The Sustainability Model is a diagnostic tool that will identify strengths and
weaknesses in your implementation plan and predict the likelihood of sustainability
for your improvement initiative.
The Sustainability Guide provides practical advice on how you might increase the
likelihood of sustainability for your improvement initiative.
I HAVE ATTACHED A PPT CONSIST OF VARIOUS COMMANDS OF MICROSOFT PROJECT.
I HAVE INCLUDED INTRODUCTION TO MACROS, WHICH ARE BEING USED IN NORMAL CONSTRUCTION INDUSTRY.
I HOPE YOU LIKE IT. REVIEWS & SUGGESTIONS ARE MOST WELCOME.
Heat recovery ventilation is a means of energy conversation in buildings. Because of reducing ventilation exhaust air, can play a good role in the effectiveness of ventilation to reduce energy use. As building efficiency is improved with insulation and weather stripping, buildings are intentionally made more airtight, and consequently less ventilated. Since all buildings require a source of fresh air, the need for HRVs has become obvious.
Ms. Victoria Burrows, Project Manager, Advancing Net Zero
World GBC, gave presentation on Zero Carbon Buildings at 15th Green Building Congress 2017 event at Jaipur
I HAVE ATTACHED A PPT CONSIST OF VARIOUS COMMANDS OF MICROSOFT PROJECT.
I HAVE INCLUDED INTRODUCTION TO MACROS, WHICH ARE BEING USED IN NORMAL CONSTRUCTION INDUSTRY.
I HOPE YOU LIKE IT. REVIEWS & SUGGESTIONS ARE MOST WELCOME.
Heat recovery ventilation is a means of energy conversation in buildings. Because of reducing ventilation exhaust air, can play a good role in the effectiveness of ventilation to reduce energy use. As building efficiency is improved with insulation and weather stripping, buildings are intentionally made more airtight, and consequently less ventilated. Since all buildings require a source of fresh air, the need for HRVs has become obvious.
Ms. Victoria Burrows, Project Manager, Advancing Net Zero
World GBC, gave presentation on Zero Carbon Buildings at 15th Green Building Congress 2017 event at Jaipur
Presentation from JAOO 09 Australia on how to design software architectures to maxmise sustainable outcomes by limiting power and resource usage. Uses the Virtualisation Maturity Model (see Architecture Journal edition 18).
Building Energy Simulation project by using eQuestAsadullah Malik
The energy shortage crisis and the rapid change of global climate have become important issues in the world now a days since modern trends are shifting to more sustainable solutions to save energy and to reduce the emission of carbon dioxide. Generally speaking, when improving energy efficiency and adopting the energy –saving design, the advantage is not only providing low operating cost for stakeholders, but also reducing the negative impact on the global and ambient environment. This study analyzes the surveyed building integral energy consumption, evaluates its energy performance, and gives further recommendations for saving energy costs by using dynamic energy simulation tool eQuest.
Presentation by Niall Gibson, Douglas Bell and David Ross from IES. This webinar covered the latest update on interoperability with IES technology and how through the use of new developments and better data exchange options, you can speed up the design process and facilitate true digital design and operation.
Book review - Landscape Architecture, Fifth Edition: A manual of Environment ...Rashmi Arya
Book review of the famous landscape Architecture book - A manual of Environment Planning and design. This book is for all irrespective of the domain of the reader. The slight wry humor and illustrations make it easy to understand and keeps the interest on going.
Building simulation is the process of using a computer to build a virtual replica of a building.
The building is built from its component parts on a computer and a simulation is performed by taking that building through the weather conditions of an entire year.
In a way, building simulation is a way to quantitatively predict the future and thus has considerable value.
Building simulation is commonly divided into two categories:
Load Design,
Energy-Analysis.
The common phrase for building simulation when energy is involved is Energy-Simulation.
This Guide for Executives is aimed at senior healthcare leaders. It provides 31 practical tips for leaders
who want to contribute positively to the culture for innovation in their organisations and systems.
A more in-depth practitioners guide, Creating the Culture for Innovation, provides much more
detailed advice and guidance, a host of additional examples, and information about an online staff
survey that can be used to assess, benchmark and understand the culture for innovation.
Nhs Sustainability Day 2016 London Road Show4 All of Us
March 26th this year saw over 300 healthcare organisations take action to promote sustainability and increase public health awareness and we are fortunate enough to have the support of; Public Health England, Department of Health, Department for Energy and Climate Change and The Prime Minister, David Cameron. Working with these stakeholders we aim to further develop the links between health and sustainability thus improving economical and health outcomes within the UK.
For the 2016 campaign, beginning in September, and to celebrate our 5th year of the campaign we will be promoting 50kg of carbon. This is effectively promoting what the public and health professionals can do to save 50kg of carbon. This could be achieved through; walking to work, cycling, planting a tree etc.
The purpose of the Organisational Sustainability slide show is to present a way organisations, both private and public sector, can :
a) Improve theirs and others sustainability, and in doing so also
b) Show how their progress can be measured in economic, community, and environmental terms .
This 'how to' guide builds upon the overarching framework set out in The route to success in end of life care - achieving quality in acute hospitals, published in 2010. The route to success highlighted best practice models developed by acute hospital Trusts, providing a comprehensive framework to enable hospitals to deliver high quality care to people at the end of life.
This 'how to' guide aims to help clinicians, managers and directors implement The route to success more effectively, drawing on valuable learning from the NHS Institute for Innovation and Improvement's Productive Ward: Releasing time to care™ series.
This guide contains individual sections that can be worked on in any given order, dependent upon the individual hospital and its current end of life care provisions. These can be downloaded below:
Introduction
Section 1: prepare
Section 2: assess and diagnose
Section 3: plan
Section 4: treat
Section 5: evaluate
Section 6: sustain
Section 7: further resources
Cover
It places emphasis on existing 'enabling' tools and models, which support and follow a person-centred pathway. These are Advance Care Planning, Electronic Palliative Care Co-ordination Systems (EPaCCS), AMBER Care Bundle, Rapid Discharge Home to Die Pathway, and the Liverpool Care Pathway.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
This is a legacy publication from the NHS Institute for Innovation and Improvement. It outlines a framework of five models for thinking about making change happen, based on the work of McKinsey and Co
Presentation from JAOO 09 Australia on how to design software architectures to maxmise sustainable outcomes by limiting power and resource usage. Uses the Virtualisation Maturity Model (see Architecture Journal edition 18).
