Slides from the session at the International Forum on Quality and Safety in Healthcare (Gothenburg) - Setting up an organisation-wide quality improvement programme
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
These are the slides for Module 4 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system.
Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff.
There is also a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources.
Programme
The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT
Friday 31 January 2014: Being a health and care radical: change starts with me
Friday 7 February 2014: Forming communities: building alliances for change
Friday 14 February 2014: Rolling with resistance
Friday 21 February 2014: Making change happen
Friday 28 February 2014: Moving beyond the edge
Tweetchat
We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are:
12 February 2014
19 February 2014
26 February 2014
5 March 2014
There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS
Resources from all modules can be found at: http://www.nhsiq.nhs.uk/9059.aspx
Introduction to Lean Principles
Planning of your work processes to improve flow
Amy Hodgkinson and Trevor Taylor
National Improvement Leads, NHS IQ
Presentation from the Productive Endoscopy Workshop, Tuesday 15th October 2013 at Ambassadors Bloomsbury , London, WC1H 0HX
This meeting brought together teams from around the country, and embarked on creating and testing the productive endoscopy toolkit. The aim of the day is to allow time with your team for sharing of experiences and exchange of good practice, learn how to apply lean techniques and hear the impact of successfully implemented case studies.
This is the presentation that Goran Henriks and Helen Bevan made at the International Forum on Quality and Safety in Healthcare, 23rd April 2015.
Follow us on Twitter:
@HelenBevan
@GoranHenriks
Here is the full report of the NHS Change Model hack event, which took place on Wednesday, 14 October 2015.
There has never been a better time to really scrutinise the way we go about change in health and care. There is a growing body of evidence and practical know-how behind effective and successful change and we must make sure that our change efforts are designed to take full account of the evidence based and lessons learned.
The NHS Change Model has been one of the leading models of change used in the NHS over the past couple of years. We know that some improvement leaders would not be without it and use the model extensively, to underpin and structure all their change activities. We also recognise that there are some change leaders that are not so keen on the NHS Change Model. They have found it hard to apply the model in a practical and useful way and there are others who think that it should be broadened out from just being an NHS-specific model.
The way we lead change must always adapt and evolve with the times and as such, we feel it is timely and opportune to review and revise the NHS Change Model. Our starting point is hearing and understanding exactly what the people leading change in health and care say they need to support them. We want to use methods that fly in the face of tradition and open up new, exciting and creative opportunities.
We organised a hack day for about 80 selected people that brought diverse and wide-ranging perspectives to the table. Hack events have traditionally been associated with technology and programming to solve problems, but we are adapting the concept and applying the same principles to ‘hack’ the NHS Change Model, in just one day. You don’t need any techie skills, just insight, ideas and energy to work with others to think deeply about change and collaborate over how we could do it better.
On the day, we:
Reviewed how change currently happens in health and care and what people leading change need to support them
Reviewed the NHS Change Model
Designed a proof of concept to support and enable change across health and care
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
These are the slides for Module 4 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system.
Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff.
There is also a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources.
Programme
The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT
Friday 31 January 2014: Being a health and care radical: change starts with me
Friday 7 February 2014: Forming communities: building alliances for change
Friday 14 February 2014: Rolling with resistance
Friday 21 February 2014: Making change happen
Friday 28 February 2014: Moving beyond the edge
Tweetchat
We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are:
12 February 2014
19 February 2014
26 February 2014
5 March 2014
There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS
Resources from all modules can be found at: http://www.nhsiq.nhs.uk/9059.aspx
Introduction to Lean Principles
Planning of your work processes to improve flow
Amy Hodgkinson and Trevor Taylor
National Improvement Leads, NHS IQ
Presentation from the Productive Endoscopy Workshop, Tuesday 15th October 2013 at Ambassadors Bloomsbury , London, WC1H 0HX
This meeting brought together teams from around the country, and embarked on creating and testing the productive endoscopy toolkit. The aim of the day is to allow time with your team for sharing of experiences and exchange of good practice, learn how to apply lean techniques and hear the impact of successfully implemented case studies.
This is the presentation that Goran Henriks and Helen Bevan made at the International Forum on Quality and Safety in Healthcare, 23rd April 2015.
Follow us on Twitter:
@HelenBevan
@GoranHenriks
Here is the full report of the NHS Change Model hack event, which took place on Wednesday, 14 October 2015.
