Improved patient visibility at MLCSU with new referral management solution

Implementing adam’s referral tool for MLCSU

Background

Previously, MLCSU managed the NHS-standard Referral process via email with a reliance on manual checks and processes. MLCSU worked in partnership with adam to develop a module within the adam system (SProc.Net) which would digitise the Continuing Health Care (“CHC”) Referral process and seamlessly integrate it with the existing Case Management System (“CMS”).

• Give better visibility of where patients are within the CHC referral process
• The digitalised tool will provide accountability for potential delays
• The digitalised process will ensure a streamlined process across MLCSU

What work did adam carry out?

adam developed a new Referral Management module within CMS which would feature a Referral Management Dashboard, allowing the user to view a summary of all Referrals.

Design and planning

A full implementation timeline was put in place and a range of workstreams were carried out to design and plan the tool. This included scoping and policy setting, system configuration, user testing, user engagement, quality and monitoring criteria and reporting design.

Implementation

The implementation was handled as part of a tried and tested managed process, designed to deliver real change and process improvement. adam’s project management team led and coordinated a wide range of MLCSU and internal stakeholders to deliver a tool ideal for the partnership and their patients and care market. Multiple project meetings were held throughout the implementation phase to ensure required tasks were completed on time, and identified risks were mitigated accordingly.

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​Which product/services were used?

adam developed a new Referral Management module within CMS which would feature a Referral Management Dashboard, allowing the user to view a summary of all Referrals. The tool works across all Checklist and Decision Support Tool (DST) referrals types and helps staff to process referrals more effectively. Workflow automation, pre-configured templates, and centralised management tools for senior staff, allow CCGs to ease their workload and speed up processing time. Other referral types are also being configured.

What challenges did the project entail and how did we overcome it?

• There are always challenges when changing processes and getting people used to a new way of working. This was the first time taking a paper-based process and making it into a streamlined fully digital process.
• Creating a streamlined process across all the different regions
• Even though there are 2 sets of documents (Checklist &DST), the teams within MLCSU all had a different process.
• Some of the MLCSU teams were responsible for the end to end services and some were only responsible for a part process. We worked together with MLCSU to develop a solution that accommodated the full and part processes.
• The users within the group are responsible for different parts in the process and this will vary across the areas. The solution needed to be flexible to allow different user groups to feed into the digital process
• E.g. user permissions to allow admin staff to add a decision if required
• Whilst the different areas were working towards a fully digital solution, we also enabled the ability to upload manual documents on a referral to support MLCSU and teams in the transition period to becoming digital.
• We worked with MLCSU to identify “at scale terminology”.
• The terminology in some cases worked and in others required to be updated, we worked with MLCSU to accommodate this and support them through the learning process.
• For MLCSU one of the biggest challenges was the implementation of the external roll out. It covers every referral at scale. This was a huge project and has now been delayed by COVID.
• Training MLCSU staff to use the new Referral Management module was initially a challenge. The training sessions had to be very detailed operationally to train the referrers in the CHC process followed by the CHC referral itself
• This was to be implemented for the 1st April 2020 but was delayed until the CHC framework was reinstated in September 2020
• Refresher training has restarted to support users however a roll out cannot be implemented at the scale that was initially planned

Benefits

1. A digital streamlined process
2. More digital information available to the clinicians
3. It becomes time saving as for some staff they do not have to create referrals
   • This is completed by the external referrer
4. There is the ability to track electronic and non-electronic referrals through the system which providers efficiencies for clinical flows
5. For the clinicians it improves the consistency of the information coming through
   • Standard information filled out
   • Scoring is automatically completed by the system – reducing human errors
   • For example, users don’t need to manipulate the word document, can’t miss anything and it lessens the need for more information
6. The dashboard provides greater visibility of where everyone is up to and this can be used to allocate resource or provider support get more resource if required
   • This provides accountability
   • Where there are delays, there are triggers in the system, return to refer accountability, why is this on hold and why haven’t they responded all available
   • Clear visibility against the 28 days clock
   • The process will help reduce the time from the referral to the decision
   • First glance visual of progress
   • Everything is captured within the system reducing the need to upload emails etc.and detail phone calls.
7. There is a full audit trail available
   • This is reportable
8. For external refers they won’t need to phone call or email the teams as they are able to track their checklist and where it is in the process.
9. The referral to decision is linked so can clearly see the journey the patient has followed.
   • This supports with reporting
10. The tool will also highlight teams not using the functionality which can be used to provide additional training and support to grow confidence.

Results

74.47% of users feel the electronic checklist will be beneficial to their role