Building Energy Simulation project by using eQuestAsadullah Malik
The energy shortage crisis and the rapid change of global climate have become important issues in the world now a days since modern trends are shifting to more sustainable solutions to save energy and to reduce the emission of carbon dioxide. Generally speaking, when improving energy efficiency and adopting the energy –saving design, the advantage is not only providing low operating cost for stakeholders, but also reducing the negative impact on the global and ambient environment. This study analyzes the surveyed building integral energy consumption, evaluates its energy performance, and gives further recommendations for saving energy costs by using dynamic energy simulation tool eQuest.
Presentation by Niall Gibson, Douglas Bell and David Ross from IES. This webinar covered the latest update on interoperability with IES technology and how through the use of new developments and better data exchange options, you can speed up the design process and facilitate true digital design and operation.
Book review - Landscape Architecture, Fifth Edition: A manual of Environment ...Rashmi Arya
Book review of the famous landscape Architecture book - A manual of Environment Planning and design. This book is for all irrespective of the domain of the reader. The slight wry humor and illustrations make it easy to understand and keeps the interest on going.
Building simulation is the process of using a computer to build a virtual replica of a building.
The building is built from its component parts on a computer and a simulation is performed by taking that building through the weather conditions of an entire year.
In a way, building simulation is a way to quantitatively predict the future and thus has considerable value.
Building simulation is commonly divided into two categories:
Load Design,
Energy-Analysis.
The common phrase for building simulation when energy is involved is Energy-Simulation.
This Guide for Executives is aimed at senior healthcare leaders. It provides 31 practical tips for leaders
who want to contribute positively to the culture for innovation in their organisations and systems.
A more in-depth practitioners guide, Creating the Culture for Innovation, provides much more
detailed advice and guidance, a host of additional examples, and information about an online staff
survey that can be used to assess, benchmark and understand the culture for innovation.
Nhs Sustainability Day 2016 London Road Show4 All of Us
March 26th this year saw over 300 healthcare organisations take action to promote sustainability and increase public health awareness and we are fortunate enough to have the support of; Public Health England, Department of Health, Department for Energy and Climate Change and The Prime Minister, David Cameron. Working with these stakeholders we aim to further develop the links between health and sustainability thus improving economical and health outcomes within the UK.
For the 2016 campaign, beginning in September, and to celebrate our 5th year of the campaign we will be promoting 50kg of carbon. This is effectively promoting what the public and health professionals can do to save 50kg of carbon. This could be achieved through; walking to work, cycling, planting a tree etc.
The purpose of the Organisational Sustainability slide show is to present a way organisations, both private and public sector, can :
a) Improve theirs and others sustainability, and in doing so also
b) Show how their progress can be measured in economic, community, and environmental terms .
This 'how to' guide builds upon the overarching framework set out in The route to success in end of life care - achieving quality in acute hospitals, published in 2010. The route to success highlighted best practice models developed by acute hospital Trusts, providing a comprehensive framework to enable hospitals to deliver high quality care to people at the end of life.
This 'how to' guide aims to help clinicians, managers and directors implement The route to success more effectively, drawing on valuable learning from the NHS Institute for Innovation and Improvement's Productive Ward: Releasing time to care™ series.
This guide contains individual sections that can be worked on in any given order, dependent upon the individual hospital and its current end of life care provisions. These can be downloaded below:
Introduction
Section 1: prepare
Section 2: assess and diagnose
Section 3: plan
Section 4: treat
Section 5: evaluate
Section 6: sustain
Section 7: further resources
Cover
It places emphasis on existing 'enabling' tools and models, which support and follow a person-centred pathway. These are Advance Care Planning, Electronic Palliative Care Co-ordination Systems (EPaCCS), AMBER Care Bundle, Rapid Discharge Home to Die Pathway, and the Liverpool Care Pathway.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
This is a legacy publication from the NHS Institute for Innovation and Improvement. It outlines a framework of five models for thinking about making change happen, based on the work of McKinsey and Co
Purpose of the Call:
Change is challenging and getting staff clinicians and physicians to participate in quality improvement initiatives is often a struggle. Understanding the clinical perspective and developing effective change strategies can help.
By the end of this session participants will:
•understand why it is often difficult to engage with clinicians and physicians
•learn how to assess their change strategies for adoptability
•gain experience with the Highly Adoptable Improvement Model and Toolkit
Watch the webinar http://bit.ly/1A0mxOR
This is the study guide 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
· Analyze a professional environment and relevant data, and develo.docxlillie234567
· Analyze a professional environment and relevant data, and develop a change strategy (3-5 pages) and discuss how to implement it successfully.
Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented.
Knowing the best practice for our patients is very important in providing safe and effective care. Understanding best practices can help nurses identify areas of care that need to be improved. To identify areas of need, nurses must use evidence from various sources, such as the literature, clinical practice guidelines (CPG), professional organization practice alerts or position papers, and protocols. These sources of evidence can also be used to set goals for improvement and best practices with an eye toward improving the care experience or outcomes for patients.
The challenge facing many care environments and health care practitioners is how to plan for change and implement changes. For if we cannot effectively implement changes in practice or procedure, then our goals of improving care will likely amount to nothing. This assessment focuses on allowing you to practice locating, assessing, analyzing, and implementing change strategies in order to improve patient outcomes related to one or more clinical goals.
This assessment will take the form of a data table to identify areas for improvement and to set one or more outcome goals, as well as a narrative describing a change plan that would help you to achieve the goals you have set.
Professional Context
One area in health care that it is necessary to consider is the environment in which nurses work. It is important that this environment evolves and changes so that all patients are adequately supported. For this assessment, you will develop a change strategy to improve the health care environment. These changes can be rooted in a desire to improve clinical outcomes and data related to assessment accuracy, drug administration, or disease recovery rates. A key skill for master's-level nurses is to be able to evaluate clinical data and create a change plan to help drive improvements in the data to reach set goals.
Scenario
Consider a current environment. This could be your current care setting, the care setting presented in the scenario Vila Health: Using Concept Maps for Diagnosis, or a care setting in which you are interested in working. For the setting that you choose you will need to have a data set that depicts sub-optimal outcomes related to a clinical issue. This data could be from existing sources in the course, a relevant data set that already exists (a data set from the case study you used as a basis for your previous Concept Map assessment or from your current place of practice), or an appropriate data set that you have created yourself. (Note: if you choose to create your own data set, check with your instructor first .
This 'how to' guide builds upon the overarching framework set out in The route to success in end of life care - achieving quality in acute hospitals, published in 2010. The route to success highlighted best practice models developed by acute hospital Trusts, providing a comprehensive framework to enable hospitals to deliver high quality care to people at the end of life.
This 'how to' guide aims to help clinicians, managers and directors implement The route to success more effectively, drawing on valuable learning from the NHS Institute for Innovation and Improvement's Productive Ward: Releasing time to care™ series.
