CAHPO 2016. Workshop 3: Jennifer French and Julia BrantonNHS England
Chief Allied Health Professions Officer’s Conference 2016
Workshop 3: Integrated Care – Chair Lindsey Hughes
Trust wide, Top down and Bottom Up Quality Improvement
AHP Collaboration in Acute Mental Health Care. East London NHS Foundation Trust: Jennifer French, Head of Arts Therapies in Tower Hamlets & Quality Improvement Coach, Brenda Naso, Dance Movement Psychotherapist, Julia Branton, Occupational Therapist and Stephen Sandford, Strategic Lead & Professional Head of Arts Therapies
CAHPO 2016. Workshop 3: Jennifer French and Julia BrantonNHS England
Chief Allied Health Professions Officer’s Conference 2016
Workshop 3: Integrated Care – Chair Lindsey Hughes
Trust wide, Top down and Bottom Up Quality Improvement
AHP Collaboration in Acute Mental Health Care. East London NHS Foundation Trust: Jennifer French, Head of Arts Therapies in Tower Hamlets & Quality Improvement Coach, Brenda Naso, Dance Movement Psychotherapist, Julia Branton, Occupational Therapist and Stephen Sandford, Strategic Lead & Professional Head of Arts Therapies
This is a summary of all of the QI projects reported by KDHE staff in 2019. For questions about projects, please contact the team leader or other team members listed for the project.
Jo Partington, AHP Lead at the Department of Health, Transforming Community Services, addresses AHP Leadership Challenges, Referral to Treatment Project, Service Improvement Project and Transforming Community Services. COT Annual Conference 2010 (22-25 June 2010)
Extended Primary Care Access in Southwark Nuffield Trust
Dr Lauren Parry, Improving Health; Rebecca Dallmeyer, Quay Health Solutions and Hayley Sloan, NHS Southwark CCG present on their Extended Primary Care Access programme.
University of Utah Health Exceptional Value Annual Report 2013University of Utah
Every year the Exceptional Value Annual Report documents the performance of University of Utah Health on all 45 of the key initiatives identified in the organization's Operational Plan. Focused on value-driven outcomes (quality, service and cost), our successes are celebrated and failures are reviewed for learning opportunities.
Dynamiser le développement économique agricole localYvonnick Huet
Dans le cadre de sa politique de développement local, l’agence MASEN soutient depuis 2014 un projet d’appui aux activités économiques locales portées par les familles de la Commune de Ghassate.
Cette commune héberge le 1er complexe énergétique solaire de MASEN (Province de Ouarzazate).
Agrisud et ses partenaires (ORMAVO et Fondation Norsys) opérationnalisent cette action et ont présenté à la COP22, au cours d'un side-event organisé par MASEN, la stratégie mise en œuvre et les résultats.
This is a summary of all of the QI projects reported by KDHE staff in 2019. For questions about projects, please contact the team leader or other team members listed for the project.
Jo Partington, AHP Lead at the Department of Health, Transforming Community Services, addresses AHP Leadership Challenges, Referral to Treatment Project, Service Improvement Project and Transforming Community Services. COT Annual Conference 2010 (22-25 June 2010)
Extended Primary Care Access in Southwark Nuffield Trust
Dr Lauren Parry, Improving Health; Rebecca Dallmeyer, Quay Health Solutions and Hayley Sloan, NHS Southwark CCG present on their Extended Primary Care Access programme.
University of Utah Health Exceptional Value Annual Report 2013University of Utah
Every year the Exceptional Value Annual Report documents the performance of University of Utah Health on all 45 of the key initiatives identified in the organization's Operational Plan. Focused on value-driven outcomes (quality, service and cost), our successes are celebrated and failures are reviewed for learning opportunities.
Dynamiser le développement économique agricole localYvonnick Huet
Dans le cadre de sa politique de développement local, l’agence MASEN soutient depuis 2014 un projet d’appui aux activités économiques locales portées par les familles de la Commune de Ghassate.
