For healthcare providers, the anticipation of a regulatory inspection can be a source of anxiety. Stress levels are not improved by the tortuous process of collating paperwork and spreadsheets for inspectors to review.However, as the peak of the pandemic recedes, regulatory bodies are resuming in-person healthcare inspections. The Occupational Safety and Health Administration (OSHA) in the US, the Care Quality Commission (CQC) in England, and its counterparts in Wales and Scotland, had reduced inspections due to social distancing guidelines.
Periodic inspections are unavoidable. But instead of poring back through past records, healthcare providers should be putting in place a more proactive approach that clarifies procedures for staff and encourages best practice continually. We need to move from passive to active, harnessing digital tools to drive improvement.
Inspectors not only need to see evidence of what has been done but how best practice and controlled processes are implemented to prevent issues from arising in the first place.
A growing number of audit reports, for example, highlight instances where staff did not fully understand the processes required of them or that standard operating procedures (SOPs) were not defined and distributed with sufficient consistency. Even NHS Trusts with a ‘good’ rating have been advised to ensure more robust governance arrangements and improve staff awareness of management and escalation processes.
Moving from paper-based processes to an intelligent platform that brings together IoT sensors and digital assistants unlocks greater accuracy, efficiency and transparency. In a facility rated as outstanding, inspectors commented: "Staff were aware of processes and standard procedures to keep people safe."
Managing medicine safety
Reports regularly refer to the safe storage of temperature-sensitive medicines whose quality and efficacy can be harmed by exposure to unacceptable conditions. Given current pressure on healthcare staff and widespread labour shortages, this is an area where automation can assist.
Checkit provides automated temperature monitoring to over 380 hospital sites in the UK and many more healthcare and life science facilities in the US. Dedicated sensors continuously monitor fridge and freezer temperatures, eradicating the need for staff to conduct regular manual checks throughout the day. Readings are streamed into a dashboard that collates trends and triggers alerts when set parameters are breached.
Unlike other monitoring systems, Checkit’s solution can be seamlessly integrated with workflow management to guide frontline staff on rectifying the issue. Step-by-step instructions are delivered to a digital assistant in the form of a mobile device or app. As a result, healthcare providers get a complete digital audit trail, not only covering temperature conditions but a time-stamped, location-specific record of what action was taken in response to any variation.
Strengthening standard operating procedures
The workflow management tool within the Checkit platform enables healthcare providers to design and roll out dynamic procedures for a range of tasks, from infection control measures to cleaning regimes and sample tracking.
Historical reliance on static checklists leaves healthcare providers vulnerable. Paper checklists and spreadsheets are vulnerable to missing information, spoilage and inaccuracy. They also take a backwards-looking stance on whether a task has or has not been completed. By contrast, digital assistants guide best practice and support staff, as well as generating evidence of adherence to SOPs.
One manager in a healthcare facility using Checkit estimated that he had reduced time spent on auditing by 40%.
Reducing the management burden
Labour-intensive processes that depend on limited, temporary or exhausted staff do not square with the needs of modern healthcare and the requirement for systematic compliance.
One healthcare leader told us: "The continued use of paper and clipboards as a method of recording compliance checks is no longer viable. This current data collection approach is antiquated and team intensive, which has led to bottlenecks. Checkit ultimately gives us complete visibility of compliance for every healthcare and laboratory process in the group. An important advantage is guaranteeing a regulatory body such as the CQC that a check has taken place, as the operator will need to scan a QR code to trigger the opening of the appropriate workflow.”
Nurses have spoken out about pressure and stress at work. The Undervalued, Overwhelmed report, which is based on a survey of 10,500 Unison members working in the NHS, found staffing shortages, low pay and changes in the health service were critical reasons for wanting to move on. Add the stresses and anxieties of the last 18 months, and you can see why staff are leaving in record numbers.
Organisations must learn to think about quality systematically by engaging with staff. The next stage of maturity centres on strengthening cross-functional accountability and collaboration for quality—such as with new performance standards to inform the design of healthcare services and the management of resources.
When systems and processes are digitised, managers can analyse cause and effect. For example, data would reveal how long it takes to respond to incidents or take corrective actions. Managers could also see how the performance of their healthcare team compares to others?
Only when data is connected and standardised can these insights become meaningful.