Heuristics for big projects

How we improved urgent and emergency care with a digital solution that could benefit health trusts everywhere Same day emergency care, known as SDEC, is a facility within a hospital to assess and diagnose patients referred from their GP or a hospital’s A&E department. It aims to benefit both patients and the hospital by reducing waiting times and hospital admissions as patients with relevant conditions can be quickly assessed, diagnosed and treated without being admitted, and if it is clinically safe to do so, they will be able to go home the same day. SmartCo Consulting worked in partnership with The Health Informatics Service (THIS) and Calderdale and Huddersfield Foundation Trust (CHFT) to create a software model that smooths the workflow between CHFT’s two A&Es and relevant SDECs by modernising the pre-existing digital solution for processing patients. Giving A&E staff the right tool to do their job Patients presenting at A&E who need to be admitted to hospital create a labour intensive workflow. To avoid this for patients who do not need to be admitted, CHFT has been using the SDEC digital solution introduced when the SDEC concept was in its infancy. The rationale was to take the existing solution and a later updated model created by Oracle Cerner – whose Millennium EPR is used in both CHFT hospitals, one in Huddersfield and the other in Halifax – and fashion a localised version, called SDECModule, that gives A&E staff the right tool to do their job as part of Oracle Cerner’s FirstNet® patient tracking system. SDECModule provides A&E staff with a much higher level overview of all the SDEC departments, enabling them to easier see who can be sent to which SDEC. It also provides SDEC staff visibility of the patients in A&E who can easily be transferred from there, thus reducing congestion and pressure within A&E.   Louise Croxall, CHFT’s Chief Nurse Information Officer: “The whole aim of this project was to give back time to nursing care while making sure the right patients are in the right place at the right time. We did this by removing the duplication of information as SDECModule uses the same documentation for A&E and the SDEC, which reduces the need for staff to ask patients the same questions over and over again.”   Additionally, the improved visibility of patient status allows for better reporting metrics, especially meeting the new standard for emergency care summaries (ECS), illustrating how long someone has been in the SDEC.   Louise Croxall: “As this is a staff-facing initiative, the main impact is on them to work differently albeit as part of the SDEC solution they’re already well accustomed to. Essentially, the SDECModule enhancement is allowing them ‘to see the wood for the trees’. “The benefit for patients referred to a SDEC is a better experience thanks to a smoother journey, waiting to be seen in a more appropriate, less pressurised environment, and even shorter waiting times, we hope. And by using SDECs for inpatients waiting to be discharged, we free up bed space for those in A&E who need to be admitted and reduce risk if A&E is congested by creating more time for staff to focus on the sickest patients.” Collaborating for a totally seamless transition Whilst THIS had the resource in-house, it did not have the capacity, so they collaborated with SmartCo to help them develop, deploy and configure their model content in CHFT’s Oracle/Cerner server domain. SmartCo worked with a wide range of stakeholders and the PMO team from THIS throughout the project’s lifecycle to create a clinically designed, operationally delivered solution. The resulting model was launched at CHFT’s Huddersfield Royal Infirmary site, going live for all three SDECs (medical, surgical and frailty) at the same time, and we then repeated the roll out at Calderdale Royal Hospital in Halifax.   Neil Staniforth, THIS’ Director of Digital Ops and Delivery: “By concentrating on the Huddersfield site first, we could focus all of our training and change management resources on the one site to ensure a smooth transition, particularly as the pre-existing and the new models were dual running. Once we’d made sure there was no impact on Huddersfield Royal Infirmary staff, we started the roll out at Calderdale Royal Hospital.   “We made sure there was enough ‘at the elbow’ support by employing the relevant technical team to work alongside the operational team working with the clinical end-users to achieve a seamless transition.”   Within this three-tiered approach, four FTE change facilitators from THIS’ digital team worked with their training team to provide hands-on help during the roll-out. Any technical issues were picked up by their Silver Service team, a proactive technical team within THIS, who then liaised directly with technical support and CHFT’s EPR teams, thus avoiding any job queues sitting with our service desk, to expedite a remedy. Although the system is still very new, initial data shows that the transition time from A&E to SDEC, to being discharged is making a positive difference. Easing pressures and smoothing the patient journey The most tangible impact of SDECModule from a staff perspective is that we have improved the visibility of which patients can be transferred to a SDEC area as opposed to waiting in A&E.   