I know I should post on the customer forum but the question I have is a fundamental one so just wanted to run it past you to see if I understood the new functionality correctly
I saw in the demo that the Delivery and Outcome sections have been broken down into a lot of sub headings. I understand the reasoning, that the clinician can hop in and out of the headings easier if they move from, for example, an instrumental delivery to a caesarean section. However, in the current version, the way the screens were designed were to force the user through a particular sequence of delivery screens so that any mandatory fields could not be bypassed. For example, we had an issue in a previous release that clinicians were bypassing the presentation of the baby at delivery, so this was made mandatory as it’s a CNST requirement. Will splitting the screens down into sub headings mean that users can bypass screens and complete a delivery with some of the sub heading being missed?
Does this make sense?
Yes, Jacqui is correct in the fact that the sub-divisions allow users to enter parts of record (as well as using the larger MPW wizards which typically still appear at the top of the notes page) so theoretically sections of the record could be left incomplete.
I would say that better management of the completion circles (which we can help with), better reporting and teaching/learning could all mitigate the potential.
The other alternative is to simply make the outcome sections very formulaic, but this brings the opposite issue in that a clinician who only has knowledge of a small bit of data can’t enter it without also entering a lot of other data that they may not have any knowledge of.
It’s a difficult balancing act that probably needs wider discussion amongst the forum.
Thanks Paul for the information.
I have major concerns with this. I can see how the idea is good in principle but we’ve only just got to the point where there’s been changes to Athena to force users to input deliveries in a certain way to ensure data completeness, and compliance with CNST/ MSDS submissions. For example, a change was made to prevent users part completing a delivery that was a caesarean as they were bypassing key screens. Fields such as fetal presentation were being bypassed and that was needed for CNST. We (and I’m sure other Trusts) have spent a long time over the last few years suggesting and implementing improvements due to DQ/ CNST/ MSDS reasons that this could easily unpick.
From experience, no amount of guidance, reporting or teaching seems to improve things, which is why we’ve had to increase mandatory fields over the years, for example with Ockenden.
I certainly wouldn’t want to make the inputting more formulaic than V5 but equally I wouldn’t want to make it any less.
Can this be raised with the team and discussed with the K2 Midwife group?
It could be tied to the completion circles (which also need to be made better!), so that we can indicate to users the sections that are not yet completed, which are in turn fed from the completion of a mandatory field in the wizards.
It would mean that we have a concept of building up ‘levels of completion’ that can ultimately lead to a discharge being permitted at the end? But the crucial thing being that a user is never having to hunt down a specific field – it’s all marshalled at section level?