The TP-CKD Team held Cohort 2 Learning and Sharing Event - Valuing Individuals – Transforming Participation in Chronic Kidney Disease
Here are the slides from the event.
Graham Lipkin, Co-chair of KQuIP and Clinical VP Renal Association, together with Ron Cullen, CEO UKRR
Presented at the Scottish Renal Association 27th - 28th October 2016
The topic was:
Kidney Quality Improvement Partnership (KQuIP) Improving care for patients with kidney disease in Scotland?
Dr Richard Fluck - Chair of Think Kidneys spoke at HPE Live yesterday. The slides from his talk:Think(ing) Kidneys
Reducing the impact of AKI in secondary care can be found here.
Transforming Participation in CKD - peer review - 10 May 2016Renal Association
The document summarizes the agenda and activities for a Transforming Participation in Chronic Kidney Disease peer review event. The day included:
- Welcome and introductions
- Program updates on data collection, interventions, and communications
- Mixed group peer support session for units to share challenges and solutions
- Renal unit group work to discuss survey implementation successes and challenges
- Feedback from group work and planning for the next cohort of units
The event provided an opportunity for units in the program to collaborate and learn from each other's experiences in working to engage patients as active participants in their chronic kidney disease care.
Kidney Quality Improvement Partnership (KQuIP): Launch
A dynamic & inclusive and professionally-led partnership supporting improved quality of care for patients with kidney disease. Slides presented at the event by Graham Lipkin & Louise Wells, Co-chairs of KQuIP
Think Kidneys: Raising the profile of AKI in EnglandRenal Association
The document discusses the Think Kidneys program in England, which aims to raise awareness of acute kidney injury (AKI) and improve care. The program has established data flows to allow audit and quality improvement, provided education to clinicians and patients about AKI, and supported leaders in prioritizing AKI care. An evaluation found the program delivered national frameworks to guide action, raised the profile of AKI, and supported other improvement initiatives. The objectives of establishing better data, education, and championing have been met.
The document summarizes the closing event for the Think Kidneys AKI National Programme. It discusses that the next phase will involve articulating a vision for person-centered care that reduces the burden of AKI by leading and inspiring the community. Data from the AKI Registry and MPI will be used to deliver and demonstrate evidence of change. Resources will support spreading improvement efforts through patient safety collaboratives and adherence to the NICE AKI Quality Standard. Additional resources still in development include guides for ambulance staff, community staff, and educators.
Graham Lipkin, Co-chair of KQuIP and Clinical VP Renal Association, together with Ron Cullen, CEO UKRR
Presented at the Scottish Renal Association 27th - 28th October 2016
The topic was:
Kidney Quality Improvement Partnership (KQuIP) Improving care for patients with kidney disease in Scotland?
Dr Richard Fluck - Chair of Think Kidneys spoke at HPE Live yesterday. The slides from his talk:Think(ing) Kidneys
Reducing the impact of AKI in secondary care can be found here.
Transforming Participation in CKD - peer review - 10 May 2016Renal Association
The document summarizes the agenda and activities for a Transforming Participation in Chronic Kidney Disease peer review event. The day included:
- Welcome and introductions
- Program updates on data collection, interventions, and communications
- Mixed group peer support session for units to share challenges and solutions
- Renal unit group work to discuss survey implementation successes and challenges
- Feedback from group work and planning for the next cohort of units
The event provided an opportunity for units in the program to collaborate and learn from each other's experiences in working to engage patients as active participants in their chronic kidney disease care.
Kidney Quality Improvement Partnership (KQuIP): Launch
A dynamic & inclusive and professionally-led partnership supporting improved quality of care for patients with kidney disease. Slides presented at the event by Graham Lipkin & Louise Wells, Co-chairs of KQuIP
Think Kidneys: Raising the profile of AKI in EnglandRenal Association
The document discusses the Think Kidneys program in England, which aims to raise awareness of acute kidney injury (AKI) and improve care. The program has established data flows to allow audit and quality improvement, provided education to clinicians and patients about AKI, and supported leaders in prioritizing AKI care. An evaluation found the program delivered national frameworks to guide action, raised the profile of AKI, and supported other improvement initiatives. The objectives of establishing better data, education, and championing have been met.