There has never been a better time to really scrutinise the way we go about change in health and care. There is a growing body of evidence and practical know-how behind effective and successful change and we must make sure that our change efforts are designed to take full account of the evidence based and lessons learned.
The NHS Change Model has been one of the leading models of change used in the NHS over the past couple of years. We know that some improvement leaders would not be without it and use the model extensively, to underpin and structure all their change activities. We also recognise that there are some change leaders that are not so keen on the NHS Change Model. They have found it hard to apply the model in a practical and useful way and there are others who think that it should be broadened out from just being an NHS-specific model.
The way we lead change must always adapt and evolve with the times and as such, we feel it is timely and opportune to review and revise the NHS Change Model. Our starting point is hearing and understanding exactly what the people leading change in health and care say they need to support them. We want to use methods that fly in the face of tradition and open up new, exciting and creative opportunities.
We organised a hack day for about 80 selected people that brought diverse and wide-ranging perspectives to the table. Hack events have traditionally been associated with technology and programming to solve problems, but we are adapting the concept and applying the same principles to ‘hack’ the NHS Change Model, in just one day. You don’t need any techie skills, just insight, ideas and energy to work with others to think deeply about change and collaborate over how we could do it better.
On the day, we:
Reviewed how change currently happens in health and care and what people leading change need to support them
Reviewed the NHS Change Model
Designed a proof of concept to support and enable change across health and care
Leading Large Scale Change: A Practical Guide - Part 1
What the NHS Academy for Large Scale Change learnt and how you can apply these principles within your own
health and healthcare setting
Written by:
Helen Bevan
Paul Plsek
Lynne Winstanley
On behalf of the
NHS Academy for Large Scale Change
Helen Bevan presents to Kaiser Permanente’s Innovation Leadership NetworkNHS Improving Quality
Helen Bevan's presentation to members of Kaiser Permanente’s Innovation Leadership Network on Friday 4 October 2013 about NHS Change Day.
In 2013, the first NHS Change Day brought together thousands of NHS staff from across clinical and non-clinical areas of work, in a single day of collective action to improve care for patients, their families and their carers. More than 189,000 online pledges of action were made to make a positive difference to the NHS, proving that large scale improvement is possible in the NHS.
Edge Talks November 2016: Fixing Patient FlowNHS Horizons
Identifying the needs of any given population and creating the capacity to manage is increasingly challenging. The origins of today’s problems can be traced back to a failure to recognise the pace of change and to respond quickly enough with new ideas and processes. Creating a clear understanding of what is happening provides a basis for measuring the effectiveness of innovation and transformation.
In November’s #EdgeTalks Sasha Karakusevic, Horizons’ Project Director will offer an overview of hissasha Nuffield publication ‘Understanding patient flow in hospitals’, and a reflection on the use of data to drive change in complex systems. Sasha started his career in dentistry and maxillofacial surgery. Early in his career he became very interested in service improvement and health system design, focusing on the systems and processes that drive innovation and improvement. He has extensive interest and experience gained nationally and internationally in using information to drive improvement and make health systems work better”
This session is a must for anyone working in, or interested in health and social care. Participants will learn how to use data to better understand patient flow, manage demand – and engage people in translating data in to a meaningful narrative to drive transformation ‘on the ground’.
How to build a high performance, high energy teamHelen Bevan
Slides from the workshop that Helen Bevan facilitated at the International Forum on Quality and Safety in Healthcare, Kuala Lumpur, 24th August 2017. #Quality2017
Accelerating primary care transformation. Commissioning Live, Birmingham 2015Robert Varnam Coaching
What changes are needed to assure primary care has a productive future at the heart of the NHS? What capabilities will be required by GP practices to transform services and their organisations? How can CCGs support provider development to ensure their population can access high quality innovative care in the communuty?
Improving quality, safety and lives - the Patient Safety Collaborative Programme 2014-2019
Presentation from Chief Nursing Officer for England's Summit 2014
26 November 2014
Leading Large Scale Change: A Practical Guide - Part 1
What the NHS Academy for Large Scale Change learnt and how you can apply these principles within your own
health and healthcare setting
Written by:
Helen Bevan
Paul Plsek
Lynne Winstanley
On behalf of the
NHS Academy for Large Scale Change
Helen Bevan presents to Kaiser Permanente’s Innovation Leadership NetworkNHS Improving Quality
Helen Bevan's presentation to members of Kaiser Permanente’s Innovation Leadership Network on Friday 4 October 2013 about NHS Change Day.