This guide contains individual sections that can be worked on in any given order, dependent upon the individual hospital and its current end of life care provisions. These can be downloaded below:
Introduction
Section 1: prepare
Section 2: assess and diagnose
Section 3: plan
Section 4: treat
Section 5: evaluate
Section 6: sustain
Section 7: further resources
Cover
It places emphasis on existing 'enabling' tools and models, which support and follow a person-centred pathway. These are Advance Care Planning, Electronic Palliative Care Co-ordination Systems (EPaCCS), AMBER Care Bundle, Rapid Discharge Home to Die Pathway, and the Liverpool Care Pathway.
The 'how to' guide box set is complemented by an e-version, containing 14 podcasts. These cover topics such as the 'enabling' tools, communications skills, DNACPR, environments of care, implementing care after death guidance and the use of data and metrics.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
A guide for health and social care workers working with adults at the end of life
25 June 2009 - Department of Health / National End of Life Care Programme / Skills for Care / Skills for Health
The purpose of this guide is to support workforce development, training and education and the development of new and enhanced roles. The principles and competences it outlines form a common foundation for all staff whose work includes care and support for people approaching - and at - the end of their lives.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
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.
1Running head CHANGE MANAGEMENT PROPOSAL2CHANGE M.docxdrennanmicah
1
Running head: CHANGE MANAGEMENT PROPOSAL
2
CHANGE MANAGEMENT PROPOSAL
Change Management Proposal
HR006: Leadership, System Thinking, and Change Management
Yasmin Abdulghafour
Walden University Comment by Dr. Steve: Yasmin – this report is intended to be one paper (two parts) – please combine your Part I and Part II into a single document when you re-submit.
Executive Summary
Organizational change is the process in which any organization brings or desires to bring changes in its organizational culture, structure, strategies, functions or technologies to cause the change within the company to achieve certain goals and improve the overall performance of the company. This study is based on proposing a change management model for Ronald Reagan UCLA medical Medical center Center which is located in Los Angeles. UCLA medical Medical center Center is focused on continuously improving its services by implementing the concept of “True North” which suggests to improve and idealize different aspect of services including quality, equity, care experience, safety, financial stewardship, and workforce development and care.
This change management proposal recommends the use of Kotter's 8-step change model to bring the change in the organizational culture of the UCLA Health System. This proposal also highlights the role of communication in bringing change in the organization. Moreover, this study suggests the strategies to motivate employees to embrace the process of change and recommends the training strategies that can be used to implement the process of change successfully. This study also provides a guideline of how the change process can be evaluated and measured on the basis of organizational and individual performances. Comment by Dr. Steve: Good
Change Management Proposal
Introduction of the Organization
Ronald Reagan UCLA medical Medical centerCenter, a 520-bed facility, is a medical service providing organization located in Los Angeles. It was founded in 1955 and initially started as UCLA medical Medical center Center but, later it became Ronald Reagan UCLA Medical center Center in 2008. The medical center has highly qualified staff which provides 24 hours of medical services. This center offers many clinical services including cancer services, cardiovascular services, pediatric services, transplantation facilities, men and women health services, and weight management programs, etc. the facility has about ten 10 floors, and every floor contains dialysis storage, satellite pharmacy, respiratory therapy workrooms, and restrooms for doctors and residents. What is your resource for this information? Comment by Dr. Steve: Run on sentence – try re-writing this as two sentences
The mission of UCLA health Health is to deliver timely and leading research, education, and patient care. It is aimed at healing humankind by providing medical services and acts of kindness. UCLA Health is focused on providing the best health care services throu.
A Guide to Applying Quality improvement to Healthcare Five PrinciplesHealth Catalyst
Healthcare is an art and a science. What many in the industry don’t understand is that systems and processes can coexist with personalized care. Quality improvement methods can be as effective in healthcare as they have been in other industries (e.g., agriculture, manufacturing, etc.).
Quality improvement in healthcare is not just achievable, it’s an absolute necessity given the amount of wasteful spending in the U.S. on healthcare. Organizations can reduce this wasteful spending while improving their processes by applying these five guiding principles:
Facilitate adoption through hands-on improvement projects.
Define quality and get agreement.
Measure for improvement, not accountability.
Use a quality improvement framework and PDSA cycles.
Learn from variation in data.
By using these principles and starting small, organizations can quicken the pace of quality improvement in healthcare.
Pathways to Success: a self-improvement toolkit Focus on normal birth and reducing Caesarean section rates
Caesarean section (CS) has an important role in ensuring safe maternity care. How can we make
sure that every Caesarean is appropriate, effective and efficient?
The NHS Institute for Innovation and Improvement is working with NHS clinical staff to promote best practice in achieving low CS rates while maintaining safe outcomes for mothers and babies.
This toolkit is designed to help maternity services review and assess their current practice in promoting normal birth and reducing CS rates. The toolkit also provides practical techniques to support sustainable changes in maternity services.
A practical, introductory guide to thinking differently. It is not a comprehensive blueprint nor is it designed to make you an expert in thinking. But it will get you started on
a journey of thinking differently, and therefore doing things differently, that we hope continues well into
your future.
We have selected concepts and thinking tools that have proven their value, ease, and applicability in a
variety of industries and in over five years of experience with front line teams in various NHS organisations.
We’ll provide you with just enough background theory to help you see why the various thinking tools ask
you to do certain things that might seem a bit odd at first. But the emphasis here is not on dry theory or
abstract concepts. Rather, it is on developing new thinking that leads to new ways of doing.
If you are involved in treating patients, managing and/or improving health services or
managing or training those that do, you will understand the importance of providing the
best care possible for all our patients.
Great progress has been made in improving service standards and access and in reducing
waiting times, but there is still some way to go to ensure consistently high standards of
patient care across the NHS.
It is clear that we need to ensure we are getting it right first time, which means better care
and better value through the reduction of waste and errors and the prioritisation of effective
treatments. Quality, innovation, productivity and prevention (QIPP) is the mechanism through
which we can achieve this.
QIPP is about creating an environment in which change and improvement can flourish; it
is about leading differently and in a way that fosters a culture of innovation; and it is
about providing staff with the tools, techniques and support that will enable them to take
ownership of improving quality of care.
The Handbook of Quality and Service Improvement Tools from the NHS Institute brings
together a collection of proven tools, theories and techniques to help NHS staff design and
implement quality improvement projects that do not compromise on the quality and safety of
patient care but rather enhance the patient experience.
The ebd approach (experience based design) is a method of designing better experiences for patients, carers and staff. The approach captures the experiences of those involved in healthcare services. It involves looking at the care journey
and in addition the emotional journey people
experience when they come into contact with a particular pathway or part of the service. Staff work together with patients and carers to firstly understand these experiences and then to improve them.