The document summarizes the closing event for the Think Kidneys AKI National Programme. It discusses that the next phase will involve articulating a vision for person-centered care that reduces the burden of AKI by leading and inspiring the community. Data from the AKI Registry and MPI will be used to deliver and demonstrate evidence of change. Resources will support spreading improvement efforts through patient safety collaboratives and adherence to the NICE AKI Quality Standard. Additional resources still in development include guides for ambulance staff, community staff, and educators.
Improving the prevention, recognition and management of AKI: the ‘Think Kidne...Renal Association
The "Think Kidneys" initiative aims to reduce preventable harm from acute kidney injury (AKI) through various workstreams including risk identification, education, detection, measurement, intervention, and implementation. The program will develop tools and interventions to better prevent, detect, treat, and manage AKI. It will also work to ensure patients who develop AKI receive appropriate care to avoid further deterioration, long-term issues, and death. A key goal is having various guidelines and educational resources adopted across healthcare settings to standardize AKI care.
Integrated Treatment for ARLD: Making it happen, 2 February 2017 Presentation...Health Innovation Wessex
The James Lind Alliance brings together patients, caregivers, and clinicians to identify and prioritize the top 10 unanswered questions about particular health areas like alcohol-related liver disease, to help ensure research funders are aware of the issues that matter most. A priority setting partnership was established for alcohol-related liver disease, where a survey and workshop were held to identify the most important unanswered questions agreed upon by patients, caregivers, and health professionals dealing with this issue. The top 5 questions focused on ways to help people stop drinking, delivering healthcare education about risks, models of community-based care, experiences of patients, and how attitudes of healthcare professionals
1) Mrs. C, an 86-year-old woman with diabetes and other medical issues, presented with declining mobility and confusion to her primary care physician and out-of-hours doctor before being found fallen at home.
2) At an ambulatory care unit, her creatinine was found to be over 3 times her usual level, indicating stage 3 acute kidney injury (AKI). She was admitted to hospital where her renal function and mobility improved with treatment.
3) The presentation discusses AKI in vulnerable elderly populations in primary care and interface settings, calling for improved diagnostics, identification of at-risk groups, and guidance on suspecting and managing AKI outside of hospitals.
This document discusses a proposed national improvement project called KQuIP to increase home dialysis rates across the UK by addressing regional variation. It would establish regional collaboratives to test ideas and share best practices using a three-phase model of discovery, idea development, and testing cycles. Barriers to greater home dialysis use include financial factors, lack of leadership support and expertise, and perceptions of patient suitability. The project aims to standardize training pathways and measurement while respecting patient choice. Clear vision, leadership, organizational culture, and infrastructure support will be key drivers of success.
On Thursday 4 May, Julie Slevin, Think Kidneys Programme Development Officer spoke at the NACC conference at Haberdashers Hall in London:Raising awareness of hydration and ways to avoid Acute Kidney Injury in the care home environment
Accelerating Primary Care Abstract 2014 V9Nikki Davis
The AHPCN CR program was developed to improve access to cardiac rehabilitation services for residents in rural Alberta and increase participation rates, as prior to 2012 only 3% of cardiac patients from the region utilized the program in Edmonton despite 48% of cardiac patients living rurally. The program has grown from serving 12 participants weekly in 2012 to 30 participants weekly by 2015, offering both supervised exercise and educational classes delivered by a multidisciplinary team. Referrals have increased each year since the program began from rural hospitals, cardiac programs, and local physicians to better serve residents and support secondary prevention of heart disease.
This document summarizes the launch event for an NHS Improvement collaborative aimed at reducing urinary tract infections (UTIs) and catheter-associated UTIs. The event covered improvement methodology like driver diagrams and process mapping. Participants learned about collecting baseline data and examples of successful UTI reduction interventions. Teams were tasked with creating a process map and poster to share ideas at the next event. The goal is to reduce UTIs through a collaborative learning process using quality improvement methods.
The document discusses initiatives by Think Kidneys to improve care for acute kidney injury (AKI) and chronic kidney disease (CKD) in the UK. It describes programmes to reduce preventable harm from AKI through education and quality improvement efforts. It also outlines the Transforming Participation in CKD programme which aims to help people with CKD live better through self-management. Additionally, it provides an overview of the Kidney Quality Improvement Partnership which works to develop and share best practices in kidney care through collaboration.
The document discusses the Think Kidneys program which aims to improve prevention, detection, and management of acute kidney injury (AKI) in care homes. It provides background on AKI, noting that it is common and preventable. It then describes the Think Kidneys program objectives and initiatives targeted at care homes, including developing an educational guide and slides for care home staff. It invites care homes to volunteer to trial these materials and provide feedback to shape the final publications.