In 2013, the first NHS Change Day brought together thousands of NHS staff from across clinical and non-clinical areas of work, in a single day of collective action to improve care for patients, their families and their carers. More than 189,000 online pledges of action were made to make a positive difference to the NHS, proving that large scale improvement is possible in the NHS.
Edge Talks November 2016: Fixing Patient FlowNHS Horizons
Identifying the needs of any given population and creating the capacity to manage is increasingly challenging. The origins of today’s problems can be traced back to a failure to recognise the pace of change and to respond quickly enough with new ideas and processes. Creating a clear understanding of what is happening provides a basis for measuring the effectiveness of innovation and transformation.
In November’s #EdgeTalks Sasha Karakusevic, Horizons’ Project Director will offer an overview of hissasha Nuffield publication ‘Understanding patient flow in hospitals’, and a reflection on the use of data to drive change in complex systems. Sasha started his career in dentistry and maxillofacial surgery. Early in his career he became very interested in service improvement and health system design, focusing on the systems and processes that drive innovation and improvement. He has extensive interest and experience gained nationally and internationally in using information to drive improvement and make health systems work better”
This session is a must for anyone working in, or interested in health and social care. Participants will learn how to use data to better understand patient flow, manage demand – and engage people in translating data in to a meaningful narrative to drive transformation ‘on the ground’.
How to build a high performance, high energy teamHelen Bevan
Slides from the workshop that Helen Bevan facilitated at the International Forum on Quality and Safety in Healthcare, Kuala Lumpur, 24th August 2017. #Quality2017
Accelerating primary care transformation. Commissioning Live, Birmingham 2015Robert Varnam Coaching
What changes are needed to assure primary care has a productive future at the heart of the NHS? What capabilities will be required by GP practices to transform services and their organisations? How can CCGs support provider development to ensure their population can access high quality innovative care in the communuty?
Improving quality, safety and lives - the Patient Safety Collaborative Programme 2014-2019
Presentation from Chief Nursing Officer for England's Summit 2014
26 November 2014
7 Day Services webinar - Workforce and delivering 7 day servicesNHS England
This webinar explores how use of enhanced roles can help Trusts in the delivery of seven day services, and aims to help trusts understand the practical issues associated with developing enhanced roles and implementing these into their organisations. During this session you will hear about:
* Workforce planning and the delivery of 7 day Services. Health Education England will provide an update regarding the national picture and provide insight into innovative workforce solutions which will support the delivery of 7 Day Services
* Practical examples from colleagues in acute trusts, where new roles have been utilised in delivering the 4 priority clinical standards
Key speakers:
Kevin Moore - Head of Workforce Transformation, Health Education England
Miss Fiona Kew - Consultant Gynaecologist, Modernising the Workforce: Physician's Associates – Sheffield Teaching Hospital
Darren McGuiness - Endoscopy Manager Royal Liverpool & Broadgreen NHS Trust. Seven Day Services in Endoscopy
Nicky Taggart - General Manager, Radiology and Imaging, Royal Liverpool & Broadgreen NHS Trust. Seven day services in Radiology
A national learning event took place in June 2014, to explore how best to present data from the Cancer Patient Experience Survey (CPES) in order to drive improvement.
Outcomes from the event will help to shape the future presentation of CPES data, so that it is more accessible and easier for professionals and the public to use and interpret.
The event was held by NHS Improving Quality's Experience of Care team, in partnership with Macmillan Cancer Support, and NHS England's Insight team, to bring together cancer managers, lead nurses and lead clinicians. They heard from speakers including patient Bonnie Green, Ben Page, chief executive of Ipsos Mori, and Sean Duffy, National Clinical Director for cancer. Delegates also undertook group activity looking at the barriers that exist in translating data into improvement, and tailoring data for the right audiences.
The event forms part of NHS Improving Quality's wider work with NHS England looking at how the NHS is using the CPES data to reduce variation in the cancer patient experience. CPES, part of the national survey programme commissioned by NHS England, generates data and insight into the experiences of cancer patients.
