In January this year, Liverpool Women’s NHS Foundation Trust went live with Athena, our full end-to-end paperless maternity system, and My Pregnancy Notes, a web-based portal which allows mums to securely view their maternity notes online.
It’s still early days, but we couldn’t wait to hear how the team at Liverpool Women’s is getting on. We caught up with Chief Information Officer Matt Connor, Programme Manager Paula Brennan, and Digital Midwife Genevieve Cousineau to find out what the implementation process was like and the benefits they’re already beginning to see from the system.
Matt, how did the team manage the implementation process?
Matt: We were able to establish some really good governance. We had clear work streams identified to support each of the key aspects from technical infrastructure through to data migration and information reporting and systems integration. That really helped because it held those particular areas to account and provided us with clear focus on activities relating to those areas. Our programme manager Paula held a weekly project catch up and we implemented a monthly project board, and I think that really helped the project stay honest in terms of what we were trying to achieve.
I think the other thing to add in terms of the implementation was that we implemented a robust authority to proceed. This enabled us to critique every key activity on the critical path. We undertook that initial assessment in November because our original go live was scheduled for December, but we felt it wasn’t ready at that point following the authority to proceed review. It was a process that really helped us focus on those key things., We undertook the second review early January, and we assessed the project as fit to proceed to go-live This allowed us to go live on 19th January.
And how was the implementation for you on the clinical side, Genevieve?
Genevieve: This was my first ever IT project and there was a lot to do in a small space of time. I appreciated there would be timescales set out and deadlines to meet but for the volume of work to do it was so fast-paced. As Matt mentioned, the original go live was meant to be earlier and then it got pushed back. But that bit of give that we had definitely helped. I felt like there was going to be something massive we’ve missed but actually it went really, really well.
Matt: The technical go live was successful because the clinical work streams had effective buy-in. And I think that was a good start. Due to the scale of the Go-Live we implemented a formalised command structure, which consisted of a central location on site with relevant subject matter experts along with the necessary coordination and logging. This enabled us to assess where support was required most and to have an overall feel for the success of the go-live
Paula: I should add that K2 was heavily involved in that as well, they were present on site for 2 weeks supporting the gold command which helped ensure the successful adoption of the system. .. Immediately following go-live, the first issues we found were technical issues such as log on issues and account issues, and in some cases the software hasn’t been fully rolled out. And those things we quite easily fixed. We got quite slick at that. Then the issues changed to training, system functionality, configuration or process related.
How have you been overcoming any challenges you encounter?
Genevieve: It’s a team effort. It’s so bespoke, because the challenges have been so varied. Because we did a full roll out across the Trust that day, the challenges have ranged from IT issues to bigger issues like process. It has been challenging but it’s definitely getting better now.
Matt: From my perspective, communication is absolutely essential and having that strong clinical leadership and midwifery leadership has been important. We have that in Gen and we would be lost without our Digital Midwife. It’s not just the role, it’s the person in our case. It’s about setting expectations and we’ve tried to do that throughout the project up to and including post go-live. As people get to use the system they want to see certain tweaks to a process functionality or configuration to meet their needs. I think the thing that you’ve got to make it very clear is that once you go live, it’s not a case of right, you’ve gone live, now you walk away and move on to the next thing. We are very much looking at the next optimisation phase, which is aimed at implementing the user feedback in place.
Do you feel like you’ve been well supported by K2 throughout the process?
Genevieve: I think that the relationship between Liverpool and K2 has been really great. And I think, it’s been fundamental to the success of this in both parties of how they combined and came together. It’s been a success based on the partnership that grew from this. I personally have built a really good relationship with Tom and Liam, I’ve spent most of my time with them. And I’ve met a lot of the team along the way. For me, they’ve really been a good source of support and reassurance and their knowledge of the system is brilliant. They’ve definitely gone above and beyond to support me in this role, because as I say, I’ve never done a role like this before. Both of them have been really, really helpful and supportive. They’ve done extra tasks for me, because I haven’t had the time, just that extra little bit of support that I don’t imagine they’ve needed to do, and being very flexible with things, mistakes that I’ve made — they’ve been brilliant, throughout the whole process.
Matt: I’ve been involved in a number of different digital system go-lives and what I would say with K2 is they are very dynamic. Liam was with us on-site for both weeks and went above and beyond including supporting some floor walking activities.. We’ve received urgent requirements to either implement configurational changes or tweak the system to how we want it to work, and K2 have been really responsive .Potentially, there’s a risk with such a big implementation that changes can get lost in bureaucracy and finding the balance between good change management governance and responding to the organisation’s needs is a difficult one, but one I felt was a success of the Digital Maternity K2 go-live. It’s been really important that K2 has been able to respond to our needs which they have done.
What benefits are you beginning to see from the system?
Paula: A main benefit is patient safety. Now we have contemporaneous capture of events during labour so clinicians can have a better idea of the sequence of events and what was going on through people’s minds which will improve care and reduce incidences. There’s obviously a cost benefit to us in terms of files and folders. And that has a knock on effect of reducing our carbon footprint. And then printed leaflets is another cost saver because obviously we have the patient portal. Also patient experience and the fact they no longer need to carry heavier hand held notes. Clinicians will have instant access to patient records via K2 Athena, which means that they have access to medical records at all times and no need to decipher sometimes poorly written clinical notes.
Matt: Like many organisations through our EPR Programme we’re on a journey to reduce paper reliance across the Trust. Implementing K2 helps towards reducing our paper reliance, improving our use of structured data and ultimately our Digital Maturity. We’re able to share that information in near real time with other clinicians, other midwives, other clinical staff, and nursing staff across the organisation.
Genevieve: From the clinical point of view, definitely single entry. Previously we’d have to document the time of birth in at least four different places. For us there’s a lot of time saved with a single entry, which is really important for the theatre staff too. Also standardisation of documentation across the board, now we’re all documenting the same information which is really good for consistency. I know that a lot of the staff are loving it for auditing purposes so we can pull the information that we need much easier. Literally in a matter of minutes rather than having to rifle through 20 sets of notes. And from the woman’s point of view, the confidentiality is massively enhanced. So previously, a set of notes laying around the ward and that kind of thing, if you lost them outside of the hospital, that data was in the wind, where now we’ve got more control over that data.
Paula: I think one thing to note there is we’re still in its infancy, it’s very new. So a lot of the benefits aren’t fully realised, or noticed in true form yet, these are all things that are potential and we will monitor their realisation through the project governance.
Matt: The system offers improved levels of reporting and that’s a key benefit from a service management perspective. But we need to make sure people are inputting their day to day data correctly to help them understand the consequence of good data entry. One of the benefits of the system is that we can undertake data quality audits more effectively than we could have before. As we gain confidence, it will really start to inform both operational decision making, but also, support the national submissions and dataset requirements. We extensively usePower BI within the Trust, and we have already plugged the K2 data into this system to allow accurate and near real-time reporting. Previously, before we had the K2 system, it was more of a blended approach to reporting. We had to receive data from different Trust systems and blend it together to meet the submission standards, we won’t need to do that in the future. So it will allow for a simpler process for the Performance and Information department.
Click here to find out more about K2 Athena, our Electronic and Personal Health Record System (EHR/ePHR), providing contemporaneous capture of data, throughout the entire pregnancy pathway.