Committed to improving healthcare
About
The Erasmus+ DISH project aims at bridging the “missing link” between the progressive digitalisation of the healthcare sector and the lack of eHealth and innovation skills among health and social care professionals to fully benefit from the use of innovative eHealth products and solutions.
The project consortium, 19 organisations overall, is made of six regional triple helix clusters composed by health care providers, educational institutions and enterprise representatives that will test DISH concepts and outcomes in Denmark, Norway, United Kingdom, Germany, Spain and Poland, and is completed by two EU-wide organisations to promote its dissemination and stakeholder’s involvement.
Started in November 2018, the project runs over three years and will include a preparation phase, a development phase and a testing phase, where the triple helix partners will work closely together to ensure the fulfilment of real needs expressed by the health care providers, exploitability and scale up of achieved results.
Background
The demographic change and the effects it has on the health care systems are among the key challenges the European society is facing. The progressive ageing of the European population increases demands from senior citizens who need integrated health and social care services whilst the care workforce is shrinking and less public funding is available to meet such needs.
In order to respond to this challenge, many innovative eHealth solutions have already been developed and many health care providers have invested in innovation. However, it often turns out that the solutions are not being implemented or are only partly used, hence the full potential of innovation is not exploited.
Many of these solutions do not reach full implementation stage for different reasons, such as:
- - the solutions have not been developed in close collaboration with the health and social care staff,
- - there is a lack of overall digital competences and specific eHealth literacy within the staff,
- - there are barriers to changing organisational practices, pathways and models of working that enable smart solutions to be deployed.
Research results point out that one of the areas to focus on to succeed in applying and implementing eHealth solutions is the development of digital skills, innovation readiness and decrease resistance to change. The health workforce needs to have adequate instruments, capabilities and knowledge to face this rapidly evolving scenario, thus being fully aware and prepared to take advantage from the possibilities offered by the digital transformation in health and care.
Objectives
DISH is aimed at strengthening the innovation readiness and digital skills of health and social care staff regarding development, use and implementation of digital solutions in their everyday practice.
The DISH project will equip the health and social care workforce with relevant knowledge and competencies as well as enabling them to use and implement eHealth solutions supported by national digitalisation strategies.
The objective of the DISH project is, therefore, to look into the present and future skills’ needs and develop, test and present different concepts, which will support health and care staff to better cope with the digital transformation of the health and social care sector.
Through work-based learning and training in a secure environment, the health and social care staff will replicate day-to-day situations where the use of eHealth is involved. The project therefore will deliver hands on education, in the form of on-the-job training, and provide the skills that the labor market demands from the staff. The project will use the concept of simulation in order to create a secure environment for learning.
Expected Results and Impacts
DISH provides a structured approach to the whole digital innovations’ implementation process. It is built around three concepts, main output of the project’s activities:
– The Learning innovation Units: An organisational concept providing a framework for co-creation which fosters multidisciplinary collaboration, innovative attitudes and team learning.
– The On-the-Job training: A concept oriented towards the achievement of concrete knowledge, skills, and competencies based on innovation and the daily use of the technologies in a secure simulation environment.
– Skills and Competences Assessment: A conceptual model to assess and acknowledge the digital and innovation skills within health care staff, which are obtained outside the official education and training system.
By making use of the DISH concepts, the six DISH pilot sites will enrol and offer training services at local level to a minimum of 600 health and social care workers and a plan for project’s results transferability and scale up will be included in the sustainability and sector skills strategy issued by the DISH partners at the project end.
Overall, DISH has the ambition of contributing to:
• the
implementation of digitisation
strategies on local level,
• the
enhanced use of eHealth solutions by
increasing the ability and
confidence of health and social care
provider in handling digital
innovations,
• the lowering of
mistakes and delays in applying
eHealth solutions in treatment and
care,
• the increase of time
spent with the patient / citizen
instead of figuring out how an
eHealth solution works.
The DISH concepts
Illustrated from the users view point and by the Consortium partners in three video interviews.
The DISH concepts should be considered as “live outcomes”. They will evolve during the project lifetime, integrating DISH pilot sites’ feedbacks about their usability, relevance and transferability. The fine-tuned and final version of the three concepts will be made available in this section for implementation beyond the partnership and the project period.
What it is?
The Learning Innovation Unit (LIU) is an organisational concept providing a framework for multidisciplinary collaboration, regarding the obtainment of digital skills and competences.
A LIU should be established every time a new technology is to be introduced and implemented in the healthcare field. The shared-decision-making is a fundamental principle within the DISH concepts. It is practiced in co-operation and open dialogue between the different actors engaged in its implementation and it is part of the conversations within the LIU meetings where all the participants define the framework for the training.
Concretely the LIU plays out as, for instance, multidisciplinary meetings between all relevant stakeholders to facilitate the implementation and use of the new technology. Those meetings could gather together managers, IT specialists, healthcare professionals and, possibly, the company supplying the technology.
From the user perspective
The LIU are preparatory meetings planned well before the training and that are aimed at clarifying issues such as:
- What is the purpose in the use of the technology?
- What desired changes in the skills/competences of health and social care professionals are needed?
- Which main workflows are affected and how the new workflows will look like?
- Which arrangements should be made to ensure that a sustainable peer-learning culture will be established after the training?
- Where, when and how can health and social care professionals be supported in the use of the technology after the training?
