National, local and personal
The Map of Medicine addresses clinical governance by making the development and sharing of local guidelines and care pathways fast and efficient. The Map combines, in a single solution, national and local information to provide all staff with a single source of personal best practice.
Clinical Governance
All healthcare organisations must support effective clinical governance and risk management. This includes development, maintenance and provision of national and local practice information such as patient information, clinical guidelines, care pathways and protocols together with programmes for continuing professional development.
Successful organisations develop a close patient-professional partnership through effective communication underpinned by quality assured clinical governance systems. Traditionally this requires a local team to sift and repurpose national and international publications to create a trusted local resource. There must be a continuous process of review to incorporate new evidence for all guidance authored or managed locally.
The Map is designed to support local teams by providing a nationally accredited starting point and tools for local customisation while maintaining linkage to national knowledge.
Efficiently adapting and extending national knowledge for local use
The Map provides a repository of international guidelines, nationally accredited versions and access to modifications made by health organisations that choose to share them. It also provides tools for customisation of pathways to meet local service configuration and clinical priorities.
The Map supports two different types of local customisation:
- administrative localisation using the Map Display allows local teams to add or link to non-clinical information such as quality procedures, clinical details, contact details and reporting protocols.
- clinical localisation using the Map Management Suite allows new pathways to be created and existing pathways or detailed information to be modified or extended to reflect local practice.
The Map of Medicine and the Map Management Suite is available entirely as a web application, making it efficient to set up on a wide range of IT infrastructure. It can be accessed from home, in a surgery or a hospital.
Where customisations are applied locally, the linkage to the original national guidance is maintained. As this guidance is updated, local teams can be made aware without having to actively review the underlying evidence. Local teams can then answer the question – should we update our local versions, retain them unchanged or switch to the updated national versions?
Support for local innovation and feedback
Local innovation can be encouraged through creation of local clinical networks that develop knowledge in the visual format offered by the Map prior to sharing with all staff. In this draft form reviewers can comment, editors can make changes directly and only when appropriate approvals have been received is the content published for a wider audience. This support for the complexity of local variation was fundamental to the design of the Map and avoids it becoming a read only cookbook sitting on a shelf.
Feedback on published content is routed and managed by the Map of Medicine system. Feedback is initially passed for local comment where it may be addressed most effectively. Where appropriate the Map allows feedback to be passed on to those responsible quickly and maintains communication on progress between the originator and all those involved in a review without the use of e-mails that might be lost and which cannot be effectively tracked.
Personal to each staff member
Each user of the Map of Medicine can reflect their working practices in the Map. Recently used pathways are quickly accessible from the front page. Information that a clinician finds relevant at a specific step in a pathway can be recorded for future reference through the addition of personal note.
Personal notes are available no matter where the clinician connects to the Map so those working in a number of settings or who use the Map for personal development as well as clinical practice see a single view.
Feedback can be generated from a personal note – providing a quick mechanism to share knowledge with a peer group.
Version managed, audited and recording medico-legal responsibility
The Map of Medicine clearly identifies and audits all changes to information including the user making the change and the date and time of the change. Only those authenticated individuals with appropriate access rights can make changes and each user must explicitly take responsibility for changes that modify national guidance.
All local additions are clearly differentiated on screen to end users of the Map of Medicine – the date and time of the change, the organisation responsible is immediately available to verify the source of the information being presented. A history of previous versions of pathways is maintained automatically and can be reviewed by users wishing to consider how knowledge has been modified over time.
Local additions such as clinic opening times can be published immediately by those with the right to edit it – allowing local information managed by administrative staff to be kept up to date easily.
It requires two separate individuals with appropriate access permissions to approve clinical information that modifies an existing pathway or to approve a new pathway. The workflow then requires an individual with publishing rights to publish it before it can be seen by users outside the reviewing community.