in paediatrics services Follow up learning webinar Wednesday 24 - - PowerPoint PPT Presentation
Sharing experiences of using Near Me in paediatrics services Follow up learning webinar Wednesday 24 June 2020, 2.00-3.30pm Please ensure your microphone and video and turned off Improvement Hub Enabling health and social care improvement
Follow up learning webinar Wednesday 24 June 2020, 2.00-3.30pm
Please ensure your microphone and video and turned off
Improvement Hub Enabling health and social care improvement
Improvement Advisor Healthcare Improvement Scotland
Microphones will be muted during the presentation. Please ensure your video is turned off. Use these buttons if you would like to turn on your microphone and video to ask a question.
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This webinar will be recorded and everyone who registered for the session will receive a link to the recording. It will also be posted on the ihub Twitter account.
National Near Me Lead Scottish Government
Clare Morrison, National Near Me Lead, Scottish Government
February 300 calls/week w/c 7 June 16,446 calls/week
Technical set up Service processes Individual training
Technical set up Service processes Individual training
https://learn.nes.nhs.scot/28943/coronavirus-covid-19/remote-consulting
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Associate Specialist in Paediatrics NHS Ayrshire & Arran
We overcame our challenges by:
service What’s worked well? Allows multidisciplinary review Implemented Near Me in: Neurodevelopmental Follow-up Clinic
Any top tips? Allow plenty of time
What have been the enablers? Staff support What have been the challenges? Technological hitches!
Neurodevelopmental Clinic Top Tips for Preparing to Attend Anywhere Ensure you have good Wi-Fi connection and that your device is well charged before the appointment. Ensure you have access to Google Chrome or Safari. Please use a well-lit room. This makes it easier for the clinicians to see your child accurately. Have your baby/child dressed in vest and nappy with their bare feet. This will help the physiotherapist to see exactly how they are moving. We may ask you to encourage certain movements with your baby/child so they need to be able to move easily and freely. We may need you to have your hands free to position your baby/child during the session. If so, please be able to prop your device securely so we can see your child when you’re not holding your phone/ tablet or laptop. It may be helpful to have a selection of toys available to motivate them during the session. Please do not record the session or take screenshots, unless discussed and agreed with the clinic team. Following the session, we will write up notes in your child’s records in the same way as we do following face-to-face appointments. In the event of any technical issues arising, a member of the clinic team will phone you.
Paediatric Respiratory Consultant NHS Lothian
What have been the enablers?
We overcame our challenges by:
What’s worked well?
What have been the challenges?
Implemented Near Me in: April 2020
Any top tips?
Plan going forward:
Wording awaiting sign off – 3 months trial period Design underway (Edinburgh Children’s Hospital Charity (ECHC))
Awareness of the limitations Example incident
Young person with CF
significantly unwell – leading to admission
On review - red flags:
What’s possible
appearance
(limited)
Paediatric respiratory examination during NM What’s not possible
child is unwell
examination
What have been the enablers?
We overcame our challenges by:
What’s worked well?
What have been the challenges?
Implemented Near Me in: April 2020
Any top tips?
Plan going forward:
Wording awaiting sign off – 3 months trial period Design underway (Edinburgh Children’s Hospital Charity (ECHC))
Consultant Paediatrician NHS Western Isles
What have been the enablers?
communication
assessment What’s worked well?
Remote Consultation (TARC)
What have been the challenges?
stakeholders
referral Any top tips?
We overcame our challenges by:
setting
evaluation in bigger sample size
Consultant Paediatric Surgeon NHS Grampian
Chris Driver Royal Aberdeen Children’s Hospital
– geographical – social – transport link related
– Inverness – Dundee – Shetland
– Wick/Thurso/Fraserburgh/Braemar/Oban/ Tomintoul/Kinlochbervie/Skye /Fort William
– no travelling – no need to miss school / work – quicker… – can deliver from anywhere
– review only.. (?) – can’t examine – child/YP can’t always engage –
change practice
around options available
– no travelling – Less (?no) need to miss school / work – can see child / YP – can inspect (not examine) – child/YP can engage via video – easier for both parents – invite in a colleague – can deliver from anywhere
– can’t examine – can’t inspect sensitive body areas
likely to be required
preferable
– reviews only – distance – complex needs with multiple appointments – parental request
– any review – selected news
good/better
need to examine
person”
to Skye/Thurso…
school with child?
consultation for review later?