Cette commune héberge le 1er complexe énergétique solaire de MASEN (Province de Ouarzazate).
Agrisud et ses partenaires (ORMAVO et Fondation Norsys) opérationnalisent cette action et ont présenté à la COP22, au cours d'un side-event organisé par MASEN, la stratégie mise en œuvre et les résultats.
RPAS related privacy and data protection: practical advice for RPAS usersTrilateral Research
Rachel Finn of Trilateral Research Ltd, London, presents practical advice for RPAS users about related privacy and data protection issues at the RPAS CivOps 2016 in Brussels.
E.S.T. No. 1 "MIGUEL LERDO DE TEJADA" Ceremonia Civica 28 de Septiembre de 2015VJ Medina Ortiz
Ceremonia Civica E.S.T. No. 1 "MIGUEL LERDO DE TEJADA" con el tema "Día Internacional de la no violencia" a cargo de la Profra. Lucia López Peza, el valor de la semana es el Respeto.
New Methods in Automated XSS Detection & Dynamic Exploit CreationKen Belva
This slide deck consists of three presentations showing both an overall and detailed view of the new patent pending methods to make Cross-Site Scripting (XSS) detection more accurate and faster as well as the creation of dynamic exploits. It was presented at OWASP AppSecUSA 2015. All Material and Methods Patent Pending Globally. All Rights Reserved.
Please visit: http://xssWarrior.com
The slides from the ELFT QI open morning on 23 December 2015 - suitable for those wanting to learn more about the approach to quality improvement at East London NHS Foundation Trust
Engaging staff and service users to partner in Quality ImprovementAmar Shah
Slides from the session at the International Forum on Quality and Safety in Healthcare (Gothenburg - April 2016) - Engaging staff and service users to partner in quality improvement
iHV regional conference: Josephine Johnson - Health Visitors as leaders in th...Julie Cooper
Presentation by Josephine Johnson at the Institute of Health Visiting Regional Professional Conferences 2015 - on behalf of Sabrina Fuller, Head of Health Improvement NHS England.
Josephine Johnson is Project Lead, NHS England.
The 2015 NHS Sustainability Campaign Kicked off on Thursday 15th October in Leeds as the NHS Employers new conference centre, Horizons Leeds played host.
Delegates were treated to a packed day of speeches, presentations and case studies from the likes of Rick Walker, Corporate Social Responsibility Senior Manager, NHS England; Steven Weeks, Policy Manager, NHS Employers; Alexis Keech, Environmental & Sustainability Manager, Yorkshire Ambulance Service and Claire Igoe, Sustainability & Energy Manager at Central Manchester University Hospitals NHS Foundation Trust.
We also had a fantastic range of Industry partners involved in the day, and delegates listened to Dr. Tim Finnigan, Director of R&D, Quorn Foods; Jeanette Hinds, HR Business Partner, Carillion; Sian McCart, ADSM and Emma Wood, Sustainability Manager at PHS Group.
The next road show will be on Thursday 13th November at the Liner Hotel, Liverpool
Making Seven Day Services a reality, pop up uni, 2 pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Commissioning for outcomes,
Wednesday 21 January 2015 - 13.00 to 13.45
Hosted by Bob Ricketts CBE, Director of Commissioning Support Services and Market Development for NHS England.
Anticipatory Care Planning: Time To Make It Happen - Early Intervention Using The Life curve Dr Sarah Mitchell (Programme Manager - AHP National Delivery Plan)
iHV regional conference: Josephine Johnson - Health Visitors as leaders in th...Julie Cooper
Presentation by Josephine Johnson at the Institute of Health Visiting Regional Professional Conferences 2015.
