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Slides from #EdgeTalks November 2017: Connecting People for Innovation and Collaboration

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Slides from #EdgeTalks November 2017: Connecting People for Innovation and Collaboration

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Slides from #EdgeTalks November 2017: Connecting People for Innovation and Collaboration

  1. 1. FabTeams Week - Connecting people for innovation and collaboration - Claire Haigh, Cath Doman, Boena Zeneli, and Andrew Messina 3rd November,2017
  2. 2. The Team Today Session Chair Janet Wildman @jwildman1 Chat Room and Technical Support Paul Woodley @PaulWoodley4 Twitter Monitor Leigh Kendall @leighakendall Twitter Monitor Rosie Redstone @RosieRedstone
  3. 3. Joining in today and beyond • Please use the chat box to contribute continuously during the web seminar • Please tweet using hashtag #EdgeTalks and the handle @HorizonsNHS
  4. 4. Creating Surprising, simple and social spaces for public service innovation and flourishing Claire Haigh Co-Founder Collaborate Out Loud @HaighClaire #CollabOutLOud @CollabOutLoud #EdgeTalks
  5. 5. Three FabTeam Stories Boena Zeneli High Intensity User (HIU) Project Teams beyond Boundaries Andrew MessinaCath Doman Transfer to Assess - Connecting People for Innovation and Collaboration The Harrogate vanguard
  6. 6. #Quality2017
  7. 7. Where do you currently do most of your team working? A. In a traditional team reporting to one line manager B. In project teams C. In collaborative teams across organisations and systems D. In teams that span formal structures and social networks #CollabOutLOud @CollabOutLoud #EdgeTalks
  8. 8. 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 2/18 3/18 8/18 5/18 In a traditional team reporting to one line manager In project teams In collaborative teams across organisations and systems In teams that span formal structures and social networks Where do you currently do most of your team working? Percentages
  9. 9. Collaborate Out Loud’s Community Manifesto Collaborate Out Loud communities are a democratic community of innovative and generous public service collaborators who work out loud to hack challenges, hatch new thinking, experiment with implementation and prototype and spread impactful new ideas that will enable the changing public services landscape to get further faster and embracing the power of new ideas, collaboration and democracy How we work • In an open and free way where anyone could follow the story • Everything that we develop is open source and free to be used by anyone • We are a group of true collaborators • In a way that successes and failures are equally welcome opportunities to learn • Where the process of collaborating in this new and free way is observed, tested and understood What we do • Serve public services at all levels and places • Work on the challenges that public services are facing in a shared space without the constraints of being within the formal systems and structures • Crowdsource challenges to work on that serve public services in a different and freer space • Actively encourages challenge, new thinking and learning from when things don’t work out as expected • Brings together the unusual suspects, thinking and approaches and allows the magic to unfold • Work with kindness, generosity and inclusivity #CollabOutLOud @CollabOutLoud #EdgeTalks
  10. 10. #CollabOutLOud @CollabOutLoud #EdgeTalks What have we learnt about Fab Teams from the edges Collaborate Out Loud’s Learning So Far…..