What have been the enablers? We have an established culture of video conferencing A96/A9… Enthusiastic early engagement be senior clinicians Early flexibility by OPD teams Hardware already available Enthusiastic and flexible engagement by local Near Me team Widespread use of MS Teams for meetings What’s worked well? Setting up of clinics “Persuading” staff to move across Link with Trakcare Text reminder function…
Implemented Near Me in: Royal Aberdeen Children's Hospital
We overcame our challenges by: Sharing fixes Peer support Re-purposing …..
What have been the challenges? Adequate hardware – microphones>webcams Software conflicts Interruptions….
Implemented Near Me in: Royal Aberdeen Children's Hospital
Any top tips? Early, brief and repeated demonstration of how it works 2 screens – makes it all work smoother Think about what else it can do rather than what it can’t ….. Put a sign on your door when “in clinic”….
Paediatric Consultant NHS Tayside
Any top tips?
We overcame our challenge by:
consultation
Implemented Near Me in: Paediatrics – Diabetes Out There
What have been the challenges?
What worked well?
What have been the enablers?
Consultant Paediatrician, NHS Grampian & RCPCH Officer for Scotland
ideal)
Other pieces of the jigsaw The vision has been there for years
Other pieces of the jigsaw The vision has been there for years
care
You might not have noticed but I am away
Try setting up practice Near Me calls with colleagues to understand the patient and clinician experience. If you are emailing patients and families with information about Near Me, remind them to check their ‘junk’ folder. Using a headset can
audio quality than using a built-in laptop microphone. Develop a checklist to help you remember the steps you need to take before, during and after the consultation whilst you get used to the technology. Conversations flow differently on video than in person. You may want to address the child/young person early in the consultation to ensure their voice is heard. Ask parents and responsible adults to use the child/young person’s name on Near Me. This will make it easier to find them in the waiting room. Try to test your equipment prior to starting consultations. For example, run a test call on attendanywhere.org.uk. If you experience technical issues during a Near Me consultation, switch to a phone call while you resolve them. Viewing patient files on a separate screen can make the Near Me consultation run more smoothly. Online information and web links could substitute pamphlets and written resources for patients. Supporting administrative staff to monitor the online waiting room can benefit your system processes. Multidisciplinary team reviews can be set up by inviting other professionals to Near Me appointments.
Paediatric clinician top tips for using NHS Near Me
Data source: Information was collected from paediatric services who discussed their experiences with Near Me across two webinars held 2 June 2020 and 5 June 2020
Top tips for using NHS Near Me
Data source: Healthcare Improvement Scotland learning while supporting teams with Near Me
Getting started 1. Getting equipment in place early can make Near Me appointments as easy as phone calls. 2. Try setting up physical meeting rooms to run Near Me in your service – this can help in particular if you are short on IT equipment 3. Try working through realistic clinical situations when learning to use Near Me 4. Small tutorials can help with staff buy-in and to understand clinician and patient perspectives. 5. Utilise the learning webinars by the national Near Me team Support 1. An effective project team includes project and IT support and engaged clinicians. 2. Don’t hide communication errors if they
limitations of the technology and ask for clarity. 3. Identifying local champions can support teams’ confidence using Near Me. 4. Enthusiasm from managers goes a long way. User experience 1. Multidisciplinary team reviews can be set up by inviting other professionals to Near Me appointments. 2. Use teach-back style questions to provide assurance that service users understand exactly what they are being asked to do. 3. Use a smartphone or tablet for Near Me ( on WiFi) call allowing you to use computer for access to clinical system. Processes 1. Work closely with Near Me lead to plan waiting room processes and manage booking appointments. 2. Adapt existing resources to provide SOPs, check the Near Me website for guidance documents. 3. Using local data can help you understand Near Me in your context and provide rapid feedback to teams. 4. Try scheduling breaks in between meetings and appointments - otherwise, you may go a long time without moving from your seat. 5. Build into current processes as an option rather than a stand alone project. Going forward 1. Using the Plan, Do, Study, Act (PDSA) framework can help support successful Near Me implementation. 2. Involve, listen to and capture feedback from the people who are involved with and who will deliver and receive the service 3. This change could be a catalyst for digitising
service, such as clinic notes.
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