Josephine Johnson is Project Lead at NHS England.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
2. Mental health services
Newham, Tower Hamlets, City & Hackney, Luton & Bedford
Forensic services
All above & Waltham Forest, Redbridge, Barking & Dagenham,
Havering
Child & Adolescent services, including tier 4 inpatient
service
Regional Mother & Baby unit
Community health services
Newham
Urgent care centre
Newham
IAPT
Newham, Richmond and Luton
Speech & Language
Barnet
5. The strategic case for change
Make quality our
absolute priority
• Improving
quality of care
is our core
purpose
• Of greatest
importance to
all our
stakeholders
• Build on the
excellent work
already
happening to
improve quality
National drivers
• The need to
focus on a
more
compassionate,
caring service
with patients
first and
foremost
• More
structured and
bottom-up
approach to
improvement
Enable our staff
to lead change
• The desire to
engage, free
and support
our staff to
innovate and
drive change
• Engaged and
motivated staff
leads to
improved
patient
outcomes
The economic
climate
• The need to do
more with less
– improving
quality whilst
reducing cost
@ELFT_QI
6. The culture we want to nurture
A listening and learning
organisation
Empowering staff to
drive improvement
Increasing transparency
and openness
Re-balancing quality
control, assurance and
improvement
Patients, carers
and families at
the heart of all
we do
@ELFT_QI
8. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build the
will
Build
improvement
capability
Alignment
QI Projects
1. Launch event & roadshows
2. Microsite
3. Using the power of narrative
4. Celebrate successes
5. Network of champions / ambassadors
6. Learning events
1. Initial assessment of alignment & capability
2. Recruiting central QI team
3. Online training
4. Face-to-face training
5. Follow-up coaching on projects
6. Develop in-house training for 2016 onwards
1. Align all projects with improvement aims
2. Align team / service goals with improvement aims
3. Align all corporate and support systems
4. Patient and carer involvement in all improvement
work
5. Embed improvement within management structures
Reducing Harm by 30% every year
1. Reduce harm from inpatient violence
2. Reduce harm from falls
3. Reduce harm from pressure ulcers
4. Reduce harm from medication errors
5. Reduce harm from restraints
Right care, right place, right time
1. Improving patient and carer experience
2. Reliable delivery of evidence-based care
3. Reducing delays and inefficiencies in the system
4. Improving access to care at the right location
@ELFT_QI
9. STARTING TO BUILD THE WILL
• The events led the trust to question
whether it had the right processes in
place to deliver quality care
• Robust assurance
• Staff and patient experience feedback not
very good
• Arrival of MD from NPSA who made a
case for more co-ordinated and systemic
trust wide approach.
10. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build the
will
QI microsite the online
hub for the
programme
qi.eastlondon.nhs.uk
Staff and service
user newsletter
reaches 4000
people every
month
QI launch event and roadshows
attended by over 1000 staff,
service users and carers
Bespoke QI learning
events for staff, service
users, commissioners,
governors
@ELFT_QI
12. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build
the will
35,000page views of the QI microsite in the last year
our one-stop shop for QI
built and managed by
the QI team, total cost
£300
qi.elft.nhs.uk
16. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build
the will
1,000Staff, service users, carers, Governors,
commissioners engaged in the first 4 months of
the programme
17. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build
the will
Bespoke learning sessions
Specialist
services
leadership
Service users
and carers
Finance team
Health visitors
Nursing
students
Band 3 nursing
staff
Psychology
trainees
Trainee
doctors
External
partners
22. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build
the will
550local services receiving the quarterly paper
newsletter, including GP practices and voluntary
sector organisations
23. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build
the will
6projects shortlisted
for regional or
national awards
1regional award
7projects being
written up for
publication with BMJ
6teams presenting
their work to the Trust
board each year
24. 1. How would you rate the will to undertake a QI
programme in your organisation?
2. What are the barriers stopping you from
undertaking this work?
3. In light of what you heard today, will you be
doing anything differently in order to make a
case for change?