  11. 11. Shot-term and project based – come together for a limited time to get something done Borderless– span across organisational, system, and professional Complex - Working on increasingly complex challenges Collaborative - a move towards collaboration rather than partnerships Virtual – geographically spread often over long distances Multi-layered - Individuals are often working across multiple teams at the same time Agile - Need to change shape and direction easily to respond to changing landscape Democratised - they are able to access people, ideas and skills in ways we never could before Technology enabled – they have a loads of tools at their finger tips that help them to connect and be productive Socially powered – need to build social rather than have positional power Self organising - often built around the idea of a community that learns and shares together. Based on shared intent and trust Whole – they encourage people to bring their whole self to the team How are teams changing? #CollabOutLOud @CollabOutLoud #EdgeTalks
  12. 12. We are all about creating surprising, simple and social shared spaces between the formal and informal and this is what we have learnt about teams in these spaces so far…….. • They embrace and harness the energy of difference and the crowd • They create surprising, simple, and social spaces between the formal structures and informal networks • They spend time building a community, trust, and a shared intent where people bring their whole selves • They embrace the principles of transparency, democracy, and openness • They are social, share with generosity and kindness • They work on real and often complex challenges collaboratively • They borrow learning and thinking from anywhere and everywhere to learn collectively • They co-create novel solutions and ideas to tackle their collective challenge • They are able to rapidly test their ides and iterate them together • They work out loud as you go —  attributing their ideas and inspirations • They spread the best ideas (as well as the learning from what didn’t work) What are we learning about teams from the edges? #CollabOutLOud @CollabOutLoud #EdgeTalks
  13. 13. Cath Doman Programme Director – Harrogate Vanguard @cathdoman cath.doman@nhs.net Working on behalf of: Harrogate and Rural District Clinical Commissioning Group, Tees Esk and Wear Valleys NHS FT, Harrogate Borough Council, Yorkshire Health Networak, North Yorkshire County Council, Harrogate and District NHS FT
  14. 14. “Being brave enough to say we haven’t got something right, …is often quite easy to say but hard to do in practice.” Sam Jones
  15. 15. March 2015…
  16. 16. Creating effective teams: the beginning The good:  Integrated care teams  Out of hospital care  Working with GPs  Involving mental health and social care  Skill sharing and role blurring  Dissolving the boundaries  Everyone working happily together The bad:  “Do something different!”  “Integrate!”  Wifi  Inadequate attention to OD  Pressure to deliver too fast: “just do it!” The just plain ugly:  Incontinence corner  General grumpiness  ‘Behaviour’
  17. 17. The journey March ‘15: •‘hey- we’re a Vanguard!’ Feb ‘16 •Pilot starts March ‘16 •Funding reduced Stop and regroup July ’16: new plan Nov ‘16: roll- out across the District Mar ‘17: STOP! Unaffordable
  18. 18. March 2017…
  19. 19. Stop and regroup
  20. 20. March ‘17: the Transformation Board’s challenge • Test something radically different • Create a ‘pop-up’ organisation that feels really different • Focus on preventing avoidable admissions • Practice population focused (3 practices) • True integration • Support and permission
  21. 21. Magic ingredients  Permission  Ground-up design  Protected time  Co-location and sharing the milk  Daily problem-solving  Access to leadership  Daily huddles  Access to systems  Parking  Anxiety management tools
  22. 22. Quality Improvement System: Purposeful and Productive Community Services (PPCS): Daily huddles Leadership team Visual controls Caseload management Cell working Diary manage- ment
  23. 23. GP Living Well Social care Pharmacist Practice manager PMO Team leader
  24. 24. Questions for Cath
  25. 25. High Intensity User (HIU) Project Teams beyond Boundaries Boena Zeneli NEE CCG 03.11.2017
  26. 26. The High Intensity Users (HIU)- Working across boundaries • We identify frequent users of urgent and emergency services, mainly A&E and the ambulance service but also 111, OOH and GPs and use multi-disciplinary team (MDT) approach to agree care/intervention plans • We work with a variety of clinicians including: ambulance service, acute trust, mental health, community services, 111, Out of Hours and GPs as well as non clinical partners including: social care services, voluntary and fire services, police and Borough Councils • We haven't been perfect but through this work we’ve learned a few things that we feel are worth sharing
  27. 27. So how do we work with teams across boundaries and build the team spirit? The Goal: Working with different professionals beyond organisational boundaries to achieve better integration of services, reduce urgent and emergency activities and ultimately provide effective and efficient healthcare for patients as well as enhancing working experience for our team members The How: Understanding the culture, be that organisational or personal is crucial to building the team spirit • Being proactive and tenacious as a leader/PM and – Establishing common aims – Building trust/commitment – Doing, in the timely fashion, what you say you would do – Putting processes in place and showing determination • A lot of: – Communicating – Sharing and learning – Reiterating – Empowering and treating each individual fairly and equally – Informal ambiance for MDT meetings – Flexibility- see, analyse and readjust… • And biscuits and cakes definitely do the trick!