This guide is an introduction to the ebd approach (experience based design).
This guide and toolkit has been produced as
a result of work that the NHS Institute for
Innovation and Improvement has undertaken in collaboration with NHS organisations and external agencies, using the experience of patients, carers and staff to design better
healthcare services.
This document is one of a series of documents that was produced by the NHS Institute for Innovation and Improvement as part of the High Volume Care programme.
Produced by the Delivering Quality and Value Team, the aim of the Focus on series was to help local health communities and organisations improve the quality
and value of the care they deliver
Support Sheet 18: PPC
This support sheet provides a description of Preferred Priorities for Care, a tool for the discussion and recording of end of life care wishes and preferences.
Support Sheet 15: Enhancing the Healing Environment
This support sheet outlines key design principles for end of life care environments and provides tips for managing an environmental improvement project
Support Sheet 14: Using the NHS Continuing Health Care Fast Track Pathway Tool
This support sheet provides answers to frequently asked questions about the NHS Continuing Health Care Fast Track Pathway Tool.
Support Sheet 13: Decisions made in a person's 'Best Interests'
This support sheet outlines the process for making decisions on behalf of someone who lacks capacity.
Support Sheet 12: Mental Capacity Act (2005)
This support sheet outlines the main provisions of the Mental Capacity Act the four tests essential for assessing capacity
Support Sheet 11: Quality Markers for Acute Hospitals
This support sheet outlines the quality markers by which acute hospitals can measure the standard of end of life care they provide.
Support Sheet 7: Models/Tools of Delivery
This support sheet outlines the key elements of
Advance Care Planning (ACP)
Gold Standards Framework (GSF)
Liverpool Care Pathway (LCP)
Support Sheet 5: Quality Markers for Care Homes
This support sheet outlines the quality markers by which care homes can measure the standard of end of life care they provide.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
Visit : https://massagespaajman.com/
Call : 052 987 1315
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Dr. David Greene R3 stem cell Breakthroughs: Stem Cell Therapy in CardiologyR3 Stem Cell
Dr. David Greene, founder and CEO of R3 Stem Cell, is at the forefront of groundbreaking research in the field of cardiology, focusing on the transformative potential of stem cell therapy. His latest work emphasizes innovative approaches to treating heart disease, aiming to repair damaged heart tissue and improve heart function through the use of advanced stem cell techniques. This research promises not only to enhance the quality of life for patients with chronic heart conditions but also to pave the way for new, more effective treatments. Dr. Greene's work is notable for its focus on safety, efficacy, and the potential to significantly reduce the need for invasive surgeries and long-term medication, positioning stem cell therapy as a key player in the future of cardiac care.
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.
Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
Feeding plate for a newborn with Cleft Palate.pptxSatvikaPrasad
A feeding plate is a prosthetic device used for newborns with a cleft palate to assist in feeding and improve nutrition intake. From a prosthodontic perspective, this plate acts as a barrier between the oral and nasal cavities, facilitating effective sucking and swallowing by providing a more normal anatomical structure. It helps to prevent milk from entering the nasal passage, thereby reducing the risk of aspiration and enhancing the infant's ability to feed efficiently. The feeding plate also aids in the development of the oral muscles and can contribute to better growth and weight gain. Its custom fabrication and proper fitting by a prosthodontist are crucial for ensuring comfort and functionality, as well as for minimizing potential complications. Early intervention with a feeding plate can significantly improve the quality of life for both the infant and the parents.
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
3. NHS Sustainability Model
Authors
Lynne Maher1
Professor David Gustafson2
Alyson Evans2
1 - NHS Institute for Innovation and Improvement, Coventry House, University of Warwick, Coventry CV4 7AL
2 - University of Wisconsin, Rm 1119 WARF Building, 610 Walnut Street, University of Wisconsin Madison 53705
Institute for Innovation
and Improvement
Sustainability 3
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 3
4. Sustainability Contents
Introduction
How to use the NHS Sustainability Model
The Sustainability Model
Process
Staff
Organisation
The Sustainability Model master score system
The score system bar chart and portal diagram
The NHS Sustainability Guide CD
4 Sustainability
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 4
5. Monitoring progress
Process
Organisation
Staff
Training and involvement
Behaviours
Senior leaders
Clinical leaders
Fit with goals and culture
Adaptability
Credibility of benefits
Benefits beyond helping patients
Infrastructure
Sustainability 5
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 5
6. The most successful organisations are those that can implement and sustain effective
improvement initiatives leading to increased quality and patient experience at lower
cost. The Sustainability Model and Guide has been developed to support health
care leaders to do just that.
Health services around the world need to consistently deliver high quality care at
lower cost and against rising expectations and demand. To achieve this we need to
continually improve our existing health systems and processes. Any change requires
a significant investment of time, financial resource and leadership effort. There is
evidence that up to 70% of all organisational change fails to survive and that is
just not acceptable when undertaking health care improvement1
.
The Sustainability Model is a diagnostic tool that will identify strengths and
weaknesses in your implementation plan and predict the likelihood of sustainability
for your improvement initiative.
The Sustainability Guide provides practical advice on how you might increase the
likelihood of sustainability for your improvement initiative.
Sustainability can be described as ‘when new ways of working and improved
outcomes become the norm’. A more detailed description, which includes
the notion of ‘steady state’, is as follows:
‘Not only have the process and outcome changed, but the thinking and attitudes
behind them are fundamentally altered and the systems surrounding them are
transformed as well. In other words the change has become an integrated or
mainstream way of working rather than something ‘added on’. As a result, when you
look at the process or outcome one year from now or longer, you can see that at a
minimum it has not reverted to the old way of working, or old level of performance.
Further, it has been able to withstand challenge and variation; it has evolved alongside
other changes and perhaps has continued to improve over time. Sustainability means
holding the gains and evolving as required - definitely not going back’.
(NHS Institute for Innovation and Improvement 2005)
1
Daft and Noe, 2000. Beer and Nohria, 2001
Quality improvement often takes longer than expected to take hold
and longer still to become widely and firmly established within an organisation
Ham et al, 2002
Introduction
6 Sustainability
“Sustainability means
holding the gains and
evolving as required -
definitely not going back.”
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 6
7. Development of the Sustainability Model and Guide
The Sustainability Model consists of 10 factors relating to process, staff and
organisational issues, that play a very important role in sustaining change
in healthcare. The Model has been developed with and for the NHS using a
co-production approach. Contributors include: front line teams, improvement
experts, senior administrative and clinical leaders from within the NHS and people
with specific expertise in the subject area from academia and other industries.
