In order for digital transformation to work, it is often necessary to change a number of things and be prepared for initial costs. However, according to Anders Fernström, Unit Manager at Psykiatrimottagning Ale, once you’re up and running the gains are very evident.
This public outpatient psychiatric service in Ale near Gothenburg has 30 employees who handle about 1,000 patients with various diagnoses. Like many similar organisations, they have struggled with challenges posed by long waiting times and difficulties recruiting and retaining staff. The change process was initiated with a clear goal: better care, for more people, in a good working environment.
When there are major staffing problems in healthcare and people are affected because there aren’t enough staff, it makes a huge difference to have tools that make things noticeably easier, says Anders.
The service has been working actively with digital transformation for several years now, and benefits have been identified in five areas:
- Work environment
Like all transformation projects, the digitisation process initially required outlay in terms of time, money and energy. The process can be seen as a curve whereby a lot of energy is spent at the outset, this increases during an initial period and then decreases to a significantly lower level than at the start of the process.
With digitisation, it’s important to be aware that more energy is required at the beginning. That’s why it’s important to prioritise what you want to start with, Anders explains.
Successfully recruiting the right staff is one of Anders’ biggest tasks as Unit Manager. This process has become significantly easier since the practice can profile itself as a digitally forward-thinking workplace that values a good work-life balance. Having the opportunity to work from home means a lot to healthcare workers, who rarely get this option.
It’s one of the most important things to be able to offer when we recruit new staff, says Anders.
Gain: about six times as many applications for vacant positions for nurses and psychologists.
One of the service’s main tasks is investigating and diagnosing neuropsychiatric disorders. Previously, the waiting time for this kind of investigation could be up to 2 years.
When a young patient receives effective treatment within a couple of months instead of nearly two years, it has a huge impact on the patient’s quality of life. If you have psychiatric problems and don’t get help, you often get other psychiatric problems, Anders points out.
The clinic has worked hard to cut waiting times by supporting its staff and changing ways of working. This is how the task force identified the problems that previously led to long waiting times:
- overly complex investigations
- bottlenecks in appointment booking
- mix up between investigations and treatments
- new visits per employee
- difficulties recruiting qualified staff.
It took multiple small changes over a period of time to solve these problems. Digitising certain elements was part of the solution; among other things, Visiba Care helped with appointment booking, digital visits and case management. Other examples of digital tools that ease the burden on staff at the practice are online CBT, digital psychological tests, automatic assessment of patients’ well-being, instructional videos and interactive job descriptions when onboarding new employees.
- waiting times for investigations were greatly reduced, from about 1.5 years to about 3 months
- waiting times for Cognitive Behavioural Therapy decreased from nine months to a few weeks
- the number of referrals received increased from 55% to 80%.
In my organisation, we primarily assess how patients and employees value a change that has been introduced. But when we started looking at the figures, I was surprised at how much more efficient we’d actually become, says Anders.
Psykiatrimottagning Ale doesn’t shy away from talking about productivity, which is not something we tend to talk about enough in healthcare. However, if you see unproductivity as an indicator of patients’ suffering, productivity becomes easier to talk about, Anders explains.
An example of how to create smoother working methods and more time for care is the digital case management in Visiba Care, which was created to avoid duplication of work and ambiguity about which employee is responsible for each case.
The metric for productivity is the number of visits the service manages to carry out. That number is affected by how much time needs to be spent on other things, as well as the conditions for carrying out these meetings. Surprisingly, the practice carried out more visits during the pandemic, when most things took place remotely.
This is an excellent testimonial to our employees, who really prioritised meeting patients and used the digital tools at our disposal to do it, says Anders.
Today, about 35% of all visits are still carried out digitally at Psykiatrimottagning Ale. The visits carried out are largely for investigations and therapies, which helps shorten waiting times in these areas. The practice has long experience of meeting patients via video and employs a special policy to determine when a digital meeting is suitable.
The employee has to consider it medically appropriate and the patient also has to approve it, Anders explains.
Gain: The practice conducts about 30% more visits in total (physical and digital).
Today it is easier for patients to be in contact with the clinic via video, messaging or chat. It creates a sense of security and allows the patient to be more involved in the whole process. For example, employees can invite the patient into a conversation earlier, instead of having discussions about the patient, without the patient. There is also a group of patients for whom contact was difficult previously because of problems interacting in person. However, this group are now more readily contactable because they find digital meetings easier to cope with.
Gain: Closer contact with patients.
In parallel with the digitisation journey, the service’s employee survey shows that the employees’ work satisfaction has improved. Anders stresses that there may be various reasons for this, but that a clear connection can be seen with the change process. The fact that the staff now have the opportunity to work remotely has been highly appreciated, and today many employees regularly work from home.
Not only are we getting significantly more people applying for our vacant positions; we’re also succeeding in retaining staff. It’s extremely valuable to be able to choose how you want to organise your work, and to work at home when it makes your life easier, says Anders.
Gain: The employee survey result has gone from red to green.
New needs in a digital workplace
However, when 20–25 % of the workforce work remotely every day, new needs arise. It has become important to have a system where all employees can see where colleagues are (at home or in situ), who is free and which rooms are booked. You also need to put extra focus on creating team spirit in order to maintain a warm atmosphere in the work team. That can’t be taken for granted.
Today, one of my most important tasks is to plan team-building activities. I’m really not used to that, says Anders, who has gone from focusing a lot on the implementation of processes and digital tools in the past few years to spending an increasing amount of time on workplace culture.
Both aspects are important to create a prosperous and effective organisation but like so many elements of this digital transformation, it is a journey.
Well worth the time and cost
According to Christina Frick, Nurse:
The time and cost you spend, or we have spent on digitisation, we get back a hundredfold. We have spent many working weeks on courses and learning different things, but the effects that work well are worth very, very much.