PARTNERS Blog

Birmingham to Trondheim in a Summer!

Tue, 4 Oct 2011 19:05:11 +0100

What a busy and quick Summer its been as the programme Chair for the BNS and BNT online programme I wanted to set in place a number of initiatives within a short deadline and I am glad to say that we managed to achieve them all. We ran a short online Summer School here from our new Community of Practice website with a face to face session for those individuals who wished to consider returning to third level education and who had an interest in engaging with some initial reading around the topic of online learning. I post this up here as it may be useful to other nurses who are considering returning to third level education.

On the domestic front a key milestone was a reasonable Leaving Certificate for my son so that he could continue his studies in a Post Leaving Cert Course and I am happy to say that this was also achieved. Happy days!

Early Summer included attendance at a conference in Birmingham facilitated by the Health Higher Network Group entitled e-learning in Health which proved to be a very good investment in time and the presentations and abstracts are available to view from here with some images from the conference are available to view from here .

Of interest to some may be the launch over the Summer of Sage publications Health and Nursing Portal which is available to view from here . Also from an Irish perspective the INIsPHO team in the Institute of Public Health in Ireland has launched The Health Well which is available from here . This exciting development offers national publications on health indicators and serves as a portal for national and international publications freely available to download.

More recently I travelled to Trondheim Norway to a health informatics standardisation conference to present work from my PhD. I am pleased to say the presentation was well received. The conference itself gave a good overview of existing national EHR developments and also the EpSOS project. A link about conference and the main conference site url is available in English from here . I understand from my Norwegian colleagues that the presentations from the international set will be published shortly just look for the international session as the presentations are all in English from the main Norwegian conference site.

Flying back from Norway to Dublin I had the opportunity to review the documentation relating to the launch of the Population Health Information Tool by Dr Michael Shannon in association with the Institute of Community Health Nursing, Ms Anne McDonald the project manager on this initiative has dedicated a vast amount of time and energy with her colleagues in Public Health Nursing to create design and implement this tool and I am glad to see that it has finally been launched with a view to being implemented nationally. A key part of this development work was a new street index for public health use. The report which I would recommend reading is available from here and is a landmark for the nursing profession in Ireland for the following reasons. It formally recognises ISO 18104:2003 Health Informatics: Integration of a reference terminological model for nursing. Currently this standard is under revision and is at final draft stages (FDIS) out for comment. The standard when published will be given a new title as follows IS18104: 2011 Health Informatics: Categorial Structures for Representation of Nursing Diagnosis and Nursing Actions in Terminological Systems. Watch this space.
Anne McDonald Assistant Director of Public Health Nursing has dedicated many years to restructuring nursing records in public health nursing and has a solid understanding of the domain. This is evident in a second shorter publication that has recently been submitted to the public health policy framework by the Institute of Community Health Nursing and which may be of interest. The document is available online from their website here.

I will finish this blog by congratulating Anne McDonald for her significant contribution and hard work on the design and development of the Population Health Information Tool. When I think of Annes work on this exciting initiative I am reminded of Chinese quote from the Chinese philosopher Lao Tzu

A leader is best when people barely know she exists, when her work is done, her aim fulfilled they will say: we did it ourselves

Lao Tzu Chinese Taoist Philosopher 531-600 BC

Well done Anne.

D Day Approaching!

Tue, 7 Jun 2011 21:27:25 +0100

Well the studies are almost done and the exam papers are worn to a thread as we count down the last few days for the Leaving Cert!

It seems there is no respite from exams this month between family at home, and students at work, exam papers are the only topic of conversation. Whilst I recognise that I am in denial and the stress levels of my son are not even registering on any scale I will stay positive. On a more serious note I think it is difficult to stay optimistic with the reality check in the recent media programme relating to health this week i.e Prime Time programme for me such programmes demonstrate only too well our systems have to change as soon as we can possibly bring about this change in a safe and effective manner. The recently launched national clinical directorates programme certainly is a step in the right direction, but I think critical to the implementation of this change process will be that everyone who is engaged in healthcare provision realising we all have a part to play as without serious and meaningful engagement the commitment to make such initiatives happen will be difficult if not impossible to implement.

Below are some examples of commitment that I refer to these initiatives originate from a grass roots perspective and are striving to bring about a positive change.

Good news stories which I can report on include some of the partner group members who have been incredibly busy - Daragh Rodger (Clinical Lead) and Anne Spencer (Clinical Learning Technologist) as part of a multidisciplinary team in St Marys Hospital in the Phoenix Park recently launched a new bone health programme entitled “I am not falling for you”. The three core educational themes in the development process relate to Bone Health, Falls Awareness and Osteoporosis. Led by Daragh Rodger the team created a suite of resources including an information package and website which you can view here.

Other interesting work that Anne Spencer has been involved in is the Mental Health Trialogue Network Ireland. This project led by Dr Liam MacGabhann is available to view from here and last week the project won the Presidents Award in DCU for Civil Engagement. The trialogue I think is another great example of Communities of Practice working at grass roots level to address the challenges of mental health in Ireland.

Some interesting links that you may or may not have seen that I came across lately include the Health Informatics Society of Ireland Spring Newsletter (click the hyperlink to view).