- See more at: http://www.nhsiq.nhs.uk/news-events/news/using-insight-data-to-improve-patient-experience.aspx#sthash.Yh1yiQ6y.dpuf
Presentations from the patient safety conference held at Teesside University on 1 and 2 September 2014 - Students at the forefront of continuing and improving our culture of safe care
Chief Allied Health Professions Officer’s Conference 2016: Main stage present...NHS England
Chief Allied Health Professions Officer’s Conference 2016
Main stage presentations
AHP Innovation Delivering #FutureNHS. Suzanne Rastrick, Chief Allied Health Professions Officer (CAHPO), NHS England.
Reshaping the workforce. Daniel Mortimer, Chief Executive, NHS Employers.
Putting the 'We' into 'Wellbeing. Roz Davies MBA Managing Director of We Love Life and Recovery Enterprises.
Sharing, learning and connecting sectors through open innovation. Paul Taylor, Innovation Coach, Bromford Lab.
How AHPs will transform care: a mandate for change. Suzanne Rastrick, CAHPO, NHS England. Dr Peter Thomond, Managing Director of Clever Together. Dr Joanne Fillingham, Clinical Fellow to the CAHPO.
Delivering innovation to make clinicians ecstatically happy. Dr Neil Bacon CEO and Founder of iWantGreatCare.
Professor Kamlesh Khunti - Introduction to CLAHRC East MidlandsCLAHRC-NDL
Professor Kamlesh Khunti, Director of NIHR CLAHRC East Midlands - Introductory presentation given at CLAHRC East Midlands launch event, 14 February 2014, Loughborough.
Evidencing the quality and productivity of Allied Health Professionals' (AHPs...NHS Improvement
We recently hosted four regional events ‘Evidencing the quality and productivity of AHPs care’ with a target audience of Allied Health Professional leads in NHS provider organisations.
These slides outline sessions from the events and provide an introduction to the Model Hospital, AHP job planning and the early findings of a deployment tracker metric ‘Therapy Hours to Contacts’ that is being implemented.
NHS Improving Quality was invited to take part in a recently held event that celebrated the work that is being done in partnership between the Pennine Acute Hospitals NHS Trust and AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP).
Gillian Phazey, Learning and Organisational Development Manager at Pennine Acute Hospitals NHS Trust explains:
'The Learning and Organisational Development and Governance teams at the Pennine Acute Hospitals NHS Trust have been working collaboratively with AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP) to support staff in developing knowledge and skills in this topic. The programme has been specifically designed to support colleagues wanting to gain an introduction to the fundamentals and concepts of quality improvement. So far, two cohorts of staff, from clinical and non-clinical areas of the Trust have completed the programme, and have completed quality improvement projects in their own work area to apply their knowledge. On 17th July a celebration event was held for cohort 2 where staff presented their work in poster or presentation form, the aim of which is to share and spread learning across the Trust. Projects were wide ranging, from introducing new processes to reduce complaints and drug errors, to improving patient experience by implementing new tools and techniques. The day was a great success with the Chief Executive and Chief Nurse in attendance. The Trust is highly supportive of this approach in equipping staff with these important techniques, and the programme supports not only our internal quality agenda and objectives, but more widely responds to the recommendations of the Berwick report. The next cohort is starting in September this year.'
Fiona Thow, Patient Safety Collaborative Delivery Lead at NHS Improving Quality delivered a keynote speech, (link to presentation slides) providing a national perspective on the plans for improving patient safety and took the opportunity to introduce the national safety collaboratives. She also highlighted the need for organisations and individuals to think differently about safety for both patients and staff.
Members of the Coleman Supportive Oncology Collaborative including over 169 cancer care providers from 44 institutions came together in person to share lessons from their 3-year project to improve supportive cancer care across the region and to launch the next step in the Coleman Foundation initiative which is to improve patient communication and experience.
Mobilising Evidence and Organisational Knowledge in the NHSCILIP
Sue Lacey Bryant (Senior Advisor, Knowledge for Healthcare, Health Education England) and Louise Goswami's (Head of Library and Knowledge Services Development, Health Education England) presentation to the CILIP 2017 Conference in Manchester #CILIPConf17
Health Education England (HEE) is driving the implementation of Knowledge for Healthcare which articulates an ambitious vision for healthcare library and knowledge services funded by the NHS. These services supply the evidence base to the NHS to make #AMillionDecisions a day. HEE is taking a strategic approach to mobilising evidence and organisational knowledge through policy and advocacy initiatives, by introducing new resources, tools and techniques and by empowering our workforce. Partnership working across all sectors, and including CILIP, is central to our success. The speakers will outline their approach, share experience and invite ongoing dialogue.