Louise Croxall: “For example, if we have 70 people in the A&E and 10 can be triaged to a SDEC, those we transfer spend their time in a more suitable environment and the hope is this positively impacts on their waiting time. “And by reducing the numbers waiting in A&E, it has a positive impact on that department too, because patients can be seen sooner, which improves the experience and the journey of both sets of patients and helps the staff because it eases some of the pressures on them.”   The digital element of the new way of working, SDECModule as part of Cerner’s FirstNet® patient tracking system, is a more seamless process than that employed previously. It not only provides clarity of who can be streamed off to a SDEC, but how quickly that is achieved.   Neil Staniforth: “The improved transparency improves CHFT’s reporting capabilities too, by helping to track waiting times. For example, the trust’s inpatient system might say someone has been in the A&E for 0.7 of a day, which is actually 9 hours, so by displaying the wait in hours as opposed to a fraction, it paints a more realistic picture.”   We think the main value generated by the modernised model is that collectively we have improved the pre-existing solution for every other trust in the country. By sharing what we have achieved we can improve patient tracking for everyone if they follow the roadmap we created collaboratively. However, a second, unintended benefit, has emerged within CHFT. Colleagues working in their assessment units have requested to use SDECModule and FirstNet®, as the streamlined process is better suited to their ways of working. The first roll-out is planned for the Paediatric Assessment Unit at Calderdale Royal Hospital with others to follow, creating a quick, safe solution to increase patient experience and patient safety. Creating a smooth workflow that can benefit other trusts SmartCo has an established record of working in and alongside healthcare organisations to create clinically led digital systems, and our staff became part of an agile project process led by CHFT’s Chief Information Officer (CIO) and Chief Nursing Information Officer (CNIO). It included a wide array of clinical stakeholders ranging from consultants, clinical leads, CHFT’s EPR team, through to junior doctors, nursing staff and operational colleagues – as well as the PMO team from THIS. SmartCo staff held workshops with stakeholders throughout the project’s lifecycle to develop, deploy and configure model content in THIS’ Cerner/Oracle server domain, mitigating all issues along the way to onboard a clinically designed, operationally delivered solution. In effect, we worked in partnership with THIS in taking off-the-shelf model content from Cerner and finding innovative ways to embed it in their Oracle/Cerner domain to create a smooth, problem-free workflow that can now benefit other organisations in the future.   Taja Quigley, SmartCo’s Director: “The work with CHFT has been a collaboration of two organisations with a single goal of developing a SDEC content which enables the smooth running of their SDEC units. It has been a long journey with some complex work along the way, but the delivery of this will be scalable to hopefully benefit many more NHS organisations.” Sharing knowledge and saving time THIS now plan to share their learnings and model content on the Cerner Model Village, a well-recognised, transparent and trusted source of intelligence, so that it can be viewed by teams from other trusts.   Neil Staniforth: “This is knowledge we have acquired from the project’s 12-month lifecycle, but now we’ve completed the ‘hard yards’ it will enable other trusts to realise similar projects in a much shorter timescale – possibly as little as three to four months. We would recommend they do this in conjunction with SmartCo, who proved to be an excellent collaborator.”   Meanwhile, the plan now is to roll out the new solution to nearby trusts sharing the Oracle/Cerner domain over the next 12 months, beginning with the Bradford Teaching Hospitals NHS Foundation Trust, which runs six hospitals, and the Airedale NHS Foundation Trust, which runs Airedale General Hospital. This means it will be deployed in three trusts and four A&E departments, all using the single domain. About SmartCo Consulting At SmartCo Consulting, we are committed to delivering exceptional digital solutions. We’re a trusted partner with an established record of working in and alongside healthcare organisations. We have tried-and-tested methods for people-centred healthcare transformation, clinical engagement and benefits realisation. If you’d like to learn more about this project or how SmartCo can help with your digital transformation, contact us here.

