An introduction to Quality MK 040309


Published on

Introducing Quality MK - a whole system approach to quality improvement across an NHS primary care trust. Sue Lacey Bryant

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide
  • Acros MK. Take... 1 CEO 2 Chairs 1 professor 12 task and finish groups: 100+ participants 10 evidence-based discussion groups 100+ participants Add - Staff team all part-time – roughly 2.5 wte posts Plus - 1 PH Consultant 1 PH Strategic planning mgr 1 leadership development manager Worked with a variety of tools and techniques Evidence itself as a powerful tool for change Using MoM as starting point for defining the clinical pathways we commission; ensuring approved commissioned pathways are available to all – clinicians & patients   SurveyMonkey – piloted by Quality:MK. Understanding attitudes, barriers to change, training needs. Now being used across the organisation. Spearheading our work through the redesign of diabetes care in Milton Keynes, developed a systematic process for pathway review Managing our knowledge of ways of working, system and process – embedding into routine HR, planning, prioritising , review and communications processes
  • An introduction to Quality MK 040309

    1. 1. QUALITY: MK A whole system approach to quality improvementdriven by primary care, patient engagement and evidenceDr Nicholas Hicks, Chief Executive / Director of Public Health March 2009 health:mk
    2. 2. The presentation Introducing Quality:MK Primary care led; evidence-based Public & patient engagement What would we do the same... and what would we do differently? How does it look to you? health:mk
    3. 3. PrinciplesPlacing evidence,service users andprimary care right atthe heart of decisionmaking and qualityimprovement - andkeeping them there health:mk
    4. 4. Partnership health:mk LINks Milton KeynesNHS Milton KeynesCentre for Evidence Based Medicine health:mk
    5. 5. Projects A WHOLE SYSTEM APPROACH Clinical pathways: Embedding Systematic review Spreading evidence bright ideas Diabetes Alcohol Depression Glitazones Dyspepsia Carpal tunnel Complex patients Lipid modification Smoking cessation Patient empowerment Delayed prescribing Weight management CLINICAL ENGAGEMENT PUBLIC AND PATIENT ENGAGEMENT EVIDENCE-BASED CARE AND COMMISSIONING health:mk
    6. 6. Project teamBoard of 4 1 programme managerAward group of 8 2 information specialistsSteering group of 16 2 GP champions 1 clinical effectiveness12 task and finish groups pharmacist10 evidence-based 1 IM&T development officer discussion groups health:mk
    7. 7. Quality:MK - Embedding Quality into CarePrimary Care Live TV highlights the work of Quality:MK - a partnership between MKPCT, health:mk, the PPIF and the Centre for Evidence-Based Medicine. The film focuses on two areas of care, diabetes and smoking cessation. health:mk
    9. 9. HOW WE ARE IMPROVING THE QUALITY OF PATIENT CARELinking academic research to everyday practice.Solving everyday clinical problems by looking at the best evidenceChanging practice in light of new evidenceEncouraging leadership from primary care clinicians to drive change health:mk
    10. 10. OUR APPROACHJournal Clubs and EBDGs (Evidence based discussion groups)Librarian support recording of discussions and sharing them on PCT intranet, Toolkit on intranet55 topics discussed across all EBDGs36 in GP practicesAt least 4 led to measurable change in the practice health:mk
    11. 11. health:mk
    12. 12. EXAMPLE 1:Management of carpal tunnel syndrome in a practiceAudit current practice- 6 GPs all do it differentlyEvidence search supported by Outreach LibrarianEBDG look at the evidence + discussed with expert in the practiceAgree evidence based pathway (Map of Medicine)Use new pathwayPatient involvement- Questionnaire + Health:MK patient focus groupLink with PCT/Practice based Commissioning Collaborative to spread evidence based care to other practices and link with services in secondary care.Identification of training need (Injection skills)Repeat audit health:mk
    13. 13. EXAMPLE 2:Prescribing projectsGlitazone prescribing All topics discussed at practice EBDGsLipid management Evidence based change inAntibiotic prescribing practice identified Support from pharmacist toby delayed develop projects and forprescriptions changes to be adopted in other practices Patient involvement ? health:mk
    14. 14. SuccessesEngaging clinicians in stimulating clinical discussionEvidence based changes in patient care in practicesEvidence based changes adopted in more than one practice health:mk
    15. 15. Key factors in ensuring SuccessMotivated clinical lead in each practiceLibrarian supportImplementation support (QMK-GP, pharmacist, audit)FundingLinking with other local initiatives to drive wider dissemination. health:mk
    16. 16. ChallengesSustainability current EBDGsEncouraging the establishment of EBGDs in more practicesLink with education/revalidationTry virtual EBDGs for locumsPatient / Public involvement- How + WhenHow to decide which topics to prioritise for wider implementation health:mk
    17. 17. PUBLIC AND PATIENT ENGAGEMENT John NeedhamMilton Keynes Local Involvement Network health:mk
    18. 18. What have we achieved?“A dynamic & organic shift”“The success of this programme can be seen in the high level of patient and clinician involvement”“... with greater use of evidence”“There is an explosion of patient involvement” health:mk
    19. 19. A self-improving system Multiple channels for innovation and improvement; Mainstreaming a systematic approach to service review and redesign Adopting Map of Medicine Defining, documenting, tools & templates Toolkits: communications, engagement, evidence Attending to information data flows System and process eg PEC, eg HR Seeing it through; supporting the change leads Making it easier to work with these values, than not to health:mk
    20. 20. What would we do sooner... or differently?Recruit GP champions Worry less about QIInvite local expertise process techniquesStrengthen channels for  Pay more attention to engagement how to implement changeOffer better information & Greater use of persuasive support for PPE dataClearer terms of referenceLearn about social Listen to Paul Plsek marketing health:mk
    21. 21. We have learnedUse the evidencePrioritiseRaise the flagImportance of leadershipClear objectivesFocus on outcomesNurture the partnership; build the teamDon’t make assumptionsDiagnose barriers to changeIdentify QI skills as core competenciesReflect health:mk
    22. 22. External evaluation: Interim findingsThe three principles are beginning to reach beyond the specific “Quality:MK provided programme to impact a way to do it…” on the wider PCT. “… that’s how we do itIn the words of two here” participants in our December workshop: health:mk