Elizabeth Stephenson and Carol Ewing: child health policy updateNuffield Trust
Elizabeth Stephenson, Children and Young People Policy Lead at NHS England, and Dr Carol Ewing, Vice President of the Royal College of Paediatrics and Child Health, give an overview of the national policy making landscape for child health.
Improving access to seven day services - Taunton 4th March 2015
The first of the regional events for the south took place in Taunton on 4 March. Over 100 delegates from local health and social care organisations came together with patient, public and voluntary sector representatives to hear about the expectations, opportunities and challenges of delivering seven day services and to review and further develop plans for their local communities.
Interactions between the delegates in their local health and social care communities, supported by the NHS Improving Quality team, made this a vibrant event with everyone contributing to the table discussions during the day.
Key themes emerging during the day included:
• The need for system resilience group members to fully understand the skills and “offer” that each of them can bring to the table to improve health and social care seven days a week. This was highlighted in discussions around clinical standard 9, which many groups focussed on as their top priority.
• The need to have an effective system of information sharing between all parts of the health and social care system.
• The huge role that patients and public groups have to play in planning services.
Sharing and Learning Together to Deliver High Quality End of Life Care for AllNHS Improving Quality
Sharing and Learning Together to Deliver High Quality End of Life Care for All
Presentations from the Sharing and Learning Together to Deliver High Quality End of Life Care for All event held on
Tuesday 24 June 2014, Congress Centre, London, WC1B 3LS
#nhsiqeolcare
Similar to Setting up an organisation wide QI programme (20)
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
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
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.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
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.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
Setting up an organisation wide QI programme
1.
2. Setting up an organisation-wide
quality improvement programme
3. • After this session, participants will:
• Have extracted key learning from three case study
healthcare systems
• Have identified key tactics in building will, building
capacity and capability for improvement, and aligning an
organisation around improvement goals
• Have developed a theory of change about how to set up
an organisation-wide quality improvement programme
4. Introducing our speakers
Jen Perry, Clinical Lead, BMJ Quality
Amar Shah, Associate Medical Director for Quality Improvement and
Consultant forensic psychiatrist at East London NHS Foundation Trust
Rob Bethune, Consultant Surgeon, Royal Devon and Exeter Hospital and
Clinical Advisor to the South West Academic Health Science Network
Aidan Fowler, Director of NHS Quality Improvement and Patient Safety,
NHS Wales
Conflicts of Interests - None
5. Agenda
• Welcome and introductions
• Building the case for change
• Engaging staff in quality improvement
• Developing the infrastructure for improvement at scale
• Disseminating learning
7. Mental Models & Quality Theories
Quality Assurance
•Inspection-looking for the “Bad Apples”
•Retrospective Review
•Risk Management
Quality Control
•Monitor Key Process Indicators (KPI’s) against
targets
•Take Action when not meeting targets
•Regulatory approach
Quality Improvement
•Process and system improvement
•Reduce Variation
•Align outputs to customer needs
•Continuous & part of daily work
•Science of Improvement
Michael Pugh, 2014
9. @ELFT_QI
Trust board bespoke
learning sessions
Visits to other
organisationsSentinel event
Developing the strategy
through engagement
Building the case for change
Early small scale
tests
Long-term business
case approved
Assess readiness
for change
Identify strategic
partner
10.
11. Building the case for change in the
South West
• They often want to but don’t know how
• No-one asks them
• Intrinsic motivation
• Extrinsic motivation
12. • Launched in April 2012, the campaign was adopted across NHS Wales to spread
the message of good cannula and catheter care.
• It was the first 1000 Lives Improvement campaign to include ‘communications’ as
a primary driver in its strategy.
• Clinical data showed the impact of the campaign led to safer practices and
prevented people contracting dangerous infections.
• Measurements in sites across Wales showed a reduction in numbers of devices
being used in hospitals and by Welsh Ambulance Staff. Device usage dropped
from between 40 and 80 per cent, in different clinical areas.
13. • ‘Ask about Clots’ campaign was developed by 1000 Lives Improvement and
supported by Lifeblood, the thrombosis charity.
• Helped the public understand the risk so they can ask for an assessment and be
given the appropriate treatment.