The development of the Model is based on the premise that the changes individuals
and teams wish to make fulfil the fundamental principle of improving the patient
experience of health services. Another important impact that can be gained by
using the Model is the effective achievement of change which creates a platform
for continual improvement. By holding the gains, resources - including financial
and most importantly human resources - are effectively employed. They are
not wasted because processes that were improved have reverted to the old
way or old level of performance.
The Sustainability Guide was developed as a direct result of requests from
NHS staff who were using the Model.
‘The problem is confirmed but I am not sure what to do about it’
Project director
‘I now have an indication of where I should focus some effort, but where do I get
further advice?’
Service improvement manager
The structure of the Guide mirrors the 10 factors identified within the Sustainability
Model. In doing so, it creates a comprehensive package consisting of a diagnostic
model and guidance for sustainability. Information within the Guide was gathered
from a variety of sources. These include the available literature on change and
sustainability, discussions with experts within and outside of healthcare and small
research studies commissioned to explore specific learning from ongoing
improvement programmes within the healthcare settings.
We have provided what we hope will be helpful, practical advice relating to each of
the 10 sustainability factors. We recognise that this is not exhaustive and that other
sources of useful information do exist. If you find something that works really well
for you and is not in the Guide, we would be happy to hear about it. Contact us at
sustainability@institute.nhs.uk
Sustainability 7
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 7
8. The Sustainability Model can be used by individuals or teams. For example, project
leaders may wish to undertake a sustainability assessment based on their individual
thoughts. This will be useful in terms of providing an overview of the likelihood of
sustainability. However, we have found that a much richer picture can be gained if
more members of the team, or those involved in the improvement initiative, complete
the diagnostic Model. In our experience, we have found that while one person might
score a sustainability factor highly, another has a completely different perspective.
It is these different perspectives that are important to understand. This is particularly
significant if the improvement initiative spans a whole system, for example a hospital,
doctor’s surgery and nursing home. In addition to providing an overall ‘sustainability
score’, the act of completing the Model can lead to useful discussions about your
improvement initiative.
We believe that the best way to use the Sustainability Model is at several different
points in time:
• at the first planning stage, just as you are setting up your improvement project -
this will enable you to identify and improve areas that require strengthening right
from the start
• around the time of initial pilot testing so that you can go into the full
implementation phase with confidence
• a few weeks after the improvement has been implemented to ensure an optimal
position for sustainability and continual improvement.
Don’t feel restricted by this though; you can use the Model at any time during your
improvement initiative.
How to use the Sustainability Model
8 Sustainability
The goal for creating the Sustainability Model was to develop an easy-to-use tool to
help teams:
• plan for sustainability of improvement efforts
• recognise and understand key barriers for sustainability, relating to their specific
local context
• self-assess against a number of key criteria for sustaining change
• identify strengths in sustaining improvement
• monitor progress over time.
The Model has been designed for use at the level of a specific planned or ongoing
improvement initiative or project. For example: within a doctor’s surgery to create
advanced access for patients; within a health community to develop a systematic
approach to care for patients with diabetes; within critical care environments to
create safer and more effective care through the development of care bundles; or
within a healthcare organisation to redesign and extend roles. These are just a few
examples to guide you.
The Model has not been designed to assess whether a department, whole
organisation or health community is likely to sustain change in general. Its use
needs to be linked to a specific improvement initiative.
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 8
9. Start from the beginning - it’s like baking a cake
People typically think that any consideration or action that might be needed to
ensure sustainability of their improvement initiative can wait until the end of the
project. In our experience, if you leave it to the end it will be too late to make any
changes that are needed to maximise the potential of sustainability.
Think about it in terms of baking a cake; if all the ingredients are measured out
correctly; if the mixing is carried out in the right way, if the cake tin is prepared
correctly, if the oven is at the right temperature and we bake the cake for the
prescribed amount of time, it is highly likely that the cake will be just as we expected-
delicious. But if the ingredients, measures, mixing and so on are not just in the right
proportion, or if the oven temperature is not exactly right, the cake will not turn out
as we expected or desired. At this stage it is often too late to rectify any problems.
The ten factors that we describe in this model and guide as being important for
sustainability could represent the elements required to create the best cake that we
can. It is really important to ensure that you have things in place from the
beginning in order to achieve the best improvement outcome that you can
and sustainability of that improvement.
Sustainability 9
What to do now
1 Read through each of the 10 factor descriptions.
2 For each factor select the level of each factor that best describes your local project.
Remember these factors may not exactly describe your situation.
3 Place a tick next to the ‘factor level’ you have selected.
4 When you have worked through all of the factors and identified a factor level for
each, go to the ‘Master Score System’ on page 22 where you will find the
numerical values for each factor level. Calculate the scores and enter these onto
the Master Score System on page 23.
5 Add up all of the scores to arrive at an overall sustainability score.
(Preliminary evidence suggests a score of 55 or higher offers reason for optimism.
Scores lower than this suggests that you need to take some action to
increase the likelihood that your improvement initiative will be sustainable.)
6 Identify the factors with greatest potential for improvement by plotting the scores.
You can either use the bar chart or portal diagram (pages 24 and 25) to do this;
choose which method you prefer.
7 We advise that you start by concentrating on the two or three factors with
the greatest potential for improvement. Go to the corresponding sections
of the NHS Sustainability Guide, on the CD attached, for some useful
information on how you might improve the score for each factor. Feel
free to browse through any of the other sections at any time.
We are continuing to assess the use and impact of the Sustainability Model and
Guide. We would be pleased to receive any thoughts or comments that you have
for their improvement. Please contact us with any advice or comments at:
sustainability@institute.nhs.uk
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 9
11. What can you find in the Sustainability Guide CD?
Benefits beyond helping patients
• Use role/process mapping to illustrate areas of duplication, waste or inefficiency. Get staff to create their own role map that can be updated as roles and processes change
• Assess ‘what is going well’ and ‘even better if’ from the perspective of staff and prioritise actions using dot voting
• Think of ways to release more time for staff and engage a wider community in the improvement work
• Support staff by making a plan to manage the transition from old to new ways of working.
Credibility of the evidence
• Find out how you can effectively identify the benefits of the improvement that you are making
• ‘Walk in their shoes’ or use experience based design techniques to understand change from different perspectives
• See tips on gathering and communicating the evidence of the benefits of the changed process
• Use seven questions to help create your improvement story.
Adaptability of improved process
• Find out how you can adopt and adapt ideas from others
• Read a short case study about adapting an improvement idea
• Think about aspects of organisational change that might disrupt the progress of your improvement project
• Prepare a succession plan for the future of the process or service.
