PT - JOURNAL ARTICLE AU - Sharma, Videha AU - Whelan, Pauline AU - Foster, Simon AU - Antrobus, Steven TI - 9 Collaborative leadership drives meaningful digital transformation AID - 10.1136/leader-2023-FMLM.9 DP - 2023 May 01 TA - BMJ Leader PG - A8--A9 VI - 7 IP - Suppl 1 4099 - http://bmjleader.bmj.com/content/7/Suppl_1/A8.2.short 4100 - http://bmjleader.bmj.com/content/7/Suppl_1/A8.2.full SO - BMJ Leader2023 May 01; 7 AB - Context This work was undertaken at the Kidney Transplant Unit at Manchester University NHS Foundation Trust, UK. The multi-disciplinary team consisted of clinicians, user experience designers, software developers and project/business managers (included as co-authors).Issue/Challenge Kidney transplantation is a complex clinical service with patients crossing speciality and organisational boundaries as they transition from chronic kidney disease to kidney failure and ultimately transplantation. However, clinical data captured along the pathway does not follow the patient. This results in missed communication, delays and increased burden on staff to manually manage data across disparate sources.Assessment of issue and analysis of its causesCurrent NHS IT infrastructures do not readily support data sharing across organisational boundaries with poor levels of interoperability between electronic health records (EHRs). To better understand this problem in the context of kidney transplantation, we undertook a national survey of all 23 kidney transplant centres in the UK.This identified that most transplant centres have mature EHRs implemented. However, due to due to the multi-disciplinary and cross-centre nature of the service, EHRs were unable to meet the necessary workflow requirements. This was further compounded by an inability to transfer data between EHRs at referral centres and transplant centres, resulting in a dependence on post or scanned files attached to email.In order to overcome this challenge and develop solutions that meet the requirements of the service, we applied a collaborative codesign methodology. By directly involving clinical, academic and health IT stakeholders we aimed to create an environment of shared ideation.Through this approach we were able to gather key requirements from front-line staff and iteratively design a usable prototype. Key features of the prototype were the ability to surface data across organisational boundaries and provide a transplant-specific view that mirrored the patient journey. Involving stakeholders in the design process created a sense of shared ownership across the leadership team, resulting in high levels of engagement with the project.Impact The impact was two-fold:The direct impact of the prototype solution was to allow healthcare professionals to consider new ways of working. The trust underwent a wider digital transformation through the implementation of a new EHR and results from our work directly fed in to this.This project identified the value of collaborative leadership and shared ownership to develop healthcare solutions that meet service requirements and are more likely to bring benefits to patients.Intervention The key intervention was a series of user workshops with stakeholders to gather requirements, elicit feedback and drive an iterative design process. As the clinical lead on this project I recognised the value of sharing responsibilities with leaders across disciplines. By assigning trust to individuals with domain expertise we were able to design a potential solution that was well received by the clinical team. Figure 1: reproducible applied codesign and workshop methodology.Involvement of stakeholders, such as patients, carers or family members:This project was aimed at improving clinical workflows and IT support for healthcare professionals. However, we envisioned any IT solution we developed may benefit patients through a patient-facing application. We thus involved the Kidney Patient Involvement Network and gathered early requirements from patients. This mainly highlighted how patients would like to be kept better informed on where they are on the pathway and what their transplant status is.Key MessagesIT systems are currently unable to support clinical workflows in kidney transplantationHealth IT systems must be interoperable by design to meet the needs and requirements of contemporary servicesEffective engagement of leaders across disciplines can create dynamic and effective teams to tackle pressing healthcare challengesLessons learntOpen–mindedness and empathy is critical when working with leaders from different disciplinesAs clinicians we can play a critical role in focussing project teams on the common goal of improving healthcareIf doing this project again, I would have formally engaged a patient as part of the leadership teamMeasurement of improvement We gathered qualitative feedback from healthcare professionals during the final user workshop. Comments included statements such as: ‘a system this like would be useful for me’.Strategy for improvement This project was undertaken in an agile-inspired iterative approach gathering feedback from stakeholders throughout its life cycle. Findings have now been incorporated in to a wider EHR implementation and a report has been compiled which will be presented to NHS Blood and Transplant.