SmartCo and Future Nurse Seeks Clinicians to Lead the Way Last month, SmartCo partnered with Future Nurse because we believe it takes a diverse group of experts to drive digital transformation in healthcare. We share the same vision and values, aiming to improve patient care with advanced technologies. Now, we’re looking to expand our team with dedicated clinicians from all professions who are passionate about making a difference. Why Join SmartCo and Future Nurse? 1. Lead Digital Transformation We believe clinicians are the key to healthcare transformation. Your expertise is crucial for integrating digital solutions like Electronic Patient Record (EPR) systems into daily practice. With your help, we can make sure these technologies meet the real needs of patients and healthcare providers. 2. Teamwork Teamwork is at the core of what we do. You’ll be part of a collaborative environment where your ideas matter. Together, we’ll create a healthcare system that uses technology to improve patient care and make operations more efficient. 3. Professional Growth We are committed to your continuous learning and development. We offer extensive training to keep you at the forefront of healthcare and technology. Your growth is important to us. 4. Make an Impact The work you do with us will directly impact healthcare organisations and patient outcomes. By helping implement and optimise digital solutions, you’ll improve diagnoses, treatments, and overall patient care. The Importance of Clinicians We know how valuable clinicians are. Your insights and experience are essential for successful digital transformation. By joining us, you’ll help shape the future of healthcare, ensuring technology enhances patient care. Opportunities for All Clinicians We’re looking for clinicians from all fields to join our team. Whether you’re a nurse, doctor, therapist or healthcare technician, your expertise is vital to our mission. We aim to drive innovation and provide top-tier consultancy services for the future of healthcare. Join Us The future of healthcare is bright, powered by dedicated clinicians and innovative technology. At SmartCo and Future Nurse, we’re proud to lead this transformation. Join us on this exciting journey and be part of a team making a real impact on healthcare. Together we can make a difference. About SmartCo Consulting At SmartCo Consulting, we are committed to delivering exceptional digital solutions. We’re a trusted partner with an established record of working in and alongside healthcare organisations. We have tried-and-tested methods for people-centred healthcare transformation, clinical engagement and benefits realisation. If you’re passionate about healthcare and excited about technology, we’d love for you to join our team. Contact us today.

We are thrilled to announce Henry Darch has joined SmartCo as a Client Support Consultant. Wishing you a warm welcome from the entire SmartCo team. We sat down with Henry to ask him a few questions about his career path, his new role at SmartCo and what he’s most looking forward to about joining. Hi Henry. What has been your career leading up to SmartCo? I have spent the last 5 years in healthcare working in both project management as well as client engagement. Digital healthcare then came to the forefront of my passions after years of estates work within the NHS. Now speaking with leaders within the NHS I want to make a difference and make sure the infrastructure for our healthcare system is up to date and successful. What is your new role and what will you be focusing on? I am joining as a Client Support Consultant. I’ll be engaging with clients to make sure their digital transformation projects are on track across the full project life cycle. I’ll be client facing from proposal to go live to allow for continued communication throughout a project, gaining the most success for our customers. What are you looking forward to most about joining? I’m looking forward to speaking with new and existing clients and collaborating together on their digital transformation projects. I’m also excited to learn from the digital leaders at SmartCo and hear about their experiences. What attracted you to SmartCo? SmartCo is highly regarded in the digital health market as a real leader. The experience of working alongside known names and leaders at SmartCo is what attracted me the most. It means that the clients are getting the best shared knowledge in the market and it also means I will gain great experience from the best. What do you enjoy doing in your spare time? If I’m not out running around with my daughter, you will find me on a golf course or watching Bath Rugby.

