Jo Cubbon and Andy McGrath: Rapid performance improvement
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Jo Cubbon and Andy McGrath: Rapid performance improvement

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In this slideshow, Jo Cubbon Chief Executive, Somerset and Taunton NHS Foundation Trust and Andy McGrath, Chief Executive, Alamac Ltd share case studies and results from a project to improve and ...

In this slideshow, Jo Cubbon Chief Executive, Somerset and Taunton NHS Foundation Trust and Andy McGrath, Chief Executive, Alamac Ltd share case studies and results from a project to improve and manage hospital performance.

Jo Cubbon and Andy McGrath presented at How can hospitals do more with less? in October 2012.

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Jo Cubbon and Andy McGrath: Rapid performance improvement Jo Cubbon and Andy McGrath: Rapid performance improvement Presentation Transcript

  • Nuffield Trust & NHS Institute for Innovation Conference Rapid Hospital Wide Performance Improvement ‘How can hospitals do more with less? Implementing best practice for efficiency’ Jo Cubbon Chief Executive, Somerset and Taunton NHS Foundation Trust Peter Colclough Chief Executive, Weston Area Healthcare NHS Trust (and previously, Chief Executive, Royal Cornwall Hospitals NHS Trust) Andy McGrath Chief Executive, Alamac Ltd NHS Performance Improvement Specialists
  • Rapid Hospital Wide Performance ImprovementWhat we would like to share with you today…• Introductions• Sharing case studies and results• How the results were achieved (intro… performanceKITBAG ™ )• Questions from the audience
  • Nuffield Trust & NHS Institute for Innovation Conference Rapid Hospital Wide Performance Improvement ‘How can hospitals do more with less? Implementing best practice for efficiency’ Peter Colclough Chief Executive, Weston Area Healthcare NHS Trust (and previously, Chief Executive, Royal Cornwall Hospitals NHS Trust)
  • Rapid Hospital Wide Performance ImprovementRoyal Cornwall Hospitals NHS Trust & Weston Area Health NHS Trust• History of finance and performance difficulty• Historic debt• Poor working relationships• Difficulty sustaining improvement• Reputation
  • Rapid Hospital Wide Performance ImprovementRoyal Cornwall Hospitals NHS Trust & Weston Area Health NHS TrustPerformance Assurance Framework• Introduced performanceKITBAG ™ – March 2011 (Royal Cornwall Hospitals NHS Trust) – October 2011 (Weston Area Health NHS Trust• Improved operational grip• Improved performance
  • Rapid Hospital Wide Performance ImprovementRoyal Cornwall Hospitals NHS Trust & Weston Area Health NHS Trust• Prospective view of performance• Framework tailored and locally agreed• Combination of tools and coaching• Skills transfer and capacity building
  • Rapid Hospital Wide Performance Improvement Royal Cornwall Hospitals NHS Trust - Results Indicators Threshold Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 As per April recovery planRTT backlog 1434 1279 1335 1088 955 847 678 529 amended in August As per April recovery planRTT overall performance amended in August - national 58.20% 62.60% 70.00% 80.50% 83.10% 90.20% 90.30% 90.10% target remains 90%RTT overall activity (admitted) As per recovery plan 2198 2520 2053 2503 2821 2669 2683 2484RTT activity per working day 109.9 109.6 114.1 125.2 128.2 127.1 122.0 128.0Theatre activity per working day 89.3 92.6 92.8 95.0 91.4 105.0 102.6 97.1ED performance 95% 90.98% 93.95% 92.69% 97.43% 96.87% 97.94% 95.30% 96.40%SHA average position (across basket out of 17 acute providers 11.1 9.4 10.3 9.4 8.8 10.3 9.9 7.2of indicators)Workforce 4726 4705 4725 4687 4672 4662 4650SIP delivery £600 £1,300 £2,200 £3,100 £4,500 £6,800
  • Nuffield Trust & NHS Institute for Innovation Conference Rapid Hospital Wide Performance Improvement ‘How can hospitals do more with less? Implementing best practice for efficiency’ Jo Cubbon Chief Executive, Somerset and Taunton NHS Foundation Trust
  • Lessons learnt Musgrove Park Hospital• Past performance is not a prediction of future success• Know your numbers…and how they connect• Separate the wheat from the chaff – Selecting the right indicators – One size doesn’t fit all – Get ownership from teams – Set stretching targets…the easy way is not necessarily the right way• Brings teams together: one common purpose… – to be ‘Green’ (‘Performing’) and avoid the need for a performance review
  • The next steps Musgrove Park Hospital• Separate outcomes from process• Focus effort at the right level of the organisation – Directorate team Performance Assurance Framework (PAF) – Getting clinician buy-in