Effectiveness of the system to monitor progress
• Use measurement and communication to help staff look ahead to continual improvement
• Find frameworks to help identify what are the most effective measures to use
• See examples of graphs, bubbles, pictures and quotes
• Learn about segmenting your messages for more effective communication.
Process
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 11
12. Choose the factor level that comes closest to your situation and tick the box to the left of it
Factor description Factor levelIdentify ()
Credibility of the benefits
• Are benefits to patients, staff and the organisation visible?
• Do staff believe in the benefits?
• Can all staff clearly describe the a full range of benefits?
• Is there evidence that this type of change has been
achieved elsewhere?
15.0
6.7
5.5
0.0
Benefits of the change are widely communicated, immediately obvious, supported
by evidence and believed by stakeholders. Staff are able to fully describe a wide range
of intended benefits for this initiative.
Benefits of the change are not widely communicated or immediately obvious even
though they are supported by evidence and believed by stakeholders.
Benefits of the change are not widely communicated or immediately obvious even
though they are supported by evidence. They are not widely believed by stakeholders.
Benefits of the change are not widely communicated, they are not immediately
obvious, nor are they supported by evidence or believed by stakeholders.
Benefits beyond helping patients
• In addition to helping patients, are there other benefits?
• For example, does the change reduce waste or avoid duplication?
• Will it make things run more smoothly?
• Will staff notice a difference in their daily working lives?
15.0
6.7
5.5
0.0
eg
Process
12 Sustainability
a
b
c
d
a
b
c
d
We can demonstrate that the change has a wide range of benefits beyond helping
patients, for example by reducing waste, creating efficiency or making people’s
jobs easier.
We can demonstrate that the change has some benefits beyond helping patients such
as reducing waste and making jobs easier, but not a wide range.
We can demonstrate that the change has one or two benefits beyond helping patients.
The benefits that we have identified are only directly related to helping patients.
We have not identified any other benefits that this initiative could bring.
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 12
13. Choose the factor level that comes closest to your situation and tick the box to the left of it
Factor description Factor level
Effectiveness of the system to monitor progress
• Does the change require special monitoring systems to
identify and continually measure improvement?
• Is there a feedback system to reinforce benefits and
progress and initiate new or further action?
• Are mechanisms in place to continue to monitor progress
beyond the formal life of the project?
• Are the results of the change communicated to
patients, staff, the organisation and the wider
healthcare community?
15.0
6.7
5.5
0.0
Adaptability of improved process
• Can the new process overcome internal pressures,
or will this disrupt the change?
• Does the change continue to meet ongoing
needs effectively?
• Does the change rely on a specific individual or group
of people, technology, finance etc, to keep it going?
• Can it keep going when these are removed?
15.0
6.7
5.5
0.0
The improved process can adapt to link in with and even support other organisational
changes. It would not be disrupted if specific individuals or groups left the project.
Its focus will continue to meet the improvement needs of our organisation.
The improved process can be adapted to support wider organisational change but it
would be disrupted if specific individuals or groups left the project. Elements of this
work will continue to meet our organisations improvement needs.
It would be difficult to adapt the new process to other organisational changes.
It would cause disruption if specific individuals or groups left the project.
The new process could not adapt if there was any other organisational change
happening and it would be disrupted if specific individuals or groups left.
Identify ()
Process
Sustainability 13
a
b
c
d
a
b
c
d
There is a system in place to provide evidence of impact, including benefits analysis,
monitor progress and communicate the results. This is set up to continue beyond the
formal life of the project.
There is a system in place to provide evidence of impact, including benefits analysis,
monitor progress and communicate the results. This is not set up to continue beyond
the formal life of the project.
There is a system in place to provide evidence of impact and monitor progress. However
none of this information is communicated more widely than the core project team. The
measurement system is not set up to continue beyond the formal life of the project.
There is only a very patchy system to monitor progress and this will end at the same
time as the project. There is no system to communicate the results.
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 13
14. 14 Sustainability
Training and involvement
Behaviours
Senior leaders
Clinical leaders
Staff
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 14
15. What can you find in the Sustainability Guide CD?
Staff involvement and training to sustain the process
• Learn how to recognise the characteristics displayed when staff feel lack of involvement
• Read tips on creating a culture of involvement
• Use the ‘Six Thinking Hats’ for maximum involvement during decision making
• Read case studies from other organisations.
Staff behaviours toward sustaining the change
• Find out about key points that affect staff involvement
• Understand a range of possible concerns from staff
• Explore a range of steps that you can take to reduce those concerns
• See links to other sources of support.
Senior leadership engagement
• Enable leaders to be involved and updated
• Think about the most appropriate communication mechanisms for leaders
• Formulate a plan to raise awareness of the improvement work with senior leaders
• Identify specific roles for leadership involvement.
Clinical leadership engagement
• Understand the clinician’s perspective
• Use the ‘Clinical engagement continuum’ as a tool
• Identify factors to support clinical engagement at a local level
• Find out how to enlist support.
Staff
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 15
16. 16 Sustainability
Choose the factor level that comes closest to your situation and tick the box to the left of it
Factor description Factor level
Staff
Identify ()
Staff behaviours toward sustaining the change
• Are staff encouraged and able to express their ideas
regularly throughout the change process and is their
input taken on board?
• Do staff think that the change is a better way of doing
things that they want to preserve for the future?
• Are staff trained and empowered to run small-scale tests
(PDSA) based on their ideas, to see if additional
improvements should be recommended?
15.0
6.7
5.5
0.0
Staff involvement and training to sustain
the process
• Do staff play a part in innovation, design and
implementation of the change?
• Have they used their ideas to inform the change process
from the beginning?
• Is there a training and development infrastructure to
identify gaps in skills and knowledge and are staff
educated and trained to take the change forward?
15.0
6.7
5.5
0.0
Staff have been involved from the beginning of the change process. They have
helped to identify any skill gaps and have been able to access training and
development so that they are confident and competent in the new way of working.
Staff have been involved from the beginning of the change process and have helped
to identify skills gaps but they have not had training or development in the new way
of working.
Staff have not been involved from the beginning of the change but they have received
training in the new way of working.
Staff have not been involved from the beginning of the change process and have not
had training or development in the new way of working.
eg
a
b
c
d
a
b
c
d
Staff are able to share their ideas regularly and some of them have been taken on
board during the project. They believe that the change is a better way of doing things
and have been empowered to run small scale test cycles (Plan, Do, Study, Act).
Staff are able to share their ideas regularly and some of them have been taken on
board during the project. They believe that the change is a better way of doing things.
