SDN conference Cologne 2012
Better Health Services by Design | Using service design to innovate in healthcare
Copyright, NHS Institute for innovation and Improvement
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Better Health Services by Design
1. Better health
services by design
Using service design
to innovate healthcare
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
2. The National
Health Service
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
3. 1 million patients use
the NHS every 36 hours
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
4. 1 million patients use
the NHS every 36 hours
466 people a minute
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
5. One but many
1,431,996 NHS employees
£102 billion spend 2010/11
£35 billion in 1997
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
8. Medical advances 1948 2008
Maternity hospital stay 13.5 days 1.9 days
Operations 5,514 49,500
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
9. • From re-active to Being an NHS patient is still
pro-active too often a frustrating
• Wider system experience. We ought to
innovation move towards becoming a
more patient-led NHS
Healthcare Commission, 2005
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
10. NHS productivity challenge
£126 billion needed by 2014
Actual funding likely to be frozen
in real terms at around £105 billion
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
11. £21 billion funding gap
We need to save £90
million a day
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
12. Innovation in the
NHS has become
business critical.
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
14. What we do
We support the NHS to
transform healthcare for
patients and the public
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
18. A proven and transferable
problem-solving methodology.
It’s not ‘design a car’ but
‘design for personal mobility’
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
19. Combined with
Lean thinking
Six Sigma
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
20. How we work
Co-creative: with not for
Learning from observation
Diverging & converging
Iterative by prototyping
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
21. What I hear I forget
What I see I remember
What I do I understand
Lao Tse
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
22. Role playing a new
portering service
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
23. Design to
Improve patient experience
Improve staff experience
Increase work productivity
Design out wasteful activities
Increase patient facing time
Inspire insights & innovative services ideas
Build internal capabilities inside the NHS
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
25. An design methodology
About using patient and staff
experience to gain insights and
identifying opportunities for
improvement
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
26. Equip people with the right skills
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
29. Opportunity areas
Onset of the condition | An increased focus on self-
management tools and self-referral
Post-diagnosis | A greater emphasis on learning and
counseling services for the family
Crisis situations | Fast access to specialist advice
Post-crisis situations | A good opportunity to
introduce future planning
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
30. The result
ENABLE | A joined-up community
service for people with long term
neurological conditions
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
32. NHS Institute
Productive work
Early scoping
General Practice
Productive General Practice
Output from innovation cycle
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
33. Using a design & lean thinking
identify opportunities for
improvement in GP surgeries.
Releasing time to deliver better
services to patients
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
34. What we did
• Practice audit, collecting measures
• Observational visits to 11 GP practices
• Contextual interviews - patient & staff
shadowing and activity follows
• 2 national and 10 local collaborative
workshops
• Towards a nationwide programme that
helps GP surgeries improve themselves
44. Specifically
• Access to health services
• Patient information
• Demand vs. capacity
• Wasteful admin processes & prescriptions
• Appointments
• Primary and Secondary care interaction
• Understanding the patient journey
• Embracing a service culture at reception
45. Impact
• Supporting doctors in their prescribing
decisions – as a result there were more
appropriate patient prescriptions
• Improved prescribing effectiveness
• The right referrals at the right time
• Increased joined-up care
• Decreased level of complaints
• Improved patient experience
• Improved work/life balance
• Reduced administration & duplication of work
• Increased levels of self care
46. Build capability
in GP practices
www.institute.nhs.uk | Assisting the NHS in transforming healthcare
47. PGP programme
Improvement tools
27 case studies
E-learning
Coaching support
www.institute.nhs.uk | Assisting the NHS in transforming healthcare