In today’s interconnected world, digital transformation and ERPs are not just buzzwords; they are strategic imperatives for organisations across all industries. The rapid pace of technological advancements, like AI, coupled with shifting customer expectations and cost pressures, has elevated digital transformation to the top of the agenda. Despite the widespread adoption of ERP and Enterprise Applications, many organisations still struggle to unlock their full potential, with many transformations documented as failures. At SmartCo, we help organisations navigate the complexities of their ERP journeys and digital transformation initiatives, driving sustainable growth, change, and innovation. Navigating Uncertainty: Why ERP is Essential for Future-Proofing Organisations In an era marked by disruption and uncertainty—from Brexit and Covid-19 to the conflicts in Ukraine and the Middle East—adaptability is crucial for organisations. While it’s easy to get swept up in the excitement around Generative AI, ERP and application transformation represents a way to fundamentally shift how businesses operate, engage with customers, and create value. From streamlining operations and optimising processes to enabling new business models and revenue streams, ERP systems like Dynamics 365 and IFS can revolutionise every aspect of an organisation. Realising this potential requires more than just deploying new technologies; it demands a fundamental change in mindset, culture, and organisational behaviour. By proactively embracing change and investing in ERP capabilities and application projects, organisations can position themselves for long-term success and stability, fostering the innovation that they ultimately need to differentiate. Charting a Course for Success: The Strategic Blueprint for ERP Transformation A successful ERP transformation initiative begins with a well-defined strategy, plan, and execution roadmap. Crafting a strategic blueprint involves aligning ERP efforts with overarching business goals, identifying key focus areas, and prioritising initiatives based on their potential impact and feasibility. It’s crucial to ensure that the ERP journey aligns with business goals for at least the next five years. Understanding the current landscape is essential before embarking on the ERP journey. This means conducting a thorough assessment of existing business processes, technology architecture, and organisational structure. Knowing your “as-is” state helps identify gaps, inefficiencies, and areas for improvement. It also ensures that the new systems integrate seamlessly with existing systems and processes, minimising disruptions and maximising value. Navigating this transformation requires close collaboration between business and technology leaders, alignment and buy-in across the organisation, and a carefully selected suite of external partners to bring in expertise and knowledge. By establishing a clear vision, setting realistic goals, and outlining an execution roadmap, organisations can navigate any transformation, ERP or other, with confidence and purpose. Leadership, Governance, and Assurance: The Cornerstones of ERP Transformation Effective leadership, strong governance, control, and project assurance are critical for ERP transformation success. Leaders must champion the agenda, foster a culture of innovation and collaboration, and provide the necessary resources and support for meaningful change. Organisations often lack the capacity to sufficiently resource internal SMEs and project teams. Addressing this early and bringing in relevant expertise to support robust governance structures and accountability mechanisms is essential. A strong project management team with the necessary experience and expertise is crucial to drive ERP initiatives, manage risks, and optimise resource allocation. We increasingly see clients running large application programmes seeking external assurance partners to act as a ‘critical friend’ to the Board. At SmartCo, we work ‘client-side’ using proven methods to assure and monitor project health, ensuring the right skills in the core team and enabling leaders to create an environment conducive to success. Leveraging Technology: Innovation and Integration While a successful ERP implementation often represents an opportunity for sticky Business Change, technology also lies at the heart of ERP transformation, serving as a catalyst for other innovation activities (like AI and RPA) and driving efficiency and growth. Organisations must embrace these emerging technologies once the enterprise platforms are stable and operating successfully across all business areas. Dynamics 365 and IFS, with their integrated suite of applications, provide the flexibility and scalability needed to meet these demands. However, successful ERP transformation isn’t just about adopting new technologies; it’s about integrating them seamlessly into existing processes, systems, and workflows and making the change stick! Sustaining Momentum: The Role of Culture and Change Management ERP transformation is not a one-time event but an ongoing journey of evolution and adaptation. To sustain momentum and drive long-term success, organisations must embrace a culture of continuous improvement, innovation, and agility using proven change management techniques. This involves fostering an environment where internal