Features, South Africa

Healthcare Innovation: Lessons from the Frontline

Healthcare innovation, in some form, is being tried and tested across the healthcare community from single sites to national roll outs. 

Healthcare Innovation - EHN

Innovation, in some form, is being tried and tested across the healthcare community from single sites to national roll outs in an effort to address the numerous barriers to realising patient-centred universal access and affordable quality care.

Recognising that everyone can contribute to changing a system, Groote Schuur Hospital (GSH) in collaboration with Inclusive Healthcare Innovation launched the GSH Innovation Programme in October 2014 to give hospital staff the opportunity to turn their ideas into a reality, and in so doing, solve some the hospital’s biggest challenges.

The GSH Innovation Programme is a year-long initiative designed to provide the necessary funding, expertise and mentorship to staff who wanted to develop their innovative ideas and address issues ranging from reducing patient waiting times to implementing electronic patient records. At the beginning of 2015, 17 teams showcased their ideas, from which the top 10 were chosen to take part in the programme.

Last week eHealthNews attended the GSH Innovation Showcase Day, where the 10 staff teams presented what they learnt, what obstacles they had to overcome and what they still needed to achieve to make their projects successful. While the projects focused on different areas, from improving patient medicine adherence with a Guide Pill Box to creating an eWard Board, the overriding message was the importance of relationships, collaboration and communication to drive innovation.

Generating quantifiable data

The first team presented their GSH Time Machine, a project that aimed to maximise the usage of existing radiotherapy machines to ensure more cancer patients receive more timely treatment. To achieve this outcome, the team, led by Dr Hester Burger, created a ‘Time Machine’ game board that could be used to maximise staff allocation to the radiology machines.

Over the year, the Time Machine team collected data to determine what the impact had been on the number of patients being treated per month and the number of new patients starting treatment every month. However, because of a six to eight week lag, they realised that they still required at least another year’s worth of data to fully understand the impact their project was having.

Top learnings from Dr Burger also included: the importance of testing the whole system; standardising and linking indicators for all patients; and preparing for unforeseen changes.

Engaging stakeholders from the beginning

The eWard Board is a project that aims to improve communication within the hospital’s wards by displaying all the patient information on an electronic white board. While the project had three clear objectives – to pilot the electronic board as a white board first; to develop the software as a web-based solution; and then purchase the equipment – they ran into difficulties early on because nurses and clerks weren’t adequately informed about the project and as a result, didn’t understand why or how they should be using the white board.

From the feedback they received, the eWard Board team then took time to implement a change management process to educate staff members and ensure that new staff, as a result of staff transfers, were told about the project and how to use the board.

The project lead also explained that another major learning to take out of the project was the decision to pilot their idea with a white board instead of the actual electronic board. As a result, they weren’t able to monitor the efficacy of their idea because of the vast difference in the two platforms.

Collaborating across the board  

One of the teams that managed to create a prototype of their solution was DextraView, who have developed a small infrared-enabled device that allows surgeons to manipulate radiology images hands-free during surgery.

During their presentation, the main presenter, Dr Jonathan King, noted that he and his colleague, Dr Kamlin Ekambaram, wanted to make a practical tool that could change medicine and push boundaries. In order to realise this, they had to reach out and collaborate with people from different fields outside of the hospital, specifically UCT PhD students specialising in ICT imagining and computer programming, Francois Malan and Pieter Holtzhausen, to ensure the right skills were involved.

Another project, appropriately named Referrals, aimed to rollout an electronic referral platform across various departments of the hospital. At the start of the GSH Innovation Programme numerous teams wanted to develop the platform for their individual departments, however they soon realised it was more practical and sustainable to collaborate on a single record platform that could be used across departments and replace paper-based records to improve efficiency and patient safety.

However, the team leader noted that while they had been working on the project for a year, they hadn’t yet piloted their system and had no data as a result. They had however met and secured backing from important stakeholders, including the Western Cape Government (WCG), and now have a better understanding of all the requirements they have to meet in order to make the platform sustainable. With WCG support, the Referrals team aims to create a single platform that can be used by healthcare facilities across the province to facilitate continuity of care for patients.

Creating a solution for a real problem

The final presentation was from the Kidney Cares Clinic, an initiative that aimed to create a cost effective model for adolescent-centric care for renal disease. From the start the project was co-designed together with patients, their parents and staff to ensure that the initiative could help improve adherence to treatment, reduce the drop-out rates for adolescents and, most importantly, improve the patient experience for these young people.

The team reported a successful year and were able to measure their success by having a growth rate from 23 patients to 35 patients at the time of the presentation. Their data also showed that follow up appointments improved dramatically because the patients were more motivated to attend.

The team credits their success to the holistic way they approached the problem and employing the use of Whatsapp and patient mentors to reach out to and communicate with patients actively receiving treatment.

“No one understands what it’s like to go through our system or the shortcomings of our system more than our patients,” said the team during their presentation with regards to using patient mentors as an integral part of their solution. “They are therefore well placed to counsel, support and guide other patients.”

Innovation takes commitment

The 10 teams have come a long way over the past year and have helped realise the hospital’s vision of leadership, innovation and change. However, as GSH Facilities Board Member, Prof Ed Coetzee, noted, it’s important for the teams to not give up and continue with their projects to ensure the vision gains more traction and the ultimate goal of patient-centred care is achieved.

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