CUPS presentation 2 from Sept 2017 CACHC conferencecachc
This document summarizes a community-based program called Connect 2 Care (C2C) that provides intensive case management for socially vulnerable patients in Calgary who frequently use emergency departments and acute care services. The program is a partnership between Calgary Urban Project Society (CUPS) health clinics, Alpha House shelters, and local hospitals. Early evaluation data shows C2C is successfully housing clients, connecting them to primary care, and reducing acute care use. The program aims to scale up its model across Calgary and Alberta to better support this high-needs population through care coordination and addressing social determinants of health.
Service Innovation - UHS Pharmacy an Opportunity to Increase the Coverage of ...Health Innovation Wessex
Getting To Grips with Alcohol 2016
Presentation Slides
Service Innovation - UHS Pharmacy an opportunity to increase the coverage of identification and brief advice
Jacqueline Swabe and Lindsay Steel
Seven Day Hospital Services Workshop: South East NHS England
This workshop event, hosted by NHS England and NHS Improvement, brought together acute trust’s working towards the delivery of the four priority clinical standards by March 2018. Trust clinical leads and operational managers shared local challenges and solutions to delivery.
The document outlines the development of best practice guidance for primary care in responding to acute kidney injury (AKI) test results by Think Kidneys. It describes the 10 key steps taken, including forming a working group, reviewing existing guidelines, conducting a consensus process, and getting feedback. The guidance aims to put AKI test results in clinical context, treat the patient not just the test, maximize utility, and minimize burden on primary care. Forthcoming pieces include medicines optimization guidance and risk cards for primary care.
Developing and Implementing a Patient Reported Experience MeasureRenal Association
Rachel Gair, Person Centred Care Facilitator on the Transforming Participation in CKD programme gave a talk at the Home Therapies conference in Manchester:
Developing and Implementing a Patient Reported Experience Measure
Improving the prevention, recognition and management of AKI: the ‘Think Kidne...Renal Association
The "Think Kidneys" initiative aims to reduce preventable harm from acute kidney injury (AKI) through various workstreams including risk identification, education, detection, measurement, intervention, and implementation. The program will develop tools and interventions to better prevent, detect, treat, and manage AKI. It will also work to ensure patients who develop AKI receive appropriate care to avoid further deterioration, long-term issues, and death. A key goal is having various guidelines and educational resources adopted across healthcare settings to standardize AKI care.
Integrated Treatment for ARLD: Making it happen, 2 February 2017 Presentation...Health Innovation Wessex
The James Lind Alliance brings together patients, caregivers, and clinicians to identify and prioritize the top 10 unanswered questions about particular health areas like alcohol-related liver disease, to help ensure research funders are aware of the issues that matter most. A priority setting partnership was established for alcohol-related liver disease, where a survey and workshop were held to identify the most important unanswered questions agreed upon by patients, caregivers, and health professionals dealing with this issue. The top 5 questions focused on ways to help people stop drinking, delivering healthcare education about risks, models of community-based care, experiences of patients, and how attitudes of healthcare professionals
1) Mrs. C, an 86-year-old woman with diabetes and other medical issues, presented with declining mobility and confusion to her primary care physician and out-of-hours doctor before being found fallen at home.
2) At an ambulatory care unit, her creatinine was found to be over 3 times her usual level, indicating stage 3 acute kidney injury (AKI). She was admitted to hospital where her renal function and mobility improved with treatment.
3) The presentation discusses AKI in vulnerable elderly populations in primary care and interface settings, calling for improved diagnostics, identification of at-risk groups, and guidance on suspecting and managing AKI outside of hospitals.
This document discusses a proposed national improvement project called KQuIP to increase home dialysis rates across the UK by addressing regional variation. It would establish regional collaboratives to test ideas and share best practices using a three-phase model of discovery, idea development, and testing cycles. Barriers to greater home dialysis use include financial factors, lack of leadership support and expertise, and perceptions of patient suitability. The project aims to standardize training pathways and measurement while respecting patient choice. Clear vision, leadership, organizational culture, and infrastructure support will be key drivers of success.
