Cerner’s approach to Safety: The journey so far… Digital Health & Patient Safety Conference: 22nd March 2018

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CRM topic brief

• A bit about Cerner (inform)

• Cerner’s Clinical Risk Management System (CRMS) Journey

• Closing thoughts

• Q&A

A bit about Cerner: ‘A World Without Medical Error’

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Cerner today

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40 countries, 10 languages

Cerner associate presence

Cerner solution(s) in country in 2015

Global presence

‘A World Without Medical Error’

Do No

Harm!..

Cerner’s Clinical Risk Management System (CRMS)

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CRMS Scope

• Core Cerner CSO function to support EHR / Population Health Solutions deployed within UK (SCCI 0129 Requirement) and CRM within Europe;

o NHS England (to SCCI 0129 Standard)

o Europe: SCCI 0129 principles adopted and linked to ICE 80001 Standard processes and deliverables

o Active CRM programs 2018: o Millennium deployments at ChelWest, Imperial, Lewisham, Milton Keynes and RFH and for Population Health

deployments within the wider Acute, Primary and Social Care health ‘economies’ at the Wirral and Oxford

o Supporting Deployments in Belgium, The Netherlands and the Republic of Ireland

o Cerner US has an established Patient Safety Council – CRM used to prioritise IP pipeline

o Cerner CRMS and Post Market Surveillance Processes are ISO 9001, ISO / IE 27001 and ISO 13485 (Medical Devices) compliant

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An Evolutionary Approach to CRMS

• The core tenets of Cerner’s CRMS

• Partnership

• Collaboration

• Inclusion

• Relevant

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Partnership

• Close working relationships

• NPSA, NHS-D, University of York

• NHS Organisations

• Other healthcare organisations

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Collaboration

• Partnership: Functions across 2 axes

• Clients help shape Risk register through feedback from SIGs

• Cerner supports Trusts through knowledge transfer and delivery of collateral

• Blurring the SCCI 0129/0160 divide

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Inclusion

• CRM cannot done in isolation

• CSO as both sole accountable and responsible officer is a recipe for failure

• Has to become part of the core governance fabric

• All parties have an important role to play

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Relevance

• Clinical risk is no different to any other.

• Different context and delivery expectations

• Aligns with existing risk and assurance governance structures.

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The SMART experience

• Held workshop in Nov 2016 at University of York.

• Calderdale and Huddersfield; Bradford NHSTs

• Original remit was to look at applicability of tool within the context of ePMA

• Interesting outcome:

• Wider applicability to hazard classes

• Consistent and aligned approach to hazard identification, risk association, workflow impact and application of controls.

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Bringing it all together…

• Calderdale and Huddersfield NHST; Bradford NHST

• Large complex program with joint governance

• Hazard log 140+ items

• Strong Governance with Chief Exec leadership.

• Clinical and Operational ownership

• Board level visibility of high scoring risks

• Delivered on all SCCI 0160 obligations.

• CRM remains a critical function to this day.

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Closing thoughts

• CRM and SCCI 0129 / 0160 obligations are not a means to an end but an integral part of the risk, issue and

benefits narrative

• Embrace clinical risk. Use as an opportunity to always ask the questions ‘What if?..’ and develop a culture of

safety

• CRM matters. Make it a relevant part of a day-in-our-lives of delivering healthcare and running healthcare

organisations

• CRM is accountable by a few but the responsibility of all!