example, every nurse may be trained in IV insertion and management, but not all nurses are equally as competent. Assessing key nursing skills, and then standardising clinical competencies across the organisation through education, drives better patient outcomes.
Additionally, trusts are struggling with staffing imbalances and night shift workers are missing key pieces of information that are more easily communicated to day shifts. Standardised information needs to be shared across settings of care regardless of shift. Finding central digital solutions can ensure that the same information on new policies and procedures is successfully shared regardless of shift. Consistently trained clinicians behaving in the same way, because they have been trained and consume information in the same way, reduces variability in patient care.
As we heard Dr Joe Rafferty, Chief Executive of Mersey Care, state when speaking at the NHS Confederation Annual Conference last week, “Digitisation is about people, not just technology”. Using technology to deliver education and record staff competency is part of the vision for a digital NHS that enables clinicians to deliver the best patient care.