Many interventions are a step into the unknown and do not always go according to plan. This is not necessarily unexpected or unwelcome. It is not unusual for interventions designed for QI purposes, particularly those that are still evolving, are complex or occurring in dynamic environments, to change during the course of a project.
Many times during the ASSIST-CKD QI intervention, a hard judgement has been made about whether to stop, continue or adjust the study and whether the level of change was practical, appropriate, affordable or even achievable. One major change, which was totally unexpected, was the complete re-design of the eGFR reporting software we inherited from Heartlands Hospital, Birmingham and Hugh Rayner’s team.
This took us over a year to re-develop, additional funding had to be found and it required huge time input from our NHS test sites at Southport and Kettering to whom we are so grateful. This unanticipated change contained important lessons and has led to very positive potential opportunities for the software programme, possibly in the realms of machine learning in the near future.
We will keep you all posted.