Q Lab UK works on a key principle that to understand a complex challenge, we need a range of perspectives to build a collective picture and shared view of how a problem plays out. Over the last few months, we have been undertaking collaborative research with over 90 people who have expertise (contributors) and four test teams to test and refine our understanding of the issues and start surfacing assumptions before moving to action.
Our third workshop on 17 February was the first opportunity for the test teams to come together. In the next stage of the Lab process, the test teams will build on these insights through a structured design process to develop and test their ideas in practice. We’ll be continuing to support contributors and teams to build relationships to offer expertise and peer support to help shape their ideas.
As we prepare for the next workshop, I wanted to introduce our four teams and their chosen challenges. I encourage you to contact the teams directly if you’d like to find out more or, even better, to offer them any support.
Chelsea and Westminster Hospital NHS Foundation Trust
Challenge: “To make the early supported discharge scheme for respiratory conditions accessible to all, irrespective of language, experience, or digital technology.”
West Middlesex Hospital rapidly implemented support for people with COVID-19 at home during the second wave of the pandemic (December 2020 – April 2021). The team is now setting up non–COVID respiratory pathways and will offer the option of remote monitoring apps and devices, including video and telephone consultations.
The team is based in Hounslow and serves a very diverse community. The team have identified some key digital exclusion considerations to ensure any solutions meet the needs of the local people. Closely working with their local authority is helping the team to build their understanding of how digital exclusion impacts the community. This relationship also ensures that the team develops different ways of working with communities.
The team hopes the project will ensure remote-enabled technology is accessible and can be used confidently by a diverse range of people. Their aim is that outcomes for all groups are improved.
Aneurin Bevan University Health Board
Challenge: “How might we design and deliver a timely, efficient, and pupil-centred remote monitoring service in secondary schools to help support, enable and manage disordered eating?”
NHS Wales eating disorder and weight management services reported a significant rise in clinical needs, resources, referrals and waiting lists since the beginning of the pandemic. 16–18-year-olds are of particular concern because of the timing and impact of COVID-19.
The team aims to work closely with schools to understand which groups of young people will benefit from their intervention. They also want to develop an approach to remote monitoring implementation that enables school staff, services and families to be able to support the young people.
Through this approach, the team hopes to:
- Develop strong relationships between NHS and education settings to understand and deliver appropriate training to school staff.
- Offer a stepped approach ranging from prevention and early intervention, to more clinically monitored services.
- Enable a balanced approach for young people to make sure interventions and support meet their needs.
- Reduce the likelihood of emergency admissions for high severity eating disorders.
- Reduce the number of low-level eating disorders progressing further and needing additional services.
South Tees Hospitals NHS Foundation Trust
Challenge: “How do we support people who receive home haemodialysis and clinicians to remote monitor potassium levels that maximises their wellbeing?”
The team is working with people who receive haemodialysis at home to introduce remote monitoring of potassium levels as part of their kidney care.
The team want to understand how this technology can maximise the wellbeing of both people receiving home haemodialysis and staff. They want to understand if the remote technology affects relationships and information flows and how to ensure sure both groups are confident about using it at home.
The team hopes that people who receive home haemodialysis are informed and empowered to use remote technology and monitor this data with a clear focus on their wellbeing. From a clinician perspective, clinicians can be clear on who will benefit from this technology, what the information flows are and what impact this has on a person’s care and wellbeing and how this model affects their workload and relationships.
Healthcare Improvement Scotland
Challenge: “How do we meaningfully engage people with rheumatoid arthritis and clinicians to introduce remote monitoring technology to support and co-produce care?”
The team are building on a pilot that supported people with rheumatoid arthritis attending outpatient appointments to capture patient-reported outcome measures. This was to support conversations and information flow between the people with rheumatoid arthritis and clinicians. The team hopes that the introduction of remote technology via an app into the service, will enable people to remote monitor these outcomes at home in-between appointments.
The team already know that some people may struggle with using technology, so they are exploring what support those people will need. They are also balancing an understanding of clinical apprehensions about the reliability of the data and additional time pressures in processing and analysing this data. The team ran two focus groups to help them understand more about these issues in practice.
The team hopes to generate learning to:
- Improve shared decision-making and co-produced care management.
- Support self-management and improved health literacy.
- Understand how a new data-driven service model could work.
- Design accessibility and inclusivity into remote technology-enabled solutions for use in real-world settings.
What will the teams do next?
Over the next month, each team will continue its research, test some of their assumptions and refine their challenge statements. They will start to focus on what success looks like, including what they hope to achieve and how they will measure impact. This will prepare them for the next phase: developing ideas to test in practice.
The Lab will support teams to think about what they are collectively learning and how they can help others interested in this complex challenge to apply this.
Have you got some thoughts or questions about the projects? Contact the teams directly or check out the Q Lab UK online group to see what support they have requested.