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![Page 1: Dr Daniel Birchall, Consultant Neuroradiologist and Chair of the Information Systems Strategy Board Newcastle Upon Tyne Hospitals NHS Foundation Trust.](https://reader030.fdocuments.us/reader030/viewer/2022032517/56649ca55503460f9496708d/html5/thumbnails/1.jpg)
Dr Daniel Birchall, Consultant Neuroradiologist and Chair of the Information
Systems Strategy Board
Newcastle Upon Tyne Hospitals NHS Foundation Trust
![Page 2: Dr Daniel Birchall, Consultant Neuroradiologist and Chair of the Information Systems Strategy Board Newcastle Upon Tyne Hospitals NHS Foundation Trust.](https://reader030.fdocuments.us/reader030/viewer/2022032517/56649ca55503460f9496708d/html5/thumbnails/2.jpg)
THE BUSINESS BENEFITS OF CLINICAL LEADERSHIP IN INFORMATICS
Dr Daniel BirchallConsultant Radiologist & Chair, Information Systems Strategy Board, Newcastle upon Tyne Hospitals
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Context
There are increasing requirements to provide effective and high quality, integrated, financially viable healthcare to patients;
Healthcare organisations are in a phase of rapidly progressing technological capability;
Pre-existing organisational structures and strategic alignments have evolved in a period in which the importance of information systems to the Trust’s strategy was not as central.
![Page 4: Dr Daniel Birchall, Consultant Neuroradiologist and Chair of the Information Systems Strategy Board Newcastle Upon Tyne Hospitals NHS Foundation Trust.](https://reader030.fdocuments.us/reader030/viewer/2022032517/56649ca55503460f9496708d/html5/thumbnails/4.jpg)
Premise
1. Information systems are at the heart of delivery of high quality effective and efficient healthcare;
2. Appropriate organisational structures and processes need to be in place to support the delivery of an effective Information Systems Strategy;
3. It is necessary to have a lead Clinician as a focal point of the Information Systems strategic organisational structure.
![Page 5: Dr Daniel Birchall, Consultant Neuroradiologist and Chair of the Information Systems Strategy Board Newcastle Upon Tyne Hospitals NHS Foundation Trust.](https://reader030.fdocuments.us/reader030/viewer/2022032517/56649ca55503460f9496708d/html5/thumbnails/5.jpg)
Newcastle-upon-Tyne Hospitals Foundation Trust
2,000 beds; > 1,000,000 patient engagements
each year; Nearly 14,000 staff – one of the
largest employers in the North; Flagship Cardiothoracic Centre,
Institute of Transplantation, Great North Children’s Hospital, Trauma Centre;
Recently completed one of the country’s largest capital investment schemes.
![Page 6: Dr Daniel Birchall, Consultant Neuroradiologist and Chair of the Information Systems Strategy Board Newcastle Upon Tyne Hospitals NHS Foundation Trust.](https://reader030.fdocuments.us/reader030/viewer/2022032517/56649ca55503460f9496708d/html5/thumbnails/6.jpg)
Newcastle-upon-Tyne Hospitals Foundation Trust
Recognition of centrality of information systems to provision of high quality health care;
Major investment in information systems;
Cerner collaboration 2008/9; Executive decision to refresh
information system strategy and operations;
Invitation to undertake strategic review.
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Personal
Consultant Radiologist – facilitative role;
Head of Department – managed significant change;
Management training – MBA Newcastle University Business School;
‘Clinical’ and ‘Management’
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Organisational Review 20091. Organisational Structure2. Operational Delivery3. Clinical / Front-line Engagement4. Reporting Mechanisms5. External focus
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Organisational Structure
Disparate groups, leading to lack of clarity of purpose and scope, and lack of co-ordination;
‘Enthusiastic individuals’; Unclear linkage with overall Trust
strategy; Lack of an over-arching information
systems strategy; Suboptimal central governance
structures.
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Operational Delivery
Proliferation of unconnected information systems;
Limited central governance, and limited knowledge of individual systems;
No comprehensive Project Portfolio; Inconsistent project management; Inconsistent prioritisation.
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Clinical / Front-line Engagement Limited front-line engagement; Little clinical governance / input into
developing overall strategy; Little clinical involvement in
implemented projects; Limited communication with the
front line; Disconnect between ‘IT’ and ‘front
line’.
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Reporting Mechanisms
No over-arching standardised Executive reporting;
Ineffective reporting of key issues arising;
Uncertain accountability.
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External Focus
Limited communication with primary care;
Suboptimal interface with University.
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Review 2009
Formal review Executive report Recommendations Executive support Implementation of Change
Management plan
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Requirements
1. To ensure that appropriate organisational structures and processes are in place to allow effective support of the Trust’s overall strategy using information systems;
2. To ensure that an Information Systems Strategy is in place and operationalised, and closely aligned to the Trust’s strategic objectives in providing high quality patient care;
3. To ensure that Information System Strategy needs to be closely integrated with clinical and other front-line functions in support of patient care.
