Introducing digital technology in community paediatrics – A journey by Susan Irving

‘Congratulations you have been shortlisted……..’

This was the start of an email I received out of the blue at the beginning of February this year. It was a notification I had been shortlisted for the ‘Digital Leader’ award at this years Digital Heath and Care Scotland awards and was a proud moment, as it highlighted that the work I have done around supporting the use of digital technology in our workplace has been of value to my colleagues, who had submitted the nomination.

I have always been a bit of a proud technology geek…… but in the workplace I am especially

passionate about making technology work for the staff who have to use it.

My journey started several years ago when we were told we had to adopt an online digital appointment system ‘Topas’. To our mind it was acute based and not really suitable for a community paediatric team with our mixture of appointments in different locations and variable appointment lengths.  We also couldn’t see how it would be of any additional benefit to us in getting any data (something we were doing manually) – in other words there was no ‘gain’ for us’. However, after some discussions about the specific set up of ‘clinics’ that would work better for us we embraced the challenge and went with it, doing some team training sessions to help us all understand it and were never afraid (and still aren’t!!) to challenge and ask questions to try and make it work for us. If we were going to have to do something that we felt was ‘an extra’ we wanted to know what we could get out of it!

From there we went to electronic note keeping (at very short notice due to external circumstances).  Our journey took us from a system called eCasenotes to the systems we now use – Clinical Portal and Morse and, from a place where we used lots of paper and scanned it, to where we are now, where our use of paper is as minimal as possible.

Along the way we jointly designed, with our colleagues in information technology, an online assessment form covering all potential areas we need to assess; bringing together the many paper assessment forms we had into one complete online entity. This form is now also available on our offline digital system and as well as all the clinical information we require, the form on both systems is also designed to pre-populate some of the essential data which is required to comply with our standards of note keeping.

We also use digital dictation for our reports and these are verified electronically; where possible notifications are sent digitally to internal recipients which also minimises the number stored on our electronic notes system.

The online video appointment system NHS near me is an integral part of our service, thanks in part to the covid pandemic. We had the system in place pre covid (who can remember such a time, but had been a little selective about how we were using it – handpicking clients we thought it would work with (and who would we thought would be supportive if it was a disaster!!). When covid hit we were well placed to upscale its use and consequently were also able to support colleagues locally in its use too.

Another digital positive from the covid pandemic has been the expedited roll out of Office 365 and Microsoft teams – Microsoft teams has transformed the way in which we meet and communicate with each other on a daily basis – gone are the days of our office message book and paper diaries (for most of the team anyway!!!!) Online diary sharing is an additional valuable tool when we have staff working remotely in the community.

Along this digital journey I completed the NMAHP Digital Health and Care Leadership programme, where I began to really explore how we could maximise mobile community working in a rural area. Initially this was looking at laptops but now we have access to systems that allow us to be truly mobile using an iPad, an asset that was extremely valuable when blended work practices were essential to maintain physical distancing in the workplace. The leadership programme was valuable in developing my skills and confidence to push forward the digital agenda, as well as giving me a network of like minded people to connect with.

This last year has seen an amazing transformation in the availability of digital technology, introduced at pace that was previously unthinkable. As a physiotherapy team we had already started on that journey so had many of the systems in place to support each other through the potholes. The covid pandemic gave us the permission to be more confident in rolling out some of the tools we already had access to and as well as to go off on roads we weren’t so sure of! – How could I forget to mention that we developed a video for demonstrating positioning for our plagiocephaly clients  – now that was an adventure!!

In this fast paced digital world there will be more miles to cover and more bridges to cross, as locally the rollout of the Office 365 suite of tools continues and as we also start to move away from Topas (and where the journey began) to Trak care; however I look forward to continuing the journey, picking up more digital converts along the way.

P.S. I didn’t win but it was a great honour to be nominated and demonstrates that whilst I may have started off in a small car, I now have a bus full of like minded passengers!

Susan Irving

Team Leader, Physiotherapy for Children and Young People

NHS Dumfries and Galloway

How to make ‘MS Teams’ work for you in the new normal by Chris Wallace

This time last year, the technology that had been available to us for some time, was suddenly an essential part of our working life. Remote working had previously seemed like too much effort, or when we attempted it, a disaster. Yet here we are a year later, reducing unnecessary travel to meetings both locally and nationally , minimising COVID – and seasonal flu- risk , and most importantly for many,  actually embracing the flexibility that MS Teams brings to influence our present and future work experience.

Yet many people continue to detest, avoid or resist it. MS Teams is a reminder that nothing is how it was before☹ . The informal office chats, the fifteen minutes headspace travelling from one meeting to the next, the ability to discuss challenging situations or debrief after an emotionally draining experience, without having to plan it- all apparently lost in a distant memory. 

So how do we make the most of it?  

Here are my top ten tips to help make MS TEAMS a positive experience

1. Plan and take control of your diary. There is nothing in the healthy working lives manual that suggests back to back meetings without ever leaving our seat are good for our mental or physical well- being. So why do we allow it on TEAMS?  If a meeting time isn’t good for you, be assertive and say so.

2. People used to arrive at meetings and have a chair of their own. This ensured that everyone felt comfortable, and had the opportunity to be seen and heard as an individual.  The equivalent on TEAMS is to use your own personal laptop or device.  There is little chance of you being taken seriously if all that can be seen is your right ear and your colleagues elbow as you squeeze onto the same laptop☺ ( also what about social distancing!?!)   

3. Check how you appear to the outside world using ‘devices’ under ‘settings’ before you log on to the meeting. As attractive as they might be, no one wants to see your new slippers or a close up of your left nostril

4. Try not to cold call. Cold calling on TEAMS is the equivalent of walking up to your colleagues desk and, irrespective of what they are doing, sitting down and saying ‘I’m more important than what you are doing, and I’ve decided you’re available now’.  There will of course be situations where this can’t be avoided but they will generally be the exception

5. Surprisingly, the organisation expects us to do more than just turn up ☺ If you’re in a TEAMS meeting, and there is something that requires an opinion, don’t just sit in silence. Even if you don’t feel confident expressing your opinion verbally, use the chat function. It often opens up new  discussions  and opportunities, providing the person chairing the meeting notices the chat( or asks someone to monitor it for them)

6. “you’re on mute” will surely be someones catch phrase of the future. Check your microphone and camera function in advance of the meeting, and if you don’t want anyone to see your dirty laundry or your half finished decorating, use the background function. You can choose to be absolutely anywhere.

7. If you’re inviting someone from a different organisation for the first time, test out their access in advance. Send them a test meeting invite that will give you both reassurances that either  the calendar link works or you are able to invite them in

8. Use the ‘Hand up’ function.  Talking over each other in a face to face setting is bad enough but in a Teams setting it’s a nightmare.  Especially for any colleagues with cognitive or sensory challenges.
9. Imagine you are in a real room. If chairing, don’t just dive into an agenda- check out how people are at the beginning  of the meeting. It’s the scene setting that will enable people to gauge the general mood of the meeting, and those within it. And if it’s a long meeting, build in a comfort break

10. Finally, hats off to our I.T colleagues, especially Murray Glaister. The regular tips actually do make work life easier   ☺☺☺☺                                                                                                                

Chris Wallace, Service Manager, Community Health and Social Care Directorate for NHS Dumfries and Galloway