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Strategies in Knowledge Transfer


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Strategies in knowledge transfer workshop by Maureen Fallon, Assistant Director, Continuous Service Improvement, Cardiff and Vale University Health Board.

Presented at "Using Research Evidence to Improve Health and Social Care". A NISCHR AHSC Workshop to Explore Strategies in Knowledge Transfer. 6th May 2014 – Cardiff

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Strategies in Knowledge Transfer

  1. 1. Faculty for Quality Improvement Cardiff & Vale UHB and Cardiff University Maureen Fallon
  2. 2. Background: • A joint venture between Cardiff University and the Cardiff and Vale UHB • Critical mass of clinical and academic staff working together – the most research active site in Wales • Bedside to Bench and Bench to Bedside (education, training and CPD) • Currently ‘virtual’ and working to a physical site in 2014/15
  3. 3. Why set up the Faculty? • Share good practice • Support • Signpost • Success
  4. 4. Faculty For Quality Improvement- what is it? Established in 2011 the ambition for the Faculty is: “to play a major role in fostering a quality improvement and innovation culture by creating a dynamic environment where excellence comes as standard” Key to the Faculty’s success is harnessing the tremendous potential and energy of our staff; particularly by engaging, encouraging and empowering them. As a result, the Faculty embraces everyone, whatever their role, on the basis that every member’s contribution is essential to care quality.
  5. 5. Faculty aims: 1. Increase the quality, reliability and effectiveness of care (Best Care) 2. Develop a culture of 'continuous improvement' through developing a programme to support capacity and capability in healthcare improvement methodology and delivery at the coal face and in the educational settings (Best Place to Work) 3. Build and maximise collaborative relationships with partnership organisations that seek to advance and promote innovations in promoting and delivering health care (Best Health) 4. Add value and improve efficiency by focussing efforts that tackle Harm, Waste and Variation (Best Value) Eliminate harm, variation and waste Develop a culture of continuous improvement and capacity building Increase quality reliability and effectiveness of care Collaborative and partnership relationships, to advance and promote innovation Best for Patients & Citizens Best health Best care Best value Best place to work Adapted from AQuA Alliance 2010
  6. 6. Secondary DriversPrimary DriversAim & Measures Aim To establish a framework to motivate and build with, enthusiasm and drive for delivering high quality care across the UHB Measures By March 2016 Be recognised as an International centre of excellence Delivery of 1000 Lives+, AQF and intelligent targets Develop and support 100 Improvement Advisers (IQT Silver Practitioners) Develop and support 1000 Improvement Practitioners (OD Programme; LQI; Yellow Belt; RCN leadership programme Implement real-time business intelligence to capture quality outcomes, efficiencies and financial savings Best Health Collaborative and partnership relationships, to advance and promote innovation Establish strategic alliances and partnerships with Cardiff University Health Care Related Schools and other external influential organisations Work with the Welsh Public Health UKCRC to tackle the underlying determinants of poor physical and mental health Build on the work of Magic & Expert Patient initiatives to incorporate shared decision making as part of the UHB’s Strategy Establish clinical and governance dashboards Build on the work of the Pt Experience Team to incorporate signposting of services & capture outcomes of Exec Walkrounds & HCS Promotion of a culture of improvement that has the patient/citizen at its centre e.g. Transforming Theatres, ERAS and the Patient flow collaborative Best Care Increase quality reliability and effectiveness of care Best Place Culture of quality improvement: Can Do Establish faculty expertise across the key themes of improvement, education & management Delivery of core curriculum to support quality improvement via OD/ IQT training & Breakfast club and web-ex methods Develop positive staff engagement activities: Chairman’s Award; competitions & ATP Establish a business intelligence for real time information and measurement systems Working with the SPN collaborative develop a quality cost matrix to pinpoint savings Improved performance against productivity benchmarks: CHKS, WAMI & Intelligent Targets Best Value Eliminate harm, variation and waste