• It is also raised awareness among staff to remind them to carry out the
assessments and give the necessary drugs.
• In the first month, over 1000 people visited the website and the launch generated
1,300 tweets.
Find out more at www.askaboutclots.co.uk
14. A force-field analysis helps identify the forces driving and
resisting a change.
In your workbook, fill in the force-field analysis template
to identify:
a) The things that are currently supporting or driving
your organisation to become more improvement-
focused
b) The things that are resisting this shift
c) The actions you could take to either strengthen driving
forces or negate restraining forces
Building the case for
change
Table Exercise – force-field analysis
19. Bring on the Weekend!
Improving the quality of weekend handover at the
Royal United Hospital, Bath
20. The old weekend handover
‘please r/v sat/sun. I am sorry but I dont
know what ward they will end up on’
‘Please chase USS report and liase with
senior if action required. Bloods sat please’.
‘please r/v bloods sat’.
‘please r/v sat + sun. Pt unwell!’
‘r/v sat and sun to ensure still well. Liver USS
sat pm – please r/v and act on as
appropriate’
Examples:
21. Aim
• To have 95% of weekend handovers scoring
maximum points on our rating scale in 6
weeks
23. Ward: Waterhouse
Name: WB
Cover 1
Hospital Number:1178430
Date 15/03/13
DOB 12/03/1934
Bed No:2.4 Patient
Priority
BACKGROUND CURRENT PROBLEM SPECIFIC JOB ACTION PLAN
COPD
Ischaemic Heart Disease –
MI 2010
Admitted with infective
exacerbation of COPD
On IV Co-amoxiclav and
Clarithromycin
Please take bloods – FBC, U+Es, CRP Please check that inflammatory
markers are improving – if not
please, r/v and discuss with
microbiology
Prescribe more IV fluids
Amber
(delete as
appropriate)
Day Scheduled: Sunday
(delete as appropriate)
Time Scheduled: Any time
(delete as appropriate) Specific Time:
Available on the desktops
(Several PDSA cycles)
28. • “I'm just one junior so no one's going to listen
to me and even if they did, it'll go to another
committee that I won't be a part of and it'll
just get squished".
29. • “It's easier to affect change than I had
thought, and that was one of the things I
really learned about this and it's something
that I'm personally able to do which I
wasn't…honestly did not believe eight months
ago.”
31. Key Learning – so far
• Format seems to be crucial
– They need support and structure
– Groups
– Methodology
– Pizza
• Make it fun and ‘cool’
• Voluntary
• Autonomy
32. Engaging Staff – Cardiff and Vale LHB LIPS
Programme
•Engaging the Board – facilitated session to agree high level aims – linked to LHB
priorities.
•Selling LIPS to Clinical Boards as an enabler to deliver their priorities – linked to the
three year plan.
•Setting expectations that each Clinical Board will sponsor about 15 people working
on about 3 improvement areas per cohort but to pull ideas in from front line staff
rather than to dictate (ownership).
•Advising on the structure of the team to increase the chance of success to include
senior leaders – e.g. consultant, directorate manager, accountant, lead nurse.
•Designing the programme content and delivery style to keep the senior people
interested – immediately useful and applicable knowledge and skills.
•Targeted communication by credible people – using steering group members who
were handpicked to represent senior echelons - Head of Delivery and Clinical
Director/respected Consultants all talking to their peers formally and informally.
Being presented here on Friday if you want to know more
Session H2 - Professors to Plumbers: Engaging all to lead QI
33. AIM:
To provide
the highest
quality
mental
health and
community
care in
England by
2020
Build the
will
QI microsite
qi.elft.nhs.uk
Staff and
service user
newsletters
QI launch event and
roadshows
Bespoke QI learning events Annual QI conference and
quarterly Open mornings
QI visibility wall
Publishing
completed projects
QI stories at every Trust
Board meeting
34. Little i
Regularly
consulted during
lifetime of the
project
Big I
Act as a full member
of the QI project team
Surveys
Focus
groupsCommunity
meetings
Service
user
forum
Service user and carer involvement
35. Engaging staff & service
users in QI
Table exercise
Consider which members of your front-line staff would
be interested in running quality improvement projects
around their area of work.
1. How will you engage them to do this?
2. What support can you and your organisation give to
help them?
3. Can you do any of this by next Tuesday?
37. • Population: 3 million.
• A devolved government with an
independent health budget.
• Two official languages.
