Tip:
Highlight text to annotate it
X
My name's Claire Hunter and I'm the training lead for NHS Pathways.
Call handlers who are new to using a clinical decision support system go through a two week
or the equivalent of a two week training programme on Pathways and that focuses very specifically
on the skills that they need to be able to use the system in a safe and competent way.
So the first thing that they do is complete a distance learning pack which focuses on
some basic anatomy and physiology and Pathophisiology so what can go wrong with the body, then they
complete about 9 days really of very very practical experiential learning where we actually
get them on the system from a very early stage, and throw lots and lots of different scenarios
at them and get them to be very confident and as proficient as they can be within the
training programme within a fairly short training amount of time to use the system. We cover
things like questioning skills, listening skills, we also cover negotiation skills,
that's quite an important skill for staff who are working within the health service
to be able to negotiate with patients because sometimes what patients want isn't always
what they need so staff need to be able to find a way through that. And we have quite
a few assessments within the course, so everything that we teach them is assessed both practically,
so we will observe them taking calls, and we also have some written assessments which
focus on the anatomy and physiology side of things as well as the system concepts and
the really important things that they need to be able to understand the system.
We tailor the training to staff working within out of hours and different organisations such
as PCT's, according to the types of calls that they are likely to receive so any call
handler going through the two week programme will cover the same principals, so they'll
all do things around questioning and listening and negotiation and they will understand the
basic architecture of the system, but the practical examples that we get them to practice
on are very much tailored to the types of calls they will receive. So for example when
we deliver the training to an ambulance organisation we will give them a lot of scenarios where
people are experiencing serious medical conditions or serious injuries. We don't solely do that,
we do give them some less serious, less urgent scenarios because of course not everyone ringing
the ambulance service has an emergency health need.
We would tailor training to staff working within PCT's so that the scenarios that we
give them, the practical exercises that they practice on would be much more tailored to
the types of calls that they are likely to receive so whilst they would cover the same
fundamental core subjects that anybody, any call handler would going through the course,
they would still do questioning skills, listening skills and so on and so forth, the scenarios
are much more focused on the types of calls that are likely within the out of hours period.
The safe guards that are in place really around call handlers doing this role is that they
don't actually diagnose over the telephone. The system isn't diagnostic, it works on the
basis of ruling out, so it will rule out the possibility of certain conditions being the
cause of the person's symptoms so I would think that's the first safeguard that is in
place, we are not asking the call handlers to diagnose. But any organisation that takes
on Pathways must have in place a very robust system of clinical support for staff so they
have to have people that are there and accessible real time for call handlers if they reach
somewhere where they feel out of their comfort zone. The other thing that we stress and is
inbuilt into the system is that anybody that calls the organisation using Pathways must
be given what we call worsening advice. So that whatever happens, if things worsen, if
symptoms change or if the person becomes concerned after putting the phone down there is still
a lifeline and they are instructed to call back. So that's a really important risk measurement
safeguard that we put in place.
There is a lot of advice I would give to a call centre looking to implement NHS Pathways,
I think one of the main things would be not to underestimate the cultural shift that is
necessary for an organisation to take on Pathways, it's not just about using a new system, it
is very much about staff adopting and embracing a new way of working, and that can take time
and often it's not without its hiccups so it's to be aware of that and to start your
change management procedures early rather than late on in the day. I would also say
that one of the important things is not to think that training is the be all and end
all or the end of the story in that once staff are trained its really really important they
are monitored and that they are supported and that you have a really good handle on
levels of performance and that you are able to respond to any problems quickly with the
support that staff need.