The NHS Connecting for Health Evaluation Programme NHS CFHEP

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NHS CFHEP 005 An evaluation of the adoption of
the NHS Care Record Service in secondary care
An overview
Bernard Fernando and Kathrin Cresswell
The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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Grant Holders
Prof. Aziz Sheikh (PI) Prof. Robin J Prescott
Bernard Fernando Kathrin M Cresswell
Prof. Nicholas D Barber Prof. Ann Jacklin Prof.
Charles A Vincent
Prof. Anthony J Avery Prof. Rachel A Elliott
Tony Cornford Ela Klecun
James A Paton
The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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Schematic model of NHS CRS
The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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What it is not
What it is

• Evaluation of technology
• Evaluation of Trusts
• Evaluation of staff
• Evaluation of Local Service Providers
• (LSPs)
• Evaluation of suppliers

An Evaluation Of the Adoption of the NHS Care
Record Service (NHS CRS)
The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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Aims

• To identify consequences (benefits and
  dis-benefits, planned and emergent organisational
  change, altered health care practices and
  outcomes) as the NHS CRS begins to be implemented
  and used. Studied across a variety of dimensions
  as reflected in 6 Work packages
• To inform both local implementation and national
  roll-out of the NHS CRS in liaison with NHS CFH

The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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NHS CFHEP 005 - Summary of Work packages
Work package 1 Implementation, deployment and
organisational learning Interviews with LSP roll
out teams, members of the implementation
planning team and trainers/support staff
Work package 2 Attitudes, expectations and
experiences of stakeholders Interviews with
patients, healthcare professionals, managers, IT
service providers, IT support personnel,
administrative staff
Feed into
Coordinated recruitment of participants for
interviews
Work Package 3 Organisational consequences
organisational workflow, professional roles and
data quality Record reviews, interviews with
healthcare professionals and administrative staff
involved in the stroke pathway, documentary
analysis of relevant documents
Work package 4 Assessment of costs of NHS CRS
implementation Quantitative framework to identify
provider-specific implementation costs, comparing
different NHS CRS systems comparing the same
system being implemented in different
hospitals and comparing implementation of
systems in different service delivery environments
Work package 5 Assessing error, safety and
quality of care Quantitative assessments of
medication histories recorded on admission,
missing information in outpatient clinics,
clinical and medication errors and medicines
reconciliation Before and after comparisons
Work package 6 Organisational consequences and
implications for future IT deployments and
evaluations Summary of findings/conclusions,
implications for policy development and
implementation, interviews with software
suppliers, politicians and members of
professional bodies
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Methodological Approach

• Mixed qualitative (WPs 1-3, 6) and quantitative
  (WPs 4, 5) methods
• Using the principles of a stepped wedge design to
  select hospital sites within each of the three
  clusters
• Information systems as socio-technical systems
• Attention to how they are implemented and adopted
  within organisations, the attitudes and opinions
  of various stakeholders, consequential change
• Qualitative data generation and analysis informed
  by realistic evaluation and Cornford et als
  evaluation framework

The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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Realistic evaluation what works for whom under
what circumstances?
The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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Cornford et als evaluation framework for data
collection and analysis Examples How do
technical structures influence human work
processes and lead to organisational
outcomes? How do organizational structures shape
technical processes and lead to patient outcomes?
The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)
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Thank you
The NHS Connecting for Health Evaluation
Programme (NHS CFHEP)