• Home of Aneurin Bevan, founder
of the NHS.
• Over 90,000 people work for NHS
Wales.
• Integrated healthcare in Wales is
delivered through:
• 7 geographical health boards
• 3 NHS trusts
A bit about Wales
40. Supporting the
NHS to improve
outcomes for
people using
services
Enable the NHS to integrate
the principles of Prudent
Healthcare to achieve
measurable quality
improvements in priority
areas
Design and deliver Prudent Programmes
for: Integration; Antibiotic prescribing;
Transforming Outpatients.
Support the delivery of the three
national programmes for planned care,
unscheduled care and primary care
Work with health boards and
trusts to achieve demonstrable
improvements in the NHS
Outcomes Framework by
reducing harm and improving
safety for patients
Coordinate and deliver a network of
support in Mental Health
Design and deliver a national safe
staffing programme
Coordinate and deliver a network or
support for acute deterioration
Support the Cancer Network and
improvements in cancer diagnostics
Coordinate and deliver the Maternity
Network
Coordinate and deliver support to
reduce HCAIs
Increase quality improvement
capacity and capability within
NHS Wales and its partner
organisations
Provide advice and signposting for
person centred care support
Further develop IQT for the current and
future workforce
Support organisations to develop QI
hubs and identify local support needs
Develop the capacity to be responsive to
arising NHS quality needsUnderpinned by prudent healthcare, the Triple Aim and
the development of a National Patient Safety Strategy
Support the Royal Colleges with
Choosing Wisely Wales
41. Director
PA
Head of
Patient Safety
Acute
Deterioration
Cancer
Maternity
Safe Staffing
HCAI
Deputy
Director &
Head of
Quality
Improvement
Mental Health
Primary Care
(inc.
prescribing)
Planned Care
(inc.
outpatients)
Unscheduled
Care
Integrated
Care (inc.
Falls)
Head of
Capacity and
Capability
IQT
PCC (& CCW)
Hubs
Measurement
Responsive /
customised
support
Head of
Business &
Planning
Business
Programme
Support
Stakeholder
engagement
(comms)
Strategy
42. International
evidence /
experience
External
Reviews
Welsh
Government
Academia NHS CEOs
Bevan
Commission
CHCs
Local and
National
Events
Comms
Data and
evaluation
PHW and 1000
Lives team
engagement
Corporate /
business
IQT
National
Organisations
Drivers
Mainstay
Steering
Group
1000 Lives
Improvement
QI leads QI Hubs
Support
Patients
Staff
Public
45. Improving Quality Together
• Developed by representatives from each
Health Board and Trust in Wales:
– Common language of improvement
– Focus on person-centred care
– Consolidation of quality improvement in NHS Wales to date
– Integrated into other learning and development programmes locally
– Integrated into Higher Education Institution curricula
46. IQT Programme Structure
• 3 levels of development:
– Bronze – what – 2 hours
– Silver – how – 3 days
– Gold – coach- network
• Complemented by Board level development
49. So how many people do you need to
do QI?
• According to Deming "the square root of an
organisation"
• For Wales the square root of 90000
• 300
• But - this is 300 people who's job it is to do QI
and not anything else = 30 per organisation -
currently this is more like 6
50. So how many people do you need to
do QI?
• Framework
• Network
• Collaborate
• Spread good internal practice
• Adopt good external practice
• Innovate where there is no exemplar
51. Developing Infrastructure in the South
West
• To start with, we did it on our own
• But you can only go so far
• Now regional support
• Capability, capacity and culture
52. Experts by experience
All staff
Staff involved in or
leading QI projects
QI coaches
Board
Estimated number needed to train = 5000
Needs = introduction to quality
improvement, identifying problems, change
ideas, testing and measuring change
Estimated number needed to train = 1000
Needs = deeper understanding of
improvement methodology, measurement
and using data, leading teams in QI
Estimated number needed to train = 45
Needs = deeper understanding of
improvement methodology, understanding
variation, coaching teams and individuals
Needs = setting direction and big goals,
executive leadership, oversight of
improvement, being a champion,
understanding variation to lead
Estimated number needed to train = 11
Needs = deep statistical process control,
deep improvement methods, effective plans
for implementation & spread
Pocket QI commenced in October
2015. Aim to reach 200 people by
Dec 2016.