  • Historic feedback Musgrove Park Hospital “We have a very historical view of performance, so where something is performing well you don’t know if it is going off in future” (Director) “You can’t see individual trends so it can’t tell you which areas are failing, it just tells you about the Division” (Performance Manager)Performance Assurance Framework feedback “It focusses the mind and we agree actions as part of the PAF process” (Director) “The PAF gives far greater visibility for Trust leaders to see where performance is waning” (Divisional Director) “The PAF has certainly added rigour and focus to performance management” (Director)
  • Initial PAF Musgrove Park Hospital
  • Refined and tailored PAF Musgrove Park Hospital
  • PAF is a tool for improvement Musgrove Park HospitalA real example ofan action log andPAF measure• The PAF increases visibility across a multitude of measures in all performance disciplines• It is the one performance reference for Directorates and Divisions, ‘one currency’• The Trust is currently in the process of rolling out a Directorate level PAF• This will help operational teams manage the Hospital more effectively
  • Nuffield Trust & NHS Institute for Innovation Conference Rapid Hospital Wide Performance Improvement ‘How can hospitals do more with less? Implementing best practice for efficiency’ Andy McGrath Chief Executive, Alamac Ltd NHS Performance Improvement Specialists
  • Our 3 main points...1. Tailored, Predict, Connected, Consistent, Relentless 2. Doing things differently by seeing things differently 3. ‘Front windscreen’
  • You will have read almost everything there is to know……about performance improvement and management……but sometimes we still do not get the results we want...
  • The definition of insanity… …is to do the same thing over and over againand expect the same result…! Albert Einstein So we must do some different things...
  • But we all know the pressures we face in the real world...
  • …and we have a complex day job to do...
  • …and not forgetting the daily miracles our teams perform...
  • …so we need to use what we already know... Here is Edward Bear, coming “… Here is Edward Bear, coming downstairs… bump, bump, downstairs now, bump, bump, bump… bump, on the back of his head, It behindfar as he knows the is as Christopher Robin. It is, as only he knows, the only way far as way of coming of coming downstairs, but downstairs… sometimes But sometimes he feels another he feels that there really is there way, if only he could stop bumping really must be a better way… for a moment and think of it .… “…but apply it in a If only he could stop for adifferent way…! moment to think of it…!
  • So how do we do this...?performanceKITBAG ™ Patient Safety & Operations Quality Finance Workforce
  • But the performanceKITBAG ™ is not rocket science... ...we use your data... …turn it into information... & show your teams how to use it
  • … in a relentless way…!
  • The performanceKITBAG ™ has 3 areas of focus...Performance… Management Improvement Culture
  • The main ethos behind the performanceKITBAG ™ approach is... Know your business... Measure... Do... Measure... Gain control... Predict and anticipate performance... Better, quicker decisions... Establish stability and assurance...‘Stickier’ efficiency / cost improvement... Reduce waste, better patient care...
  • This all helps us manage the ‘business’ of health through the ‘front windscreen’...
  • And most importantly the performanceKITBAG ™ creates a performance culture...
  • Own up to what is not workingto develop a ‘cross hospital’ team...
  • Do what you say you will do... What we think, or what we know, or what we believe… is in the end of little consequence…John Ruskin(1819 - 1900) it is what we do that counts Poet
  • Action = Benefit... E=MC2 Albert Einstein
  • Set small incremental goals to ensure we are always improving...
  • Be positive, be brave...
  • ...be innovative and fail fast (!)...
  • But, we will always have bad days...
  • Balance ‘challenge’ with ‘motivation’... Encumbered by low self-image, Bob takes a job as a speed bump... !
  • Through support and encouragement...
  • …To ensure our people can be the ‘best’ they can be...
  • To ultimately create a freedom to perform...
  • Our 3 main points...1. Tailored, Predict, Connected, Consistent, Relentless 2. Doing things differently by seeing things differently 3. ‘Front windscreen’
  • Many thanks & Q’s...?