Implementing the NHS information technology programme: qualitative study of progress in acute trusts
Implementing the NHS information technology programme: qualitative study of progress in acute trusts
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DOI：
10.1136/bmj.39195.598461.551
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发表时间：
2007-06-30
影响因子：
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通讯作者：
Collin, Simon
中科院分区：
文献类型：
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作者：
Hendy, Jane;Fulop, Naomi;Collin, Simon
目标 描述在英格兰实施 NHS 信息和技术 (IT) 计划的进展和感知到的挑战。设计案例研究和深入访谈，并使用基于扎根理论开发的框架确定主题。我们采访了 18 个月前接受过采访的人员，或者同一职位的新人员。在英国设置了四个 NHS 急性医院信托。参与者是高级信托经理和临床医生，包括首席执行官、IT 总监、医疗总监和护理总监。结果受访者毫无保留地支持该计划的目标，但有一些严重的担忧。与以前一样，该计划的实施受到当地财政赤字、符合该计划的患者管理系统延迟实施以及 Connecting for Health（负责该计划的机构）与当地管理人员之间沟通不畅等因素的阻碍。提出了新的问题。由于财务优先事项相互竞争以及该计划的不确定性，当地管理者无法确定实施该计划的优先顺序。他们认为，由于延误和项目各组成部分的整合，患者的安全风险越来越大，并且对“选择和预订”（初级保健转诊的电子预订）感到不满。 结论 我们建议该项目为个人信托设定切合实际的时间表，并向管理人员提供建议。由于延误超出了他们的控制范围，他们必须购买临时 IT 系统。建议需要注意信托的需要，以确保与计划的长期兼容性和物有所值。信托在优先考虑 IT 现代化方面需要帮助，例如，包括在绩效管理框架中实施该计划。即使“健康互联”采取不同的方法来制定中央标准并在当地实施，这些问题仍然需要解决。 NHS 的经验教训具有更广泛的相关性，因为法国和澳大利亚等国家的医疗保健系统希望实现大规模 IT 现代化的潜力。
Objectives To describe progress and perceived challenges in implementing the NHS information and technology (IT) programme in England.Design Case studies and in-depth interviews, with themes identified using a framework developed from grounded theory. We interviewed personnel who had been interviewed 18 months earlier, or new personnel in the same posts.Setting Four NHS acute hospital trusts in England.Participants Senior trust managers and clinicians, including chief executives, directors of IT, medical directors, and directors of nursing.Results Interviewees unreservedly supported the goals of the programme but had several serious concerns. As before, implementation is hampered by local financial deficits, delays in implementing patient administration systems that are compliant with the programme, and poor communication between Connecting for Health (the agency responsible for the programme) and local managers. New issues were raised. Local managers cannot prioritise implementing the programme because of competing financial priorities and uncertainties about the programme. They perceive a growing risk to patients' safety associated with delays and a toss of integration of components of the programme, and are discontented with Choose and Book (electronic booking for referrals from primary care).Conclusions We recommend that the programme sets realistic timetables for individual trusts and advises managers about. interim IT systems they have to purchase because of delays outside their control. Advice needs to be mindful of the need for trusts to ensure longer term compatibility with the programme and value for money. Trusts need assistance in prioritising modernisation of IT-for example, including implementation of the programme in the performance management framework. Even with Connecting for Health adopting a different approach of setting central standards with local implementation, these issues will still need to be addressed. Lessons learnt in the NHS have wider relevance as healthcare systems, such as in France and Australia, look to realise the potential of large scale IT modernisation.