How can we help AHPs spend more time with patients and less searching or updating information in patient records?
AHPs wide ranging roles and working environments
Allied Health Professionals (AHPs) make up one tenth of the NHS workforce. Almost 70,000 work in the UK delivering over four million client and patient interactions per week. AHPs work in the community, in hospital trusts, in peoples’ homes or for specialist providers helping people at every stage of their life.
Given the range of professions under the AHP umbrella and their varying working environments, AHP documentation requirements vary greatly. Regardless, AHPs must keep full, clear, and accurate records for everyone they provide a service to. This can prove problematic: inadequate hardware for community-based staff, a lack of access to real-time data or having to write notes in front of patients. All can impact negatively on the patient interaction.
Nuance convened a roundtable to discuss the impact of clinical documentation on AHPs. We wanted to investigate the challenges they face day-to-day in creating, reviewing, updating and sharing clinical documentation. We also explored how they currently manage the documentation process. The roundtable was chaired by Alicia Ridout, Chief Allied Health Professions Officer (CAHPO) and Digital Innovator of the year 2017.
Uncovering the scale of documentation challenge for AHPs
Prior to the roundtable, Nuance held a tweetchat via @WeAHPs to explore key areas for discussion. According to a poll run during the tweetchat, just under half of those involved said they spent one to two hours on patient record keeping every day. Twenty eight per cent spend two to three hours. Documentation also has an impact on AHP work-life balance. Forty per cent reported that completing documentation often resulted in them going home late at the end of the working day.
The tweetchat gave us a valuable insight into AHPs daily challenges. During roundtable we discussed the issues of IT infrastructure, patient record template design, the purpose of documentation and how it fits into the wider NHS landscape. Perhaps, most importantly, we discussed how AHPs could get back to spending more time with their patients and less time documenting care.
The implications for patient record keeping and sharing
Sharing patient documentation across organisational boundaries and between professionals creates several challenges including:
- inability to read information recorded by other professionals in patient records can lead to duplication and delays in professional referrals;
- issues capturing the patient story as there are fewer templates and standardised care plan tools than in other areas of healthcare;
- inability to access patient records due to the number of different IT systems being used;
- difficulty sharing notes due to the number of different IT systems being used.
Top recommendations from the AHP roundtable
Recommendations from the roundtable discussion aligned neatly with NHS England’s publication ‘AHPs into Action’ . The report and the roundtable recognises that AHPs need to access tools to support their use of informatics. Use of these tools should form part of core training, registration and daily work.
In all there were 10 recommendations arising from the roundtable including:
- Ensure end-to-end care pathways are taken into consideration (secondary, primary, AHPs, commmunity, social, carer, patient) when reviewing documentation
- Ensure IT systems are designed for interoperability and shared record viewing so all healthcare providers (HCPs)can view relevant health and social care data
- AHPs should be at the forefront when it comes to designing IT systems which are interoperable
- Put patients at the centre of process – their experience, their outcomes, their care record.
- Combine the introduction of new software and technology solutions with bone fide change management and stakeholder engagement.