On Thursday 4 May, Julie Slevin, Think Kidneys Programme Development Officer spoke at the NACC conference at Haberdashers Hall in London:Raising awareness of hydration and ways to avoid Acute Kidney Injury in the care home environment
Accelerating Primary Care Abstract 2014 V9Nikki Davis
The AHPCN CR program was developed to improve access to cardiac rehabilitation services for residents in rural Alberta and increase participation rates, as prior to 2012 only 3% of cardiac patients from the region utilized the program in Edmonton despite 48% of cardiac patients living rurally. The program has grown from serving 12 participants weekly in 2012 to 30 participants weekly by 2015, offering both supervised exercise and educational classes delivered by a multidisciplinary team. Referrals have increased each year since the program began from rural hospitals, cardiac programs, and local physicians to better serve residents and support secondary prevention of heart disease.
This document summarizes the launch event for an NHS Improvement collaborative aimed at reducing urinary tract infections (UTIs) and catheter-associated UTIs. The event covered improvement methodology like driver diagrams and process mapping. Participants learned about collecting baseline data and examples of successful UTI reduction interventions. Teams were tasked with creating a process map and poster to share ideas at the next event. The goal is to reduce UTIs through a collaborative learning process using quality improvement methods.
The document discusses initiatives by Think Kidneys to improve care for acute kidney injury (AKI) and chronic kidney disease (CKD) in the UK. It describes programmes to reduce preventable harm from AKI through education and quality improvement efforts. It also outlines the Transforming Participation in CKD programme which aims to help people with CKD live better through self-management. Additionally, it provides an overview of the Kidney Quality Improvement Partnership which works to develop and share best practices in kidney care through collaboration.
The document discusses the Think Kidneys program which aims to improve prevention, detection, and management of acute kidney injury (AKI) in care homes. It provides background on AKI, noting that it is common and preventable. It then describes the Think Kidneys program objectives and initiatives targeted at care homes, including developing an educational guide and slides for care home staff. It invites care homes to volunteer to trial these materials and provide feedback to shape the final publications.
CUPS presentation 2 from Sept 2017 CACHC conferencecachc
This document summarizes a community-based program called Connect 2 Care (C2C) that provides intensive case management for socially vulnerable patients in Calgary who frequently use emergency departments and acute care services. The program is a partnership between Calgary Urban Project Society (CUPS) health clinics, Alpha House shelters, and local hospitals. Early evaluation data shows C2C is successfully housing clients, connecting them to primary care, and reducing acute care use. The program aims to scale up its model across Calgary and Alberta to better support this high-needs population through care coordination and addressing social determinants of health.
Service Innovation - UHS Pharmacy an Opportunity to Increase the Coverage of ...Health Innovation Wessex
Getting To Grips with Alcohol 2016
Presentation Slides
Service Innovation - UHS Pharmacy an opportunity to increase the coverage of identification and brief advice
Jacqueline Swabe and Lindsay Steel
Seven Day Hospital Services Workshop: South East NHS England
This workshop event, hosted by NHS England and NHS Improvement, brought together acute trust’s working towards the delivery of the four priority clinical standards by March 2018. Trust clinical leads and operational managers shared local challenges and solutions to delivery.
The document outlines the development of best practice guidance for primary care in responding to acute kidney injury (AKI) test results by Think Kidneys. It describes the 10 key steps taken, including forming a working group, reviewing existing guidelines, conducting a consensus process, and getting feedback. The guidance aims to put AKI test results in clinical context, treat the patient not just the test, maximize utility, and minimize burden on primary care. Forthcoming pieces include medicines optimization guidance and risk cards for primary care.
Developing and Implementing a Patient Reported Experience MeasureRenal Association
Rachel Gair, Person Centred Care Facilitator on the Transforming Participation in CKD programme gave a talk at the Home Therapies conference in Manchester:
Developing and Implementing a Patient Reported Experience Measure
Think Kidneys Chair, Richard Fluck presented at the Home Dialysis conference in Manchester: A proposal for a improvement project for home dialysis
Read his presentation here.
Measurement for Improvement - Management of Acute Kidney Injury in primary c...Renal Association
Charlie Tomson, Consultant Nephrologist at theFreeman Hospital Newcastle upon Tyne and Chair of the Intervention Workstream, NHS England/UKRR Think Kidneys Programme
presented at a Measurement for Improvement event on 16th March.
Valuing Individuals – Transforming Participation in Chronic Kidney DiseaseRenal Association
This document provides an overview of a learning and sharing event for the Transforming Participation in Chronic Kidney Disease Programme. The day-long event included presentations on the programme methodology, introducing patient activation measures and collecting patient-reported outcomes and experience measures. It involved group work for renal teams to develop 30, 60, and 90 day plans to