Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Similar to LKS Improvement Practice - UHDB - HLG Presentation/Workshop
Similar to LKS Improvement Practice - UHDB - HLG Presentation/Workshop (20)
Recently uploaded
Recently uploaded (20)
LKS Improvement Practice - UHDB - HLG Presentation/Workshop
- 1. Our Improvement Practice Journey: A Reflection Beth Rawson Deputy Library & Knowledge Service Manager, UHDB Caroline White Library & Knowledge Service Manager, UHDB Barrie Humphriss Head of PMO, UHDB
- 3. UHDB - Improvement Practice Vital Signs: An Improvement Practice • Launched by NHS England in 2018 • Developed for the NHS, by the NHS • To transform and continuously improve patient safety, quality of care and capacity by removing waste • Derby became part of Cohort 1 https://www.england.nhs.uk/vital-signs/
- 4. UHDB - Improvement Practice • Links to Trust’s PRIDE objectives • Evidence for QIOF • Built on Toyota Kata processes • Uses PDSA model (Plan-Do-Study-Act) • Involves techniques such as process mapping, root cause analysis, force-field analysis, driver diagrams • Life QI system – registering/tracking projects
- 6. LKS Improvement Practice The Jefferson Memorial and The 5 Whys https://youtu.be/N7cR2gArCFE
- 7. LKS Improvement Practice June 2019: Workshop 1 Exercise – Stop – Start – Continue and Success Identify problems with processes or Identify what we want as a future state Procedures as What are we most proud of. What’s our service here for?
- 8. LKS Improvement Practice August 2019: Workshop 2: Exercise – Stop – Start – Continue
- 9. LKS Improvement Practice Seek Funding from the trust for the policies & Guidelines post Create our own research repository “Get it live in libraries” Trudi to deliver IT training (complex thing) to library staff from around the region Sell Withdrawn stock on Ebay or Amazon for market values TED talks? Get people in, charge a fee? Charge £5 per patient journey Purchase stocktaking software/hardware and stocktake for other libraries. Look for adding/claiming compensation in contracts for resources going down
- 10. LKS Improvement Practice • Write a project plan (to cover 6-8 weeks) • Create milestones within this time period • Create actions to get to the milestones • Put this into a template, which populated the overall project plan
- 11. LKS Improvement Practice Process Map the Procedure
- 12. LKS Improvement Practice Inter-Library Loans: • Challenge: To improve efficiency of the process • Defects: Users having to register on KOHA and CLIO • Experiment: Compared the KOHA ILL Module to the current system (CLIO) • Measures: Timed experiments, user surveys • Outcomes: A move from CLIO to KOHA, number of processing steps reduced and users only have to register once, cost savings of £4,000
- 13. LKS Improvement Practice User Registrations: • Challenge: A complex registration and remote self- registration process, paper-heavy, duplicate accounts • Defects: Paper heavy, users not collecting their barcodes and thus completing their registration – instead registering again in person - duplicate accounts • Experiment: Developed a self-registration form on the website and tablets, timed the registration process, looked at alternatives for barcodes, • Outcomes: A time reduction in registration and self-registration, removed paper from the process, reports set up for duplicate accounts • Ongoing : E-Barcodes, removing validation email
- 14. LKS Improvement Practice Overview of improvement practice: useful videos Overview of Toyota Kata https://www.youtube.com/watch?v=7yNPEEGRBNI Dr Mike Evans: an illustrated look at quality improvement in health care https://www.youtube.com/watch?v=nPysNaF1oMw&t=445s
- 15. LKS Improvement Practice Waste What is it?
- 16. Workshop: 6S
- 18. LKS Improvement Practice Workshop: 6S What are the 6Ss and how do you implement them? 1. Shift/sort out (get rid of what’s not needed) 2. Set for flow (organise what belongs) 3. Scrub/shine (clean up, see and solve problems) 4. Safety (see and fix unsafe conditions) 5. Standardise (who does what, when, to keep it up) 6. Sustain (be disciplined … keep it orderly)
- 19. LKS Improvement Practice Waste: • Challenge: Reducing clutter and creating a tidy working environment • Defects: Messy desks, no real organisation to the cupboards and store room, excess of furniture and stationary supplies • Experiment: Red tagged items for disposal, staff given the opportunity to feedback • Outcomes: Clear desk policy, removed handouts and guides, removed excess furniture, disposed of excess bins • Ongoing: Keeping up the momentum!, shared drive
- 20. LKS Improvement Practice Workshop: 6S Benefits of 6S • Defects are made obvious • Eliminates excess inventory and equipment • Saves time looking for things • Well organised support flow • Safer and cleaner work environment • Freeing up work space/better utilisation of space • A way of encouraging everyone to get involved in an improvement activity • Pride in workspace • Morale
- 21. LKS Improvement Practice Workshop: 6S How to Implement 6S Before you start: • Get agreement • Facilitate the team • Take photos: picture speak louder than words • Get floor plans to see where equipment, stock and people move in the area Also consider: • Risk assessments • Infection prevention and control
- 22. LKS Improvement Practice Waste: Before After
- 23. LKS Improvement Practice Waste: Before After
- 24. LKS Improvement Practice Challenges/Barriers: • Clashes in personalities • People taking it personally when processes have been questioned • The “buy-in” for some staff has been problematic at times • COVID • Can anyone think of any more?
