Implementing digital innovations requires people like me – nurses

Damian Larkin is on our NHS Digital Pioneer Fellowship Programme, that supports up to 30 change makers employed by NHS organisations in London, who are leading digital programmes


I trained as a mental health nurse in Galway, Ireland where everything was, and probably still is, paper based. That’s all I ever knew, and I never questioned it. So, if someone told me a few years ago that I would become a nurse lead, driving digital innovation in one of the most reputable Trusts in the UK (and world), I would have laughed but I am and I’m loving it. I want to share with you why implementing digital innovations successfully in health care requires people like me, nurses, to be involved in the implementation process.

I know only too well that often when a new initiative is introduced, nine times out of 10 it is nurses that are expected to implement it, often without any previous consultation. As a nurse, I can say that all we want to do is provide safe and high-quality care to our patients. Over the last few years many new initiatives, strategies and programmes have been introduced. A lot of the time nurses like me have felt like we are spending less time delivering the type of care we got into nursing to do and more time sitting in front of a spreadsheet proving what we have done.

That’s where the Digital Health Nurse Leads come in – me! Now, when a new product or process is considered, I (and the amazingly competent and good-humoured team I work with at SLaM) assess what processes we are currently using, what strategies are running, what policies are in place and what our mandatory recording requirements are. We then map our process and workflows based on the relevant care pathway. This enables us to see where there are areas of duplication and/or unnecessary manual auditing. I then work with our in-house developers to find a solution to streamline the process in a way that, put simply, just makes sense.
These new digital solution/platforms then get mapped to Power BI to produce dashboards that give us a snapshot of what we have achieved so far and where we need to place more emphasis. This means no more manual audits on Microsoft Excel.

Even with the best ideas and systems, staff are slow to embrace them because they are new, unknown and let’s not forget – “if it’s not broke, don’t fix it”. Often staff don’t realise their current systems are broken, or at least disjointed. By embracing technology and digital innovation they are not necessarily doing anything new rather they are doing what they already do, just in a way that is much more efficient.

I am now one of those people who comes in and tell staff the way they work could be improved. Essentially, most of the time I am just telling them to do yet another new thing. The level of resistance still sometimes shocks me but now it is something I factor into my roll-out and implementation plans. However, when staff are involved in the implementation process and they are made aware that a new process, usually replaces multiple other ones the mood in the room usually perks up. These people, usually nurses, spend their working lives helping others, they are missing their own families while they support other people’s families and are often abused both verbally and physically while doing so. The last thing they want is to take on yet another new thing to do. I know I didn’t, I just wanted to get on with caring for people.

That’s what makes this job as a Digital Health Nurse Lead a joy. Spending time with staff, understanding the source of their reticence and demonstrating how I can help them be much more efficient, work remotely and spend more time with their patients. When they have been given the support needed to use it and see first-hand how it can make the recording and reporting side of their job much easier, they become eager to see what else we can offer them.

I initially had guilt when I took this job, asking myself questions like; am I selling out? What do I even know about technology anyway? But now that we have implemented quite a few successful projects that have been proven to save time, improve patient safety and staff experience (kudos to my Quality Improvement colleagues and their data collection assistance here), staff are becoming less resistant to digital change and feel like they have more clear direction. We are also seeing a steady improvement in the quality of our data collection. All of this leads to safer and higher quality delivery of care and I’m really proud to be a part of that.

Find out more about the author of this blog, Damian here