Children’s Health Queensland Hospital and Health Service is being recognised both nationally and internationally for how it is leading the delivery of digital services and adding value to the organisation – and CIO Alastair Sharman is recognised as a pivotal player in laying the groundwork for this transformative journey.When Sharman started as CIO at Children’s Health Queensland (CHQ) in January 2015, his immediate challenge was building a team to deliver all of the IT services for a major hospital that operate 24/7.At various times, he has worn many hats, acting as a strategist and visionary (setting strategic direction and goals as well as defining a roadmap to achieving these); storyteller (communicating complex concepts to stakeholders); salesman (selling the vision); and advocate (at both a state and national level to ensure resources were allocated not only to operational capabilities but also to the digital improvement program); and also as coach (developing the next generation of digital leaders in the organisation).And there’s been many accomplishments, particularly on the electronic medical record front. “We are one of the first health services in Australia to introduce an integrated electronic medical record (ieMR) across both our hospital and community services,” Sharman explains.“Adoption of the ieMR began in 2014 and in the past year we have significantly introduced ieMR modules including electronic ordering, specimen management, the ability to view documented results for medical imaging and pathology as well as a single appointment scheduling solution,” he says.“Additionally, we have provided mobile devices linked into the 4G network in order to provide real time access and updating of children’s medical records by our nursing staff delivering ‘hospital in the home’ services well as by School-Based Youth Health Nursing Service across South East Queensland.”He says there are several key outcomes of this investment. First, the health service no longer store physical medical records in the hospital, which provides increased space for clinical and support functions. Additionally, it can claim over 30,000 pathology electronic orders were placed using the ieMR per month.Sharman says it has seen a significant and sustained increased endorsement from approximately 30 per cent pre-ieMR to now 80 per cent – improving reliability of its clinical services, and has seen completion rates within 48 hours for Electronic Discharge Summaries rising from 30 per cent to 58 per cent.“Alongside the ieMR we have also invested in solutions to improve the sharing of clinical information between public health services and private partners involved in the care of children across the state. Due to this investment clinicians from public hospitals can now view the clinical portal from a private hospital in the context of a patient and vice a versa,” he says.Over the last three years, he says the transition and improved access to the electronic medical record has resulted in over 2.0 million patient charts being opened and over 750,000 progress notes electronically documented and signed annually.Demonstrating innovationSharman sees innovation as a pivotal first step to organisational success. With that in mind, Sharman says the health service has launched a number of initiatives.For starters, it has more than 1,000 biomedical devices integrated into its converged data network, which enables real-time clinical and biomedical data to be accessible in clinical systems.“Over the last 12 months, we have extended this capability through the use of Bring Your Own Device (BYOD) to deliver ‘biomedical’ information to our clinical teams mobile devices. For example, this enables our on call cardiologists to monitor the condition of children in the hospital from home or from wherever they have mobile phone coverage.”He says the health service has also invested in advanced analytics to drive operational improvement and decision-making including the 3D visualisation of patient flow data.“We have used this capability to establish a consistent approach to managing patient flow and have delivered the following outcomes for one of the early adopters of this capability they achieved the following:130 additional appointments and children seen each month; decreased length of time for children in clinic; increased overall activity; and the highest amount of compliments for any outpatient service.”He says some other specific digital innovations have focused on improving the experience for children and families including: a virtual tour of the hospital developed in partnership with Google, a first in Australia, providing children and families the ability to explore each level of the hospital with 360 degree views.His team has rolled out the development of a series of ‘My Trip to Hospital’ online videos to tell patients and their families what to expect when coming to hospital; and is offering free Wi-Fi across the health precinct as well as mobile device “charging stations” in waiting areas.Additionally, the organisation has also delivered a mobile app for doctors called CrewCHQ.“Doctors can seamlessly and securely access the information and training materials they need to provide the best possible service to patients and their families. Upon download to their smart devices, they experience a personalised, role-tailored on-boarding and training program to help build their professional capability and knowledge as well as on-the-go access to key, medical-specific workflow processes, guidelines and resources.”Fostering changeAnd while the technology discussion is top of mind when talking about the important milestones at the health service, the people discussion is equally important.“I aim to create an environment where staff feel a sense of belonging, valued, safe and supported and striving to make a difference every day. I have been fortunate to be supported by an executive that understand the value of information and technology and staff at all levels who wish to deliver great care and dream big.”He says his team has a service excellence culture which was recently reflected in the accreditation survey conducted by The Australian Council on Healthcare Standards of Children’s Health Queensland.“The survey team was impressed on how engaged the clinical and corporate workforce were in the strategy and commended the CIO and team on achieving such a visible level of staff satisfaction,” he says.“I am extremely proud of being part of a leadership team that has a focus on culture and staff engagement, which is also reflected by our annual Working For Queensland survey on staff attitudes where we again achieved 100 per cent response rate from my team illustrating high levels of engagement and belonging to our organisation.”He says he’s taking the staff on a journey, engaging with the team about how technology is playing a role in achieving organisational objectives.“We have developed a creative and engaging internal change management communication program to support and motivate our people in the transition to new technology and adopt innovative approaches to our service delivery.“Our multi-media campaign titled ‘Our Digital Future – Imagine what’s possible’ has been instrumental in bringing together a range of digital and information projects under one banner to help staff understand the big picture benefits of the transformation program. This includes a dedicated space on the website for staff information, training materials, videos, news, cheat sheets, contacts and more.”He says he has used this campaign to build the organisation’s innovation culture with a focus on delivering change in the interests of better care for the children and young people of Queensland.“The ‘Our Digital Future’ internal campaign elevates the role of digital and helps everyone visualise and understand it’s importance. It works to engage, involve and motivate staff to take on transformational challenges with the shared higher purpose of improved patient care and to position the hospital as an innovation leader.”Taking risksAsked his biggest lesson learned during his career as a CIO, Sharman says it involves not avoiding risk for fear of failure.“The most important lesson I learnt as I built the team was not about technology, it was about leading. To be successful in the role, I had to find the ability to inspire the team, build confidence in the organisation’s digital vision and have the courage to challenge the status quo.“My time as a CIO has reaffirmed my belief that you must be passionate about growing and leading people. As well, success was dependent upon the ability to balance between the often competing needs of individuals, teams and the organisation.”As he has grown the team to now more than 200 project and operational staff, he says he has learnt to focus on culture and creating a values based organisation.“Without the focus on values and culture, strategy will fail when the going gets tough. There have been many times when I have been amazed by what my team has achieved despite the challenges faced and the obstacles placed in their way. This is due to their sense of purpose, their belief that what they do is important and their willingness to make a difference.”In discussing some of his team’s accomplishments, Sharman highlights a notable project that demonstrates the team’s focus on supporting patient and family centred care, namely in the form of the eye-gaze technology.“As a first in Australia, CHQ Occupational Therapy, Speech and Language Pathology and Paediatric Intensive Care Unit (PICU) successfully introduced ground breaking eye-gaze technology to enable children to use eye movements to communicate within the critical care environment.“Patients like Sam, who has a spinal cord injury (long segment transverse myelitis), no speech due to ventilation and no movement in his upper limbs, can now use eye movements to operate and communicate clearly via a computer or tablet.”Jennifer O’Brien
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