  7. 7. Creating the Conditions Build Infrastructure & Capacity Formal programmes of QI education Embed QI into all development work e.g. leadership and management development Enabling people to lead improvement in their daily work processes •Tools, techniques, support “Data is our vision - we must learn from it” • Real time measurement and Information systems Shaping the Culture: • Will and commitment • Quality reinforced at every level by behaviour, action and communication • Patient/Family/Carer centredness at all times
  8. 8. Creating the conditions: •Academic •Clinical •Research •Partnerships •Networks •Training/education •Bench to Bedside •Culture - 2 jobs • Celebration • Recognition • Dissemination Growth Capacity ExpertiseCapability
  9. 9. Our Journey So Far….. Awareness •Safer Patient Initiative •Change & Innovation Plan •Faculty for Quality Improvement Education •Learning from 1000 Lives+, Qulturum, Tayside and the IHI •Links to Harmonisation; C21 and HEI programmes •Improvement experts and practitioners training – LQI/IQT •Board Effectiveness Development Programme CSI • Lean and Rapid Improvement work • Real time data and measurement for improvement Redesign •Improvement as a Systems Property •Triple Aim – Excellence at a lower cost per capita •Co-production / Prudent Healthcare Movement • Task force •System Infrastructure - IQT and LIPS •Creating Breakthrough and Leverage Scaling Up •Public Health •Working with Communities • Clinical innovation centre 2010 2012 2016 and Beyond
  10. 10. Faculty outputs – improvement and innovation in action
  11. 11. Faculty outputs in action (clinical training) Academic NHS Research New Instruments Smoke remover surgical innovation Further development of surgical skills Advancing clinical practice Centre of excellence Education/ QI Post Graduate Skilled workforce Training Spin-out opportunities New model of training Innovation/ CSI Simulation Reduce Harm, Waste and Variation Shared Purpose Medicentre – shared facility Collision Space - Faculty Cedar – shared facility Collision Space - Faculty
  12. 12. Will NCEPOD Report ‘ Caring to the End’ (2009) highlighted that poor communication between teams at handover contributed towards 13.5% of adverse outcomes in Acute Hospitals.
  13. 13. Innovation Ollie Tan Rob
  14. 14. Delivery ~ what we Did • 13th Aug – 15th Sept e-learning package • 17th Sept – 4th Nov e-handover training Support- HANDS ON) • …….PDSA……. Feedback from Junior Doctors 5th Nov……….Software updated
  15. 15. Engagement…….Enduring E SpRs/Jnrs Post Graduate Dept Directorate Mgt Team IM&T Clinical & MGT Lead Medical Director SNPs
  16. 16. e- Handover – screen shot
  17. 17. Sustainability UHL UHW 0 20 40 60 80 100 120 140 1 3 5 7 9 11 13 15 17 19 21 number of requests requests on w/e& BH 0 20 40 60 80 100 120 140 160 1 3 5 7 9 11 13 15 17 19 21 number of requests requests on w/e& BH Mean: 88/week; 70 at w/ends Mean: 94/week; 68 at w/ends
  18. 18. Spread I am moving to Surgery next month....I can’t believe that they don’t use e- handover………what can we do? F2 - Catherine Emma F1 – Medical Assessment Unit Why can’t we use e-handover…… would be much safer and easier to keep a track on patients - Emergency Unit - Paediatrics - Surgery Visit by Cwm Taf…………..
  19. 19. Standard map. Service nodes in blue, demand nodes in yellow.
  20. 20. Heat map showing demand density. Service nodes in blue. Demand nodes on gradated red (high) – green (low) scale.
  21. 21. In closing 1928: Pencillum discovered by Fleming 1939: Chain and Florey took an interest……..Penicillin 1940’s: Heatley got involved………….. 1945: Nobel Prize for Medicine Without Fleming, no innovation; without Chain and Florey, no testing, without Heatley, no wide scale use of penicillin
  22. 22. …but really, we all know it takes more than tools to make real change happen! And finally……….if you always do………..