Staff do not feel empowered to run small scale test cycles (Plan, Do, Study, Act).
Staff are able to share their ideas regularly but none seem to have been taken on board
during the project. They don’t think that the change will be a better way of doing
things. They don’t feel empowered to run small scale test cycles (Plan, Do, Study, Act).
Staff do not feel they have been able to share their ideas. They do not believe that the
change is a better way of doing things and they have not been empowered to run
small scale test cycles (Plan, Do, Study, Act).
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 16
17. Sustainability 17
Choose the factor level that comes closest to your situation and tick the box to the left of it
Factor description Factor level
Clinical leadership engagement and support
• Are the clinical leaders trusted, influential, respected
and believable?
• Are they involved in the initiative, do they understand it
and do they promote it?
• Are they respected by their peers and can they influence
others to get on board?
• Are they taking personal responsibility to help break
down barriers and are they giving time to help ensure
the change is successful?
15.0
6.7
5.5
0.0
Staff
Clinical leaders are highly involved and visible in their support of the change
process. They use their influence to communicate the impact of the work and to
break down any barriers. Staff regularly share information with and actively seek
advice from clinical leaders.
Clinical leaders are highly involved and visible in their support of the change process.
They use their influence to communicate the impact of the work and to break down
any barriers. Staff typically don’t share information with, or seek advice from
clinical leaders.
Clinical leaders are somewhat involved but not highly visible in their support of the
change process. They use their influence to communicate the impact of the work but
cannot be relied upon to break down any barriers if things get difficult. Staff typically
don’t share information with, or seek advice from clinical leaders.
Clinical leaders are not involved or visible in their support of the change process.
They have not used their influence to communicate the impact of the work or to
break down any barriers. Staff typically don’t share information with, or seek advice
from clinical leaders.
Senior leadership engagement and support
• Are the senior leaders trusted, influential, respected and
believable?
• Are they involved in the initiative, do they understand it
and do they promote it?
• Are they respected by their peers and can they influence
others to get on board?
• Are they taking personal responsibility to help break
down barriers and are they giving time to help ensure
the change is successful?
15.0
6.7
5.5
0.0
Organisational leaders are highly involved and visible in their support of the
change process. They use their influence to communicate the impact of the work
and to break down any barriers. Staff regularly share information with and actively
seek advice from leaders.
Organisational leaders are highly involved and visible in their support of the change
process. They use their influence to communicate the impact of the work and to
break down any barriers. Staff typically don’t share information with, or seek advice
from leaders.
Organisational leaders are somewhat involved but not highly visible in their support
of the change process. They use their influence to communicate the impact of the
work but cannot be relied upon to break down any barriers if things get difficult.
Staff typically don’t share information with, or seek advice from leaders.
Organisational leaders are not involved or visible in their support of the change
process. They have not used their influence to communicate the impact of the
work or to break down any barriers. Staff typically don’t share information with
or seek advice from leaders.
Identify ()
eg
a
b
c
d
a
b
c
d
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 17
18. 18 Sustainability
Fit with goals and culture
Infrastructure
Organisation
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 18
19. What can you find in the Sustainability Guide CD?
Fit with organisational strategic aims and culture
• How to embed improvement into the organisations mainstream business
• Use a framework to demonstrate the relationship between the improvement and organisational goals and vision
• Read the case study illustrating non-alignment of improvement and organisational goals.
Infrastructure for sustainability
• Align roles and job descriptions with the new process.
• Use a table to help develop new procedures reflecting the improvement
• Use a simple cost benefit analysis framework to consider ongoing resource needs for staff and equipment
• Read about four important questions to ask when developing your communication plan.
Organisation
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 19
20. Choose the factor level that comes closest to your situation and tick the box to the left of it
Factor description Factor levelIdentify ()
Infrastructure
• Are the staff fully trained and competent in the new
way of working?
• Are there enough facilities and equipment to support
the new process?
• Are new requirements built into job descriptions?
• Are there policies and procedures supporting the
new way of working?
• Is there a communication system in place?
15.0
6.7
5.5
0.0
Staff are confident and trained in the new way of working. Job descriptions,
policies and procedures reflect the new process and communication systems
are in place. Facilities and equipment are all appropriate to sustain the new process.
Staff are confident and trained in the new way of working. However, job descriptions,
policies and procedures do not reflect the new process. Some communication systems
are in place. Facilities and equipment are all appropriate to sustain the new process.
Staff are confident and trained in the new way of working. However, job
descriptions, policies and procedures do not reflect the new process and there
are no communication systems to adequately support the new process. Facilities
and equipment are not appropriate to sustain the new process.
Staff have not been trained in the new process and are not confident in the new way
of working. Job descriptions, policies and procedures do not reflect the new process
and there are no communication systems to adequately support the new process.
Facilities and equipment are not appropriate to sustain the new process.
Fit with the organisation’s strategic aims
and culture
• Are the goals of the change clear and shared?
• Are they clearly contributing to the overall organisational
strategic aims?
• Is improvement important to the organisation and
its leadership?
• Has the organisation successfully sustained improvement
in the past?
15.0
6.7
5.5
0.0
The goals of the change are clear and have been shared widely. They are consistent
with and support the organisation’s strategic aims for improvement. The organisation
has demonstrated successful sustainability of improvements before and has a ‘can
do’ culture.
The goals of the change are clear and have been shared widely. They are consistent
with and support the organisation’s strategic aims for improvement. The organisation
has not demonstrated success in sustaining previous improvements and does not have
a ‘can do’ culture.
The goals of the change are clear and have been shared widely. They have not
been linked with the organisation’s strategy so we don’t know if they support any
organisational aims for improvement. The organisation has not demonstrated success
in sustaining previous improvements and does not have a ‘can do’ culture.
The goals of the change are not really clear and they have not been shared widely. They
have not been linked with the organisation’s strategy so we don’t know if they support
any organisational aims for improvement. The organisation has not demonstrated
success in sustaining previous improvements and does not have a ‘can do’ culture.
eg
Organisation
20 Sustainability
a
b
c
d
a
b
c
d
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 20
22. 22 Sustainability
Process
8.5
4.7
4.0
0.0
Benefits
beyond
helping
patients
9.1
6.3
3.1
0.0
Credibility of
the evidence
7.0
3.4
2.4
0.0
Adaptability
of improved
process
6.5
3.3
2.4
0.0
Effectiveness
of the
system to
monitor
progress
11.4
6.3
4.9
0.0
Staff
involvement
and training
to sustain
the process
11.0
5.1
5.1
0.0
Staff
behaviours
toward
sustaining
the change
15.0
6.2
5.7
0.0
Senior
leadership
engagement
15.0
6.7
5.5
0.0
Clinical
leadership
engagement
Staff
Organisation
7.0
3.5
3.3
0.0
Fit with the
organisation’s
strategic
aims and
culture
9.5
4.4
3.3
0.0
Infrastructure
for
sustainability
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
Write your
score in the
circle
a
b
c
d
a
b
c
d
a
b
c
d
a
b
c
d
a
b
c
d
a
b
c
d
a
b
c
d
a
b
c
d
a
b
c
d
a
b
c
d
Enter your scores
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 22
23. Process total score
+
+
=
Staff total score
Organisation total score
Sustainability total score
To calculate your score, use the master score system on the opposite page. Add the Process,
Staff and Organisation scores together and place in the Sustainability total score box above.
