INR Service

Undernutrition Service

Leadership

Senior staff member—intensive support from trust management, technology provider and Neurolinguistic Therapist.

Regular staff member—limited support from trust management and technology provider.

Development time

Extended duration—long lead in time for design, development,

and staff engagement.

Limited duration—tight deadlines for completion, resulting in short lead in time for staff development/engagement and pathway redesign.

Staff/service team engagement

Continuous—wider team involved in service design, development and implementation.

Limited—wider team involved in training for new service but not design and development.

Alignment to prevailing service pathway

Close alignment—the new pathway mirrored the existing one.

Not aligned—the new pathway was significantly different from the existing one.

IT and Technical support during implementation

On site, in-person support from technology provider during implementation phase; technology provider quick to respond to requests for changes.

Off site, remote support from technology provider; technology provider slow to respond to requests for changes.

Relative advantages

Staff perceived relative advantages to themselves from better functioning clinics and to patients from convenience and improved time within therapeutic range.

Staff did not perceive relative advantages; Health Call perceived as generating new work.

Decision to adopt

Financially comparable to existing service but with relative advantages—better functioning clinics and time within therapeutic range.

Financially comparable to existing service but additional costs for software licenses which could not be offset at service level by savings from reduced ONS and improved time within therapeutic range.