All staff receive intro to QI at
induction
500 people have undertaken the
ISIA so far. Wave 5 = Luton/Beds
(Sept 2016 – Feb 2017)
30 QI coaches graduating in
January 2016. To identify and train
second cohort in mid-late 2016
Most Executives will have
undertaken the ISIA.
Annual Board session with IHI &
regular Board development
discussions on QI
Currently have 3 improvement
advisors, with 1.5 wte deployed to
QI. To increase to 8 IA’s in 2016/17
(6 wte).
Internal
experts (QI
team)
Bespoke QI learning sessions for
service users and carers. Over 50
attended in 2015. Build into recovery
college syllabus, along with
confidence-building, presentation
skills etc.
Needs = introduction to quality
improvement, how to get involved in
improving a service, practical skills in
confidence-building, presentation,
contributing ideas, support structure for
service user involvement
53. QI ResourcesService User Input
Support around your project team
Project Sponsor QI Coach
QI Forums
QI Team
54. 1. What improvement capability and capacity exists in
your organisation?
2. How good a framework or network is there?
3. How do you increase the time available for QI?
Infrastructure for improvement
at scale
Table Exercise
56. 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. Newsletters (paper and electronic)
2. Stories from QI projects - at Trust Board, newsletters
3. Annual conference
4. Celebrate successes – support submissions for awards
5. Share externally – social media, Open mornings, visits,
microsite, engage key influencers and stakeholders
1. Build and develop central QI team capability
2. Online learning options
3. Pocket QI for those interested in QI
4. Improvement Science in Action waves
5. Develop cohort and pipeline of QI coaches
6. Bespoke learning, including Board sessions &
commissioners
1. Embed local directorate structures & processes to
support QI
2. Align projects with directorate and Trust-wide priorities
3. Support staff to find time and space for QI work
4. Support deeper service user and carer involvement
5. Support team managers and leaders to champion QI
6. Align research, innovation, improvement and operations
Reducing Harm by 30% every year
1. Reduce harm from inpatient violence
2. Reduce harm from pressure ulcers
3. Other harm reduction projects (not priority areas)
Right care, right place, right time
1. Improving access to services
2. Improving physical health
3. Other right care projects (not priority areas)
57. Start drawing a driver diagram that helps you
understand how you could prepare for an
organisation-wide approach to quality improvement
Your theory of change
Table Exercise
61. What is BMJ Quality?
An online platform which supports
individuals, teams and
organisations to
work through healthcare
improvement projects and onto
publication by
providing the necessary framework
and tools to make healthcare
improvement simple.
www.quality.bmj.com
62. • Aims to become the world’s
largest repository of quality
improvement evidence
• Standardised SQUIRE
guideline template
• PUB-MED Indexed
• Publish >50% submissions
• Publishes both successes and
projects which haven’t worked
63.
64. Implemented a Friday afternoon
ward round to discharge
patients before the weekend.
Saved Trust £150k pa.
Tripled 30-day compliance with
medication after discharge from
outpatients department.
Reduced weekend ICU mortality
from 42% to 22% over 12
months
Pushed up bowel cancer
screening in over 65s from 32%
to 46%
Reduced
financial
impact of
cancelled
operations in
Trust by 41%
View the full repository at –
qir.bmj.com
65. Some examples of recently published projects
•Multifaceted bundle interventions shown effective in
reducing VAP rates in our multidisciplinary ICUs
•The Participative Design of an Endoscopy Facility using
Lean 3P
•Improving residents' handovers through just-in-time
training for structured communication
•Eliminating guidewire retention during ultrasound guided
central venous catheter insertion via an educational
program, a modified CVC set, and a drape with reminder
stickers
67. BMJ Quality: www.quality.bmj.com
BMJ QIR Journal: www.qir.bmj.com
BMJ Quality breakfast session on Thursday 14th April
at 8am
Come and speak to the BMJ Quality Team at the end
of the session
69. Find out more about BMJ Quality at our
breakfast session on Thursday 14th April
at 8am
• Dr Jen Perry; jperry@bmj.com; @BMJQuality;
www.quality.bmj.com
• Dr Amar Shah; Amar.shah@elft.nhs.uk; @DrAmarShah ;
http://qi.elft.nhs.uk
• Dr Rob Bethune; rob.bethune@nhs.net; @robbethune
• Dr Aidan Fowler; aidan.fowler@wales.nhs.uk;
@aidanfowler1000