- 25. LKS Improvement Practice Workshop: 6S Pledges: Personal pledges – followed up by progress on outcomes Dynamic noticeboard – encourage staff and user involvement Team and personal objectives: Written within each of our performance objectives for 2021-2022
- 28. LKS Improvement Practice Action: What ONE thing will you take away from today that you feel will be useful? If you’re happy to, please share them in the chat. Please feel free to contact us directly after the session.
- 29. Further Reading Websites: Lean Enterprise Academy https://www.leanuk.org/ Lean Enterprise Institute https://www.lean.org/ NHS England https://www.england.nhs.uk/sustainableimprovement/ Catalysis https://createvalue.org/ Shingo https://shingo.org/ The W Edwards Deming Institute https://deming.org/
- 30. Further Reading Books: Becoming the Change – John Toussaint McGraw-Hill Education (21 Sept. 2020) 978-1260461688 The Toyota Way: Second Edition – Jeff Liker McGraw-Hill Education; 2nd edition (6 Jan. 2021) 978-1260468519 The Toyota Kata Practice Guide – Mike Rother McGraw-Hill Education (15 Feb. 2018) 978-1259861024 The Infinite Game – Simon Sinek Portfolio Penguin; 1st edition (15 Oct. 2020) 978-0241385630 Mindset – Carol Dweck Robinson; 6th edition (12 Jan. 2017) 978-2133487514 The Fearless Organization – Amy Edmondson Wiley; 1st edition (28 Dec. 2018) 978-1119477242
- 31. LKS Improvement Practice Contacts: Caroline White, Library and Knowledge Service Manager caroline.white15@nhs.net Beth Rawson, Deputy Library and Knowledge Service Manager beth.rawson@nhs.net
Editor's Notes
- CAROLINE – SETTING THE SCENE Very much our journey. We are by no means experts. Abstract written jointly back in early 2020. We’ve had a hiatus during COVID, but definitely picking up again
- CAROLINE – SETTING THE SCENE Very much our journey. We are by no means experts. Abstract written jointly back in early 2020. We’ve had a hiatus during COVID, but definitely picking up again. This is Caroline, Beth, Barrie and Mic. The picture in the middle shows our improvement journey displayed on the corridor. They’re discussing updates.
- Caroline - Notes on Vital Signs – why did the NHS pick this up. An initiative to support providers and systems in removing waste from day-to-day activities. Launched by us in early 2018, Vital Signs supports providers and systems to transform and continuously improve patient safety, quality of care and capacity by removing waste from day-to-day activities. The initiative is now run by our Improvement directorate. It draws on the principles of lean, which aims to optimise processes to remove waste and maximise value for patients through continuous improvement. Vital Signs was created in response to requests from NHS trusts for an affordable lean programme. Developed for the NHS by the NHS, it helps trusts to develop organisation-wide quality improvement expertise, while adapting to their specific circumstances. Cohort 1 The Hillingdon Hospitals NHS Foundation Trust The Dudley Group NHS Foundation Trust Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust East Lancashire Hospitals NHS Trust University Hospitals Plymouth NHS Trust (partnering with Livewell Southwest) Derby Teaching Hospitals NHS Foundation Trust Royal Surrey County Hospital NHS Foundation Trust. We had a Vital Signs Coach – Barrie Humpriss Mic’s connections with Strategy and Improvement – established relationships. He worked in a seconded role within Strategy and Improvement. Team’s interest in improvement, we are constantly trying to improve and we’re united in this.