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Trust Aims
1. To put patients at the centre of all we do, providing the safest and highest quality health care;
2. To be the healthcare provider for Newcastle, and a national specialist centre;
3. To promote healthy living and lifestyles;
4. To be nationally respected for our successful clinical research leading to benefits in healthcare and for patients;
5. To maintain financial viability and stability.
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Change Management Plan
1. Organisational Structure;2. Operational Delivery;3. Clinical and Front-line Engagement;4. Reporting Mechanisms;5. External Focus.
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Organisational Structure
1. Establish Information Systems Strategy Board (ISSB)
1. Single governance board; 2. Accountable to CEO / Executive;3. Executive support / authority;
2. Clear definition of roles & responsibilities[50% Clinical (including Chair); IT Director; Head of Programmes; Development; Technical; Trust Operations; Finance]
3. Responsibility for all Trust information systems development, implementation and maintenance
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Organisational Structure
4. Align ISSB Purpose with Trust’s Aims, Values, and Strategic Objectives;
5. Clear statement and communication of Purpose & Scope of ISSB:
• The primary reporting mechanism to the Executive relating to Trust’s Information Systems Strategy;
• The primary decision-making group with respect to implementation of Information Systems Strategy;
• The primary coordinative mechanism for optimisation of Information Systems Strategy;
• Oversight of all Trust information systems;• Communication to Clinicians, Nurses, Directorate
Managers, IT.
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Operational Delivery
1. Establish comprehensive Project Portfolio;
2. Set clear strategically-aligned SMART goals for the near term (1 – 3 years);
3. Rigorously review progress towards set goals;
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Operational Delivery
4. Objective prioritisation of Project Portfolio;
5. Identify business-critical projects;6. Executive review and endorsement;7. Optimise match between projects
and organisational resources.
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Operational Delivery
8. Standardise project management methodology;
9. Clearly and objectively track project progress;
10.Systematically re-prioritise and review status of Project Portfolio.
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Clinical & Front-line Engagement 50% ISSB are clinicians; Deputy Medical Director a sitting
member; Clinical Informatics Committee as a
day-to-day clinical forum; Clinical Advisory Group as a
governance structure; Two-way communications with
Clinical Directors, Directorate Managers, Nursing.
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Reporting Mechanisms
Systematise ISSB Monthly meetings, Minutes, Report structures;
Defined reporting responsibilities into ISSB;
Defined, structured monthly Executive reporting;
Key issues identified and highlighted.
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Organisational Structure
Disparate groups ►Unified co-ordinated structure;
Lack of clarity of purpose ► Defined strategic and operational governance role;
Unclear linkage to Trust strategy ► Clearly aligned with Trust’s strategy;
No overarching information systems strategy ► Clearly stated Information Systems Strategy
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Operational Delivery
Uncontrolled emergence of unconnected information systems ► Co-ordinated information system architecture;
Limited central governance ► Comprehensive governance / corporate responsibility;
Inconsistent project overview ► Comprehensive Project Portfolio;
Inconsistent prioritisation ► Prioritised (and re-prioritised) Portfolio;
Non-standardised project management ► Standardised project management.
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Front-line Engagement
Little front-line engagement ► Effective front-line engagement;
Little front-line governance of strategy ► ISSB; Clinical Informatics Committee; Clinical Advisory Group;
Little front-line project engagement ► Clinical leadership of projects;
Little front-line communication ► Communication channels established.
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Reporting Mechanisms
Unstructured Executive reporting ► Standardised, monthly Executive reporting;
Suboptimal critical issue reporting ► Monthly highlighting of key issues;
Uncertain accountability ► Defined responsibilities / ISSB review & reporting.
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External Focus
Poorly supported primary care interactions ► Central inclusion in strategic approach;
Suboptimal interface with University ► Interface / forum established
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What has been required to effect this change?
Strong Executive support; An effective team; Effective interactions between
Executive, IT, and front-line users; A key clinician leader to act as an
enabler and as a bridge between ‘clinicians’ and ‘management’.
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What attributes are required of the clinician leader?
Clinical leadership and credibility; Authority with clinicians, and non-clinicians; Clinical contextualising; Clinical communication skills: influencing and
listening; Experience of change management and
leadership in the clinical setting;
Co-ordinative skills; Organisational skills; Systematic approach;
An enabler.
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What characteristics does a clinician leader need?
Clinician; Innovator; Communicator; Change management skills / training; Systematic thinker; Good inter-personal skills – emotional
intelligence; Good ‘team captain’.
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What does a clinician leader need? The above skills; Executive support; A good team; Time.
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Business Benefits
Effective, unified strategic and operational structure aligned with the Trust’s strategic objectives;
Effective, high–performance Project Portfolio management supporting the Trust’s strategic objectives;
Effective clinical and front-line engagement with ISSB Strategy and Operations;
Effective Executive reporting of progress towards objectives, and of key issues arising;
Effective interaction with key external bodies in support of patient care