Feature Content, Interview

“At the heart of Keystream’s approach is our gold-standard ethos” – James Quirke on the importance of preparedness and onboarding in EPR implementation

For our latest interview, we sat down with James Quirke, director of training and support at Keystream, to discuss his career journey so far, experiences in the industry and the steps for success in Keystream’s EPR implementation process.

Hi James, can you introduce yourself and tell me a bit about your background? 

I started working in the NHS in 2002, initially in a series of admin roles which culminated in becoming interim service manager for cancer services at Bart’s and The Royal London NHS Trust, before it merged with Whips Cross and Newham Hospitals to become Barts Health.

I also spent two years in the training team there, working to deliver Cerner’s Millennium product, and since then I have worked with organisations up and down the country – St George’s, Croydon, Newcastle-upon-Tyne, Guy’s and St Thomas’, to name a few. There have been lots of primary and secondary care organisations that I have had the privilege to work with and help with their digital journeys, as well as several shared care record programmes in recent years.

Keystream’s approach to building system-specific training

Implementing a new Electronic Patient Record (EPR) system in the NHS requires meticulous planning, and training forms a crucial part of this process. A well-established framework for structuring this training is the ADDIE model. ADDIE, which stands for Analysis, Design, Development, Implementation, and Evaluation, provides a step-by-step process that ensures effective training and support.

Keystream’s approach is rooted in a deep understanding of Hospital workflows and processes as well as the technology in use and the specific needs of the organisations it serves.

Wherever possible, we emphasise the early onboarding of the training workstream lead. This early engagement is crucial as it ensures that there is a clear roadmap right from the start.

Once onboarded, a robust training risk / readiness assessment is conducted. This assessment does not just skim the surface; it delves into the capacity and capability of the incumbent training team, scrutinises workflows, evaluates services and user groups in scope, and assesses training space and infrastructure. Additionally, we gauge the EPR programme’s training needs, identify champions and super users, assess internal Learning management Systems and overarching domain strategies within the EPR programme.

After the readiness assessment, we transition into the Training Needs Analysis phase. Here, we pinpoint the specific requirements for each user group, ensuring that no stone is left unturned. Collaboration is key here, both with the vendor and internal stakeholders, such as the business change team and the testing workstream.

Then you can Segment the target audience into distinct groups based on their roles, responsibilities, and interactions with the EPR system. This will enable the development of role specific training programmes that address the unique needs of each group.

Following this, we formulate a comprehensive training strategy, ensuring that it aligns seamlessly with the wider organisation and programme mission and vision, making certain that training is not just about the ‘how’ but also the ‘why’.

At the heart of Keystream’s approach is our “gold standard” ethos. This ensures that training is tailored not just to the system, but also to the unique characteristics and requirements of the organisation. By marrying the strategic approach with the “gold standard” execution, we not only assist during the initial transition but also lay a solid foundation for a sustainable legacy of in-house expertise for the future.

Approaches and tackling challenges

I have had the privilege of working on a number of projects, but a couple of large NHS Trusts transitioning to a new EPR system stand out. Our approach always starts with stakeholder engagement. In this instance, the key was to not only understand current and future state workflows but also to secure buy-in from leadership, project sponsors, and directorates within the organisation. Their support was fundamental to the success of the programmes, acting as a catalyst for effective change management across the board.

The most notable challenges we faced were ensuring the readiness of a such a diverse range of staff from clinical professionals to administrative personnel. To tackle this, we implemented experience centres well ahead of the go-live date, providing staff with a tangible, hands-on opportunity to interact with the new system in advance of training sessions. The importance of these experience centres should not be underestimated. They provide crucial awareness for both individuals and groups of staff well in advance of go-live dates, as well as offering hands on exposure to the new system in a safe environment. This approach contributes significantly to excellent adoption rates when the new system goes live.

Beyond the logistics and technicalities, I think it’s fair to say that the heartbeat of our approach lies in our super users. Super users are onboarded far in advance of the go-live – that’s a key part of our gold standard approach. It means that they can immerse themselves in detailed training; ideally, they should be committing to training and awareness sessions regularly, say once a week for at least six months prior to the transition. Then by the time it comes to the system roll-out, they can really become pivotal figures as they’re experienced with the system and have a level of preparedness that makes them invaluable in terms of peer support.

Allowing super users to support trainers in a classroom setting also brings a unique dynamic; they provide that crucial context needed to bridge the gap between the technical aspects of the system and its real-world application, which also helps to inject empathy into the training process. In past collaborations with forward-thinking organisations, this intricate integration of super users into the training process has been instrumental. Their involvement has resulted in go-lives, stabilisation, and optimisation phases that have impressive adoption rates as well as safe and effective use of the new system. The gold standard approach, where super users and champion users are nurtured and empowered, is transformative for EPR implementations in the NHS.

Key learnings

Preparation is paramount. The more groundwork you do before go-live, the smoother the transition.

Secondly, it’s about understanding the unique workflows and challenges of each department and recognising that a one-size-fits-all approach does not work.

Lastly, I would say that investing in super and champion users and giving them adequate training and support is invaluable. They act as anchors during the transition, providing on-the-ground expertise and assurance.

Benefits of this approach

The most significant benefit is the seamless transition with minimal disruption to patient care. Our approach ensures that staff are confident in using the new system, thereby reducing errors and inefficiencies.

Additionally, the legacy of in-house expertise we establish means that the organisation continues to benefit long after the external teams have left.

Advice for those embarking on an EPR adoption project

Firstly, onboard the training workstream lead as early as possible. Plan meticulously and engage stakeholders early.

Understand that while technology is a significant part of the transition, the human element – ensuring your staff feel supported, trained, and heard – is equally crucial.

Always have a robust support system in place for the go-live phase, leveraging both internal and external expertise.

Lastly, the success of any EPR adoption does not end at go-live. Continuous training, feedback, and system refinements are essential to adapt to evolving needs and ensure the long-term success of the implementation.

Thank you again to James for taking the time to share his insights with us. To learn more about early onboarding of the training work stream, read James’s article here.

James further amplifies the importance of risk and readiness assessments in this article. 

To learn more about James’s views on the importance of robust learning management system, click here.