Now go to the bar chart and portal diagram provided at the back of this document and
plot your scores.
Interpreting your scores?
We do advocate that you use the Sustainability Model at the beginning of your improvement initiative
as it can provide you with a vaulable understanding of where you can strengthen your work in order
to maximise the potential for sustainability. You need to note that at this stage it is normal to have
low scores in one or two of the factors. For example; infrastructure often has a low score initially as
the tasks of fuly training staff in the new process and revieiwing role descriptions are usually
undertaken later in the project. With each score teams should assess what the score means to them in
their particular context. Use the scores as a reminder of important tasks even if they need to be
undertaken at a later stage. (See the example on page 24).
Date:
Sustainability 23
Calculate your total scores
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 23
24. Use either the portal diagram or the bar chart to plot your scores and identify which
factors require most attention. You can use both if you prefer.
Within the example diagrams here, we have inserted example scores as an illustration.
You will note that ‘Adaptability of the improved process’ has the lowest numerical score
of 3.4. However, this is not the factor where the biggest improvement gain can be made.
Now look at the factor ‘Clinical leadership engagement’. You will see that the overall
potential for improvement is much bigger therefore this is the factor to focus on.
Now plot the scores for your project on either the portal diagram or the bar chart and look
to see which are the two or three factors with the greatest potential for improvement.
Interpreting your scores
Look at the example scores in the bar chart or portal diagrams. What do they tell
you? Use the ideas here to help you interpret your scores.
• Clinical leadership
A large amount of work is needed to help clinicians be more involved.
Some have been involved in the early stages but this is too little.
None are actively involved in the work or promote the initiative.
One meeting has been arranged recently, but we need to build on this.
• Involvement and training
Some staff have not been involved from the beginning of the initiative and
we need to catch up with them. There does seem to be some confusion
about what we are really trying to do and we also need to see what their
ideas are. We also need to have a sharper focus on training staff to manage
the new way of working as it is implemented and established. We will link
this in with the ‘Infrastructure’ factor.
• Infrastructure
We have not thought about changing any policies or procedures yet.
Communication systems are limited at this early stage of the work, but
we do need to strengthen this factor urgently. One of the first things
to do is set up some information in the work area so that staff can
see progress.
The dark blue points represent the maximum possible numerical score
achievable for each of the 10 factors
The grey points represent the example score
The gap between the dark blue and grey points shows the improvement
potential for each of the 10 factors - ie, the bigger the gap, the greater
the potential for improvement.
Portal diagram Benefits
Credibility of
the evidence
Adaptability
Monitoring
progress
Involvement
and training
Behaviours
Senior
leaders
Clinical
leaders
Fit with
goals and
culture
Infrastructure
16
12
8
4
0
Example score
Maximum score
Portal diagram and bar chart
24 Sustainability
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 24
25. Benefits beyond helping patients
Credibility of the evidence
Adaptability of improved process
Effectiveness of the system to monitor progress
Staff involvement and training to sustain the process
Staff behaviours toward sustaining the change
Senior leadership engagement
Clinical leadership engagement
Fit with the organisation’s strategic aims and culture
Infrastructure for sustainability
Your score
Your score
Your score
Your score
Your score
Your score
Your score
Your score
Your score
Your score
Example score
Example score
Example score
Example score
Example score
Example score
Example score
Example score
Example score
Example score Sample score
Maximum score
0 2 4 6 8 10 12 14 16
Score system bar chart
Sustainability 25
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 25
26. The Guide will help you ensure your sustainability activities are:
1 Focused: you don’t need to read the whole Guide - just go straight to the parts
where your scores were lowest and where you can have most impact
2 Practical: the Guide is packed with practical ideas and tools for you to try
3 Visual: you’ll learn about the best process mapping techniques to help you and
your staff visualise how improvements are changing processes and roles
4 Inclusive: you’ll find out how to get your staff involved, for instance ‘dot voting’
to pinpoint the really important issues
5 Doable: bringing benefits to life will become easier with simple, achievable
techniques like creating a ‘data wall’ and letting service users do the talking
6 Balanced: if you’ve never used the ‘Six thinking hats’ method (De Bono 1999)
find out how it can help you consider sustainability from every angle
7 Tailored: find out how to present your data and communications in a way that
your different audiences will welcome and understand
8 Forward thinking: plan for long-term sustainability by making sure your
improvement goals fit with the organisation’s wider strategic aims and visions
9 Holistic: explore better ways to ensure your change is embedded in your
organisation’s wider systems - through detailed job descriptions, clear policies
and communication channels that work
10 Real: read real life case studies from frontline teams who are successfully
sustaining their improvements.
10 top reasons to look at this CD…
If you’ve already worked through the Sustainability Model, you’ll now know where your
priority areas are for sustaining your improvement - but what next? You might be
wondering what you’ll gain by going into the Sustainability Guide: will it be worth
the effort; will you be able to find what you want; and even then, will it tell you
anything new?
In putting this Model and Guide together, we have been constantly aware of the
huge pressures on your time as improvement leaders; clinicians; service managers and
frontline professionals. You’ll want to know that any time you spend going through
the Guide will be as useful and practical as arriving at your sustainability score
through the Model.
Here’s 10 good reasons to use this Guide and get some new ideas and practical
measures for tackling the areas most relevant to you.
Why should I use the Sustainability Guide?
26 Sustainability
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 26
27. Sustainability Guide CD
How to use this CD
This CD has one downloadable PDF file that contains all of the Sustainability Guide
information. The Guide is intended to be used with the Sustainability Model.
Once you have identified the factors with the greatest potential for improvement,
using the Sustainability Model, go to the appropriate section(s) on this PDF where
you will find valuable guidance and advice.
The PDF files on this CD are:
ST_GUIDE_FEB2010
ST_WHYTHE_CD - Top ten reasons to look at this CD.
Sustainability 27
ST_MODEL_FEB03:Layout 1 3/2/10 10:06 Page 27