- Caroline - PRIDE objectives – Putting patients first, right first time, investment in resource, developing our people, ensuring values and partnerships. All of our work relating to IP has been documented as part of the QIOF evidence framework – with the recent submission. IP commitment to the longer term – not quick fix – it is a mind set / culture continuous learning. Not a short term project. Toyota KATA – lean thinking and waste – new staff from S & I came from Toyota. Had that working knowledge. Toyota KATA - Toyota Kata is a way for managers and educators to initiate and coach practice of practical scientific-thinking skills in their teams, to develop and mobilize creative capability. Terminology – difference between QI and IP – from our perspective and experience. QI has been driven more within a clinical context whereas improvement practice is driven more towards supporting administrating processes. QSIR – Quality, service improvement and re-design – Mic QSIR trained and Caroline will be shortly. Mic is part of the QI faculty. QI driven by a clinical lead here at Derby and IP driven by a non-clinical lead. CLs are heavily involved in QI groups within the organisation. Tend to be clinical? Life QI – Quality improvement platform – submit QI projects and track progress. Terminology – maybe it should be badged as Service Improvement which covers both and is driven by one lead? Thoughts?
- On-going cycle of improvement. These are the stages. It takes time, we are learning along the way. Positives – methodical approach, like undertaking an experiment, continuous cycle of experiments and learning. You as a team take ownership which helps to shape the right processes going forward. Reduces waste, maximises efficiencies etc. Negatives – takes time, commitment, change in culture, staff need to be open and be able to positively challenge. We’ve done lots as a team to get into this mind-set. Away days have helped, getting external facilitators in to help us to work together more effectively as a team. This has helped enormously.
- Caroilne - After showing this video; demonstrate a scenario. ILLs C- Why does the ILL process need changing? B – Because the process is not working, everyone is doing different things. C – Why are staff doing different things? B – Because they’ve been trained by different people, each taking a slightly different approach to the task, plus nothing is written down. There’s no consistency. C – Why is nothing written down? B – Because we have no up to date staff manual and nobody has taken responsibility for it. C - Why is there no staff manual? B – The current staff manual is out of date, need someone to write the process and come up with a consensus, so everyone will know what to do. C – Why is a complete process important? B – So that everyone can confidently and consistently follow.
- Beth Coming together as a team and brainstorming Identified problems What does the future look like – true North – identified our long term aim – so we are all heading in the same direction Vision statement
- Beth - 3 groups Idenfified the main issues or problems Then put in to themes Each group wrote a vision statement Came together as a group and fedback. We were sentisitve and mindful of contentious issues. So at the beginning we set some ground rules.
- Beth - As an aside we also looked at income generation – example of an effective chart – after brainstorming ideas you can then plot on the diagram, top right hand corner is easy to introduce with maximum impact. Avoid doing any that sit in the difficult to implement and low in terms of benefits. Chart helps you to visualise and focus on what to prioritise We’ve achieved a number of the above.
- Beth - What’s important – document everything along the way. Helps to demonstrate IP to the wider group.
- Beth - All doing different things Complex procedures
- Beth
- Beth - Always another aspect found as we process map. Don’t be overwhelmed. Focus on one thing at a time
- Beth – In their own time
- Pop your thoughts in the chat? Are different themes emerging?
- Caroline – Demonstrates the scope of waste in its meaning Can everyone resonate with this?
- 6S Model for process improvement It originates from five Japanese words Seiri, Seiton, Seisō, Seiketsu, Shitsuke, which translates as sort, set, shine, standardize, and sustain. In the 6S concept, we add safety as the sixth step, which concentrates on ensuring workplace safety and risk assessment. There is a 6S checklist that you can follow.
- Caroline Sustain bit is the hardest. It’s easy to go back to bad habits.
- Caroline – COVID/PPE and the importance of the clear desk policy. New laptops and docking stations
- Caroline -
- COVID/PPE and the importance of the clear desk policy New laptops and docking stations
- COVID/PPE and the importance of the clear desk policy New laptops and docking stations
- Ground rules.. People take things personally. Classed as work, as important as other aspects of roles
- Personal pledges – work and home
- Other outcomes for the 6S waste group have been identified in other areas of the service. Looking at our dynamic waste board; Financial Knowledge Space – stock room, stationery cupboards Network – shared drive Movement Pollution – bin etiquette, Physical – got rid of surplus items, recycled to other areas Time – CL searches saving time with reference manager/native interfaces – presented at ICLC Time – microwave – cover – saves time cleaning
- Beth Pop them in the the chat? Richard B to support.
- Beth
- Beth
- Beth