And an interesting new site in Cochrane which relates to a classification of evidence based reviews which relates to research for nursing is available from the main website from here and then by selecting nursing care in the browse by topic search, alternatively you can use a direct link from here . What a great resource for anyone who is engaged in research or practice orientated assignments on evidence based practice .
Another useful resource is the World Health Organisation Global Observatory which is a powerful research tool and available to view from here

That is all for this time – will keep in touch Pam

Forget the PhD here comes the leaving cert!

Tue, 5 Apr 2011 18:52:36 +0100

As the flurry of activity relating to my viva and PhD sink into the background more pressing needs are surfacing in relation to my sons leaving cert preparation.

Where once the focus was syntactic interoperability now its Megalithic and Mesolithic art forms. After my sons Friday night social scene Saturday mornings are taken up with mind maps notes and recall activities relating to art history. I am not sure which one of us finds the process more painful but suffice to say the research on PhD work was incredibly easier to complete than this process is turning out to be. I draw some comfort in the fact that there is a time limit on this process and we are both doing our best to stay motivated whilst the normal Saturday morning chores are put on the back burner!

Blog March
The NDLR fest this week was a great showcase of what can be achieved when individuals work together in communities of practice. One hundred and thirty eight digital resources were showcased from around the country with a wide variety of topics including digitalisation of 18th Century Limerick Periodical, the magazine of magazines by the University of Limerick to a 3D model of the human skeleton by UCD.
The funding call for NDLR was launched at the fest further information on the NDLR can be found here.

PISA
An interesting new website launched in SON DCU PISA which is an acronym for psycho social psycho educational Interventions for people with recurrent Suicide Attempts has been launched this week further information available from here

Daragh - Caring for the Carers!

Tue, 5 Apr 2011 18:44:18 +0100

As our population ages, there is an increase in the number of older adults accessing specialist services for geriatric assessment. It has also become more apparent that a lot of older adults remain at home due to the input of informal carers – husband, wife, sister , brother etc. Often these carers are of a similar age experiencing their own health problems. To this end a more formal assessment of carers needs to be addressed when planning the care of the referred patient to ensure a better outcome for all. This is something we hope to formulate in the near future.

Anne talks about ICHN

Tue, 5 Apr 2011 18:39:34 +0100

Despite the fact that Phase 1 of PARTNERS has completed, the group continues to provide a community of practice for me where I can meet and share information with colleagues who are engaged in clinical and health informatics specialties in a variety of nursing care settings. This community has helped me to appreciate the challenges and benefits involved in moving to an integrated model of care. A core value of the group is that patient’s needs are paramount and should be consistently identified and met across the continuum of care settings.

My particular speciality is public health nursing and aspects of our recently developed health information tool, the PHIT, have been integrated into the Partners assessment process. The Professional Development Forum under the Institute of Community Health Nursing (www.ichn.ie) has also consistently provided a rich environment for debate and development of practice for me and my public health nursing service colleagues nationally. The ICHN is currently developing the following three Interest groups: Care of the Adult, Child and Family Health, and Population Health. These Interest groups reflect specialties and groupings of specialities which span care settings and which will benefit from an integrated model of care.

The population health approach to care as endorsed in the HSE Population Health Strategy (2008) will inform integrated models for delivering health and social care services in order to provide best possible outcomes ‘while moving to a person centred approach, with integrated services, across the entire continuum of care crossing organisational boundaries’. The HSE National Service Plan 2011 describes integrated care as delivery of services crossing between primary, community and hospitals and the purpose of this is to ‘focus on the complete needs of the patient and / or client, while also prioritising effective working relationships across services, providing a more responsive and accountable service’.

Integrated systems of care have been recommended by the Commission on patient safety, through a system of clinical directorates in order to promote the governance and accountability needed to achieve a safe, high performing health system (DOHC 2008). The HSE contract with the Irish Medical Organisation and the Irish Hospital Consultants Association in 2008, included provision for the introduction of clinical directorates and placed consultants at the helm for leadership roles in the management of the proposed directorates. It is internationally recognised that leadership by clinicians delivers more effective patient outcomes and financial returns and over 100 clinical directors are planned nationally. Integrated Service Area Managers are currently being appointed to manage Integrated Service Areas (ISA) at HSE Local Health Office Level.

In my opinion and based on the evidence uncovered in PARTNERS Phase 1 and the developing work of the ICHN, clinical directorates should not be confined to a single speciality but should be organised in groups within and across health care settings which reflect the patient’s care pathway. It will be incumbent on primary care team members to ensure that reconfiguration of services to a system of clinical directorates within ISAs is properly informed and reflects the vision and values of the population health strategy and the HSE Transformation Programme. The art of communication and collaboration grounded in a community development approach will be necessary ingredients in the management of change from the current services to a more integrated health and social care model.

The process of implementing an integrated model of care will also require clearly defined, agreed and understood roles and responsibilities and valid, timely and reliable data to support practitioners in the delivery of safe, high quality integrated care to those who are most in need. The health impact of care delivered to these shared populations will also need to be continually assessed.

The PARTNERS community has helped me to appreciate that any successful model of integrated care will need a comprehensive mix of mutually agreed roles and responsibilities for all participants supported by health information technology and competent leadership.