Building the Will
Table Discussion
25. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020 Build
improvement
capability
Face to face improvement training
- hundreds of staff, services users,
Governors to be trained over the
next few years
Support for
improvement work from
the Trust’s QI team
IHI Open School
available to all
Strategic
partnership
with IHI
Board
sessions
@ELFT_QI
26. Experts
Front line staff
Clinical leaders
Directorate
improvement
leads
Board
Estimated number = 3300
Requirement = introduction to quality
improvement, identifying problems,
change ideas, testing and measuring
change
Time-frame = train 10-20% in 2 years
Estimated number = 250
Requirement = deeper understanding
of improvement methodology,
measurement and using data, leading
teams in QI
Time-frame = train 30-50% in 2 years
Estimated number = 30
Requirement = deeper understanding
of improvement methodology,
understanding variation, coaching
teams and individuals
Time-frame = train 100% in 2 years
Estimated number = 10
Requirement = setting direction and
big goals, executive leadership,
oversight of improvement, being a
champion, understanding variation to
lead
Time-frame = train 100% in 2 years
Estimated number = 5
Requirement = deep statistical process
control, deep improvement methods,
effective plans for implementation &
spread
Time-frame = train 100% in 2 years
Where are we?
On track to train over 500
people through 5 six-month
waves of learning between
2014-16. First 3 waves
delivered with the IHI
On track. All senior staff
being encouraged to join QI
training over next 2 years
New need recognised.
Developing improvement
coaches programme will train
30 QI coaches in 2015
On track. Most Executives
will have undertaken the
ISIA, and Board training has
been delivered in 2015.
Currently have 3
improvement advisors, with
1.5wte deployed to QI.
Will need to build more
capacity at this level.
30. Coaching teams from the very start
Success
Form a team
Agree the
quality issue
to be tackled
Ensure
patient (and
carer)
involvement
Find time to
meet
@ELFT_QI
31. Prework
Workshop
9/29-10/1
Webex 1
10/14
Webex 2
11/2
Supports:
• Listserve
• Assignments
AP-1 AP-2
Webex 3
11/30
AP-3
Project
Planning
Reliability
Sustaining
Gains
Workshop
(3 days)
Webex #2Webex #1
• Faculty consults
• Webex calls
• Coaching calls
Webex #3 Learning Set
2 &
graduation
AP-5AP-4
The two learning sets will be focused on sharing the participants’ work on their
projects and learning from each other. These sessions also will reinforce the
content from the Webex calls and the ISIA workshop.
Learning
set 1
@ELFT_QI
Learning and coaching over 6 months
32. 1. What improvement capability exists in your
organisation?
2. How could you shuffle existing resources to create
some capacity to start improvement work?
3. How would you build a business case and convince
your leadership team about the need to invest in
building capability and capacity for improvement?
Building Capability
Table Discussion
36. 1. What would you have to change to produce
alignment in your organisation?
2. How do you look at data, and talk about
improvement and safety at every level?
3. What can you change, stop or review to create
space for improvement? What are the structures
in place to support improvement?
Alignment
Table Discussion
44. Right Care, Right
Place, Right Time
TH Collaborative
Roman, Globe, Bricklane, Lea,
Millharbour, Rosebank
MHCOP
Larch Lodge, Cedar Lodge,
Sally Sherman Ward
CHN
EPCS Teams (North East,
North West, Central, South)
Multiple I/P Wards
C&H
Rehab, AOS, Connolly, Bevan
Newham
Multiple I/P wards
Newham
Psychology
MHCOP
Training Lodge
Children’s
CDC x2
CAMHS x3
MHCOP
Memory Service
C&H
All CMHTS
Forensics
Clerkenwell
REDUCE HARM
BY 30% EVERY
YEAR
RIGHT CARE,
RIGHT PLACE,
RIGHT TIME
VIOLENCE
REDUCTION
PHYSICAL
HEALTH
ACCESS
PRESSURE
ULCERS
@ELFT_QI
49. Buildingwill
Build a broad
coalition for
change
Take time to
bring people
with you
Shift decision-
making to the
edge
Develop a
compelling
narrative
Find some
clear signals
of change
Use the power
of stories
Take every
opportunity to
celebrate
51. Alignment&integration
Start at the top
Create a
support
structure
Build a learning
system
Ensure patients
and carers are
integral
Ensure the
context is ripe
Line of sight
from team to
system goals