stakeholders are regularly engaged to have their ‘WIFM’ (What’s In It For Me) questions answered. By driving these conversations and investing in change management expertise where needed, organisations can ensure ERP transformation initiatives continue to deliver value long after the initial implementation. Measuring Success: Key Metrics for ERP Transformation To gauge the effectiveness of ERP transformation efforts, organisations must define clear key performance indicators and project metrics to track progress and measure outcomes. These metrics should align with strategic objectives and reflect the desired outcomes of ERP initiatives. A crucial step at the beginning of any major application-enabled transformation is to baseline the current business state/metrics, including spend, headcount, or process lengths (e.g., month-end close). These metrics can expose some uncomfortable truths but help form the business case for change and investment. Once baselined, these numbers should be regularly reviewed to prove that value is being created. External companies can support this value realisation process, providing tools and templates to aid this effort. Organisations must establish quantifiable targets and benchmarks to assess the impact of ERP transformation on business performance. By regularly monitoring and analysing performance data, the Project Delivery Team can identify improvement areas, course-correct as needed, and drive continuous improvement. SmartCo Consulting ERP Services System Integrator and Client-Side Assurance Services: Our expertise in system integrator assurance and client-side advisory services is a key offering that separates us from some of the other consultancies. We excel at maintaining clear project scopes that align with your organisational objectives. Through rigorous quality assurance processes, we identify and mitigate project-related risks and manage transformational changes effectively, including comprehensive communication and training strategies. Acting as your strategic partner, our client assurance team oversees SI partners, offers expert advisory services, and ensures alignment with your vision. We manage all aspects of your ERP implementation with a focus on quality, transparency, and continuous improvement. Project Planning and Control: Our consultants develop detailed implementation roadmaps covering timelines, risk and issue management, resource allocation, budget tracking, and milestone setting. This meticulous planning ensures your ERP project stays on track and within budget, delivering expected outcomes efficiently. Configuration and Data Migration: We ensure that business requirements align perfectly with optimised ERP functionality through effective vendor management. Our data migration experts handle the seamless transfer of data from existing systems to the new ERP system, ensuring data integrity and minimal disruption. Change Management: Our change management strategies ensure a smooth transition to the new ERP system, minimising disruptions to your operations. We focus on preparing your team through training and engagement, enabling them to embrace new processes and technologies confidently. Programme Audit: We offer a comprehensive programme audit service that provides an unbiased review and robust challenge of the programme at key stages, such as scope, plans, and budget. Our independent oversight ensures that project decisions are sound and aligned with best practices, providing an additional layer of confidence. By leveraging best practices and tools, we provide SteerCo-level assurance, challenging and validating programme decisions and direction to ensure success and adherence to strategic objectives. ERP Testing and Quality Assurance: SmartCo Consulting also offers a dedicated ERP testing and quality assurance (QA) service. Our QA experts rigorously test every aspect of your ERP implementation to ensure it meets your business requirements and performs flawlessly. We conduct comprehensive functional and non-functional testing, including system integration testing, user acceptance testing (UAT), and data integrity testing. Our focus on meticulous testing processes helps identify and resolve issues early, ensuring a smooth and successful go-live. By leveraging advanced testing tools and methodologies, we ensure your ERP system is robust, reliable, and ready to support your business operations. Resource Augmentation: Our extensive network of skilled professionals allows us to assemble multi-disciplinary teams to provide specialised assurance on specific functions or roles as required, ensuring you always have the right expertise at your disposal. About Oliver Oliver is SmartCo’s Partner and COO with 20+ years of experience leading large-scale, multi-million pound transformations. ​Oli is responsible for overseeing all programmes to ensure on-time and within budget delivery, creating scalable solutions that exceed objectives. About SmartCo Consulting At SmartCo Consulting, we are committed to delivering exceptional ERP programme results. Our dedication to flexibility, data integrity, transparent communication and continuous improvement ensures your ERP system not only meets but exceeds your expectations. Trust SmartCo to be your partner in achieving ERP success. For more information on how we can support your ERP needs, please contact us here.