F028 Anaesthesiology and the challenge of change management in hospitals (Chris Johnson…
Have you ever heard the joke that anaesthetists are really good at sudoku because they don’t do much else during surgeries? In reality, it turns out, they have a lot more work and personal contact with patients than one would assume without an insight.
Chris Johnson is a Children’s Anaesthetist with 30 years of experience in clinical practice. Chris was the medical lead for the healthcare IT transformation of the Perth Children’s Hospital in Australia, which was planned after the institution relocated into a new building, approximately 10 years ago. The digitalization plan included the implementation of an electronic health record system (EHR) and instalment of a pharmacy robotics system to enable new level of care supported by the latest IT innovations.
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What should hospital design be about?
The implementation of the EHR and robotic pharmacy system took several years of meticulous and careful planning in Perth Children’s Hospital. Chris Johnson travelled abroad to see some of the best practices in institutions such as the Boston Children’s Hospital in the USA, and Evelina London Children’s Hospital.
“Both mentioned hospitals in the US and UK have a reputation for their design, with Boston’s Children’s Hospital retaining an utilitarian focus,” says Chris Johnson.
He believes architecture and design in healthcare are important, but ambitions of creating an architectural marble can shadow the focus on utility.
For example, the Perth Children’s Hospital is liked by the patients but has a large atrium in the middle of the building, which is causing various inconveniences in terms of patient transportation, and high maintenance costs.
This raises the question of what should matter in healthcare. In the public system, the priority of outcomes is clear. While the design of the environment is important, says Chris Johnson, the entrance of the profit motive into healthcare can quickly blur the picture of what healthcare should be about.
Perth Children’s Hospital (Photo: Government of Western Australia)
For many healthcare specialists working in the public systems, visiting hospitals in the US can quickly feel like travelling to the future, at least in the infrastructural sense. While facilities in the US have a lot of amenities for the patients and offer the comfort of high-tech options regarding data storage and access, public system facilities don’t re-invent themselves quickly. When it comes to IT, paper is often the main information carrier for everything — electronic records and medication management.
Digital transformation
During the planning of implementation requirements for the Perth Children’s Hospital, which took several years, Chris Johnson made sure to include in planning representatives of all the groups in the hospital, who would be affected most in the end — pharmacists, doctors and nurses.
In the end, around 40 people reviewed the implementation requirements and took part in meetings, where IT vendors were demoing their solutions.
The robotics system was bought, but the EHR project was stopped, leaving the hospital medical records management right where it was — on paper.
Several reasons contributed to the outcome in the huge process of change management. After all, the IT support projects presented only 25% of the budget for transformation.
Some questions addressed:
What do anaesthetists do in practice?
What are the digital trends in anesthesiology? Will doctors be replaced by automation and precision dosing algorithms?
How does a tender for digital transformation of a hospital look like? Who has to be included? How long does it take?
How can hospitals be more pleasant for patients?
What is the role of architecture and design in the hospital?