The Role of Chief Nurses in Digital Transformation: A Senior Nursing Leader Shares Her Tips Towards EPR Implementation Success

What Good Looks Like (WGLL) for Nursing and Midwifery was launched to support profession leaders, and one of the key success measures is Well Led - a focus on defining good system-wide nursing leadership that represent the diversity of the nursing workforce.

Since it’s launch the National CNIO team have worked to identify and share good practice.

One organisation that was an exemplar of the well led success measure is Manchester Foundation NHS Trust (MFT). We were lucky to secure the time of the leadership team at our WGLL masterclass series, where attendees heard about their experiences implementing the HIVE Electronic Patient Record (EPR) System.

In today’s CNIO spotlight we invite back Cheryl Lenney, Executive Chief Nurse, who oversaw this big-bang go-live across 10 hospitals. As she retires from service, we hear her advice how other chief nurses can be supportive leaders in digital transformation.

Bring People on the Journey with you

We asked Cheryl to share her biggest lessons from implementing Hive, and something she stressed the importance of good communications and engagement across the organisation to “bring people on the journey with you” empowering staff to get involved, and keep patients informed of the change happening.

Cheryl stressed the importance of collaboration, and keeping people informed to support and secure buy-in.

“You can't do it on your own, but then you're gonna take all those people with you because there are more cynics at the beginning than there are leaders.”

When implementing change you need to work closely with all your stakeholders impacted, inviting people to the table and listen to their views and fears.

This involves avoiding assumptions, just because your familiar with someone, you need to consider the communication needs of colleagues who aren’t overly involved or interested in digital – failure to translate on their level risks not understanding what you’re saying

“Don't assume that anything that you do as a leader or any advice you give to the person at the sharp end will know, (you need to)… check, check, double check.”

Consider your communications

You need to ensure your communication methods are appropriate for your audience, Cheryl highlighted the danger of depending on one method

“Your average nurse or practitioner on the frontline might read emails once a week, once a month, you know they're busy and just because you think it's important doesn’t mean they do.”

Therefore create a mix of communication channels, both digital and offline, that will repurpose messages in different formats to increase chance of reaching your intended targets, and encourage involvement through two way communications (such as creating engagement platforms).

Create credible training, education and support

The biggest issue Cheryl found was ensuring the workforce was correctly trained to utilise the full potential of digital systems.

It wasn’t just about giving out the training, but ensuring the right people were carrying out who fully understands the needs of clinical practice.

“the only way to train is for people who are credible on the job practitioners, …start with the premise that the right people to train are going to be the people that use the programs - they are your people who are credible with your people and who understand the nuances of practice.”

Patients should always be kept in mind

Although patients may not be the system(s) end users, they are the core focus on who we are serving, and therefore need to satisfy.

Transitioning to digital is a cultural change for them too! So it helps to keep them informed what is going on in your organisation:

“I visited a trust before we went live and I was with one of my grandchildren, actually, and I remember thinking at one point why were they on their phones? And then it clicked, they were was doing their observations”

To support rollout amongst patients Cheryl outlines how the trust put posters up everywhere telling patients that the clinicians they see on their phones, aren’t actually using it for personal use, but a part of practice

“…it looks like their on phones, but they're not playing on it, so because I thought as somebody using a service, I'd wanted to make it clear that they were actually catching observations.”

Be an active leader

When we asked Cheryl what she would do differently she emphasised the important role Chief Nurses play in leading digital transformation as a supporter, and someone who knows all the different challenges across the organisation.

Digital transformation is a huge change to an organisation, so it’s essential that senior leadership be active partners in the change, keeping informed so they can anticipate the implications it has on day-to-day practice.

“People have done a lot of work into the build up of this, and suddenly I was thinking “…Doing what?... Actually that’s going to impact on clinical practice like this and it’s going to impact on nurses like…” No, I need to be in the middle of it.”

Chief Nurses (and other senior leadership roles), should focus on being in the middle, which can be achieved by building a strong relationship with your CNIO and other digital leaders – as a senior nurse leader you might have the responsibility for appointing and managing your CNIO, therefore you have a role to play integrating them into both the digital team and wider organisation.

The CNIO relationship is key to aligning your organisations digital goals into the Chief Nurses deep understanding of clinical practice.

Fundamentals to EPR implementation success

Cheryl highlighted the significance of having a well-informed business case as a fundamental requirement to a successful EPR rollout.

Investment in this in the early stages will pay dividends later on to better manage the implications of the digital team required, training and the funding to run a significant programme of work (along with the costs of maintaining a live service).

Strong governance structures put in place was another must-have to oversee digital transformation, and maintain accountability in progressing the work. Setting up forums with senior nursing and midwifery leadership is a good step to prioritise issues, secure multi-profession collaboration and address unintended consequences from initiating the change.

“…we developed a digital forum, which is chaired by the CNO (Chief Nursing Officer), that fits right into our profession, and aligns to our other number of the forums as well as digital.”

Both a good business case and clear governance in place is important to ensure that digital priorities keep aligned with broad organisation goals, patient needs, and develop processes for continuous service improvement/learning.

Go-live is just the beginning

Cheryl stressed the importance that just because a digital project moves into business as usual, it doesn’t mean the hard work is over – it’s just beginning as there is lots of learning on the job.

“Whilst that was great work, actually the real learning starts when you're on the job, but you can't do the preparation, so the real learning starts there.”

However with the challenges you also are presented with opportunities to build your data to support decision making and quality improvement.

“This is a golden opportunity to start to use all that input data that we as professionals spend our lives putting into the machine.”

Data can be used to inform practice, and in close collaboration with research practitioners develop the body of knowledge and look at what the data tells you, so you can make appropriate service improvements.

Thank you

Thank you to Cheryl Lenney for sharing her insights on the importance of Chief Nurse involvement, and how it has influenced the success of the MFT Hive EPR system rollout - the CNIO team thank you for your role embracing digital and data, and wish you all the best in your retirement.

Find out more about the EPR here: Hive EPR - Manchester University NHS Foundation Trust (mft.nhs.uk)

Originally posted on the FutureNHS Digital Nursing Community May 2024 - join our workspace to receive updates first

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