  28. 28. Challenges to how we developed as a Team and achieved our objectives? • The main challenge was to securing meaningful engagement from all providers so that we could work as a team without boundaries and provide integrated healthcare for our patients • The bigger challenge, however, was not implementing the change, it was (and still is) finding and engaging with the right players/champions in order to maintain the team’s effort to continually engage with the process and not accept slippage… • The process of team engagement across boundaries needs to persevere and continuously improve, typically requiring endless pushing/support from a leader/PM • Keeping myself inspired whilst being faced with endless obstacles
  29. 29. How establishing meaningful connections resulted in achieving great success? • By introducing novel methods to communication and engagement we created a culture that has high performance standards and accountability, along with positive relational glue keeping everyone supported and engaged (team members willingly coming to MDTs on their days off) • Success: we have had great engagement across the economy but also we are starting to see engagement from new services. Furthermore, due to the Information Governance limitations, we have established separate non clinical HIU MDT and have an excellent partnership with Borough Councils, Fire/Voluntary services • Success: we have and continue to explore different avenues to empowering patients to take ownership of their health and well-being whilst decreasing their dependency upon unscheduled care services, i.e. home MDTs, fire services home visits • Success: Started to helping others to set up similar way of working collaboratively and across boundaries
  30. 30. What do our team players say about the project… ‘’Without collaborative multi-disciplinary working we cannot expect to deliver patient focused, cost effective services that allow us to maximise resources where they are needed most…’, East of England Regional Clinical Coordinator – Paramedic ‘’…If it stopped I would not have access to provide better quality care for my patients. There would be no integration at all between primary and secondary care and it would be very difficult to support these patients without the MDT approach…’’, GP Practice matron. ‘’We have made a difference to patients who are now not high intensity users due to our regular communication… I do feel that it would negatively impact our patients if the group were to disband’’, Deputy Clinical Director, East of England Out of Hours
  31. 31. Where do we go next? The HIU project enhanced our understanding about managing teams beyond boundaries in achieving common aims and shared purposes. It also showed us that in order to implement and sustain improvement in an integrated and multidisciplinary team environment, team members must understand the objectives and logic of the change and collaborate without boundaries. A lot has been done but we still need to: • Continue with partnership working which is crucial to enabling team members to engage and withstand engagement in implementing changes across boundaries • Continue creating and sustaining a patient focus and cost effective services as well as encouraging a positive working experience for our team members • Encourage and engage with more services to share our experiences, successes and lessons learned and understand and seek to learn from the successes of other teams and organisations
  32. 32. Last thought…
  33. 33. Questions for Beona
  34. 34. Transfer to Assess Connecting People for Innovation and Collaboration Andrew Messina (Programme Lead)
  35. 35.  Through the Stockport Together programme, we’ve introduced Discharge to assess pathways, which we’re calling Transfer to Assess (T2A).  Within the T2A pathways, identified patients are discharged as soon as they are medically well enough to leave hospital. What is Discharge to Assess?  Nationally recognised as best practice for supporting patients who no longer have care needs that can only be met in an acute hospital.  Proven to enable a shorter discharge process of up to 2 weeks, with care packages being put in place directly with the person at home. T2A pathway cuts across multiple organisational/ service boundaries Lack of trust across teams Period of significant change Our challenges
  36. 36. Empower staff to make change happen No blame All views equal Patient journey Problem solving Plan, Do, Study, Act Learning environment
  37. 37. Improvedsystemflow Around 50 people discharged through T2A each month. Care packages reduced by half. Breaking down silos & better relationships. Greater level of trust Champions of change Staff benefits Solution focus
  38. 38. Any questions?
  39. 39. Questions for Andrew
  40. 40. How energised are you to try some of the approaches and tools you have heard about today in your work? A. Very motivated B. A little bit motivated C. Not sure yet D. I still need some convincing #CollabOutLOud @CollabOutLoud #EdgeTalks
  41. 41. 0% 10% 20% 30% 40% 50% 60% 70% 11/17 5/17 0/17 0/17 Very motivated A little bit motivated Not sure yet I still need some convincing How energised are you to try some of the approaches and tools you have heard about today in your work? Percentages

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