- Are there other workflows that can be improved by the implementation of the new technology?
Technology and professional
competences cannot be
separated. Bringing the
technologies into practical
use is a matter of both
being able to understand and
being able to deal with the
technology.
Dealing
with and understanding
technologies have several
dimensions and one of them
is getting to know the
technology enough to be able
to use it properly. The
other dimensions relate to
relational aspects such as:
shared commitment in the use
of the technology in
practice; complexity in the
daily work and difficulty in
making the technology part
of it; changes in
professional competence and
workflows.
Each
dimension affects chosen
relations between the
clinical practice and the
technology and each
dimension should be seen as
an element in developing the
technology comprehension.
Therefore, upon the
implementation of new
technologies, it is
essential to reflect over
the technology’s influence
on the clinical practice and
start from this point to
plan the development of the
needed digital skills and
competences
The LIU also consists of follow- up meetings after the training
What it is?
Each training session is based on the need in the health and social setting and the trainees define the topics to be part of the training together with the trainers.
The skills’ training is based on practice-related cases, drawn from the daily work of the health and social care staff. The training should be based on the concrete technology, which has either been already implemented but is not in use yet or which should be still into the clinical practice. The staff should be trained on how to use the technology basing on cases from their daily work. The training can take place in specifically set-up simulation facilities or in the own wards/own areas with on-the-job training, as well as across professional groups and sectors.
From the user perspective
The training can last from 2 to 6 hours, depending on the specific cases and the extent of training needs. To start with, the training will focus on when the technology is working properly and is responsive, and during the second half of the training session, the training is oriented towards troubleshooting and handling the situations when the technology is not working (unresponsive).
The recommended team size is 8-12 participants, because it is essential to give each participant a chance to actively participate in the hands-on training.
The target group is health and social care professionals (irrespectively from theis professional background).
The training
itself increases in
complexity of
learning levels
from:
Training
elements with emphasis on
usage, such as technical and
manual skills, practical
data and
information
to
Training
to be able to use the
technology in relation to
professionalism and ethics,
as well as training in
understanding the applied
technologies
to
Training
skills to be able to
participate in digital
communication, as well as
training the skills of
teaching others, hereby
colleagues, patients and
citizens to use digital
tools.
Overall, the training offers the staff the possibility to take part in the development/implementation of new digital technologies, to be able to properly make use of the digital tools and to understand the organizational changes that a new technology has the potential to bring at the workplace.
Follow-up
training:
By
the end of the training
session, the participants
are offered follow-up in the
form of
participation/support at the
first use of the technology
in the ward. Meetings and/or
workshops at 30, 60, 90 and
365 days after the training
are held together with the
clinic/involved parties.
These activities have the
purpose of ensuring the
quality and development of
the training, in such a way
that support is given for
maintenance of the new
workflows. Finally, the need
for repeating the training
is addressed.
Health and social care professionals should be able to use the technology in relation to:
•
their own work area and
workflows
•
professional and
interdisciplinary
cooperation
•
supporting the
citizens/patients’ use of
the technology
The training should in general qualify the staff to:
•
Be able to use the
technology in a secure and
competent manner (the
hands-on aspect of the
training)
• Be able to
support citizens’ use of
technology
• Be able to
adapt to technological
transformations (the
behavioural aspect of the
training)
• Be able to
participate in technological
innovation
• Be able to
critically and ethically
reflect on technology
What is it?
The assessment concept is developed in relation to the ‘On-the-job-training’ concept. This means that the assessment of competences is approached as an integral part of the training and implementation of technologies in the health and social care settings. The actual design of an assessment process , besides reflecting the content of the training, takes into account the organisational and professional contexts of the training itself.
From the user perspective
Tools
have been developed
for the recognition,
assessment and
documentation of
digital/
technological
skills acquired
by health and
social care
professionals
elsewhere than
their formal
educational
system.
These
tools consist
of:
•
Recognition:
releasing a course
certificate based on the
evaluation of achieved
skills
•
Assessment:
evaluation tools, which
evaluate the participant’s
own learning and the
training itself (for
instance, in situ
evaluation, see below for
details)
•
Documentation:
a portfolio for storing
materials for potential
later use
The
aim of using the
three tools is to
develop a competence
assessment framework
that can be adjusted
to the specific
learning situation
and to specific
technologies.
The
assessment process
shall reflect over
the learning content
and be based on the
organizational and
professional
contexts in which
the
training/teaching
will be rolled
out.
Emphasis is made upon the assessment as a process that supports teaching and provides documentations which can be used as a basis for a formal recognition of skills. The main idea is that health and social care professionals participate in training/education sessions related to the various technologies throughout their entire work life, and they should have the chance to have these skills recognized in order to be able to spend them also in different contexts.
In-situ
assessment
This
tool for the
assessment of
participants’
knowledge, skills
and competences
acquired shall be
adjusted to each
specific learning
situation. The
reflective questions
are mainly a
suggestion:
questions may be
added, removed
and/or adjusted to
be relevant for the
learning situation
and for the learning
outcome.
A web
2.0 Learning
Management Platform
(LMS) can be used to
store the
documentations
produced. Course
materials can also
be saved on the
platform and the
participants can
download their
certificate from it
after the
training.
For instance in Denmark Mobile phones can be used to produce documentation using It’s Learning app ( Learning Management Platform (LMS)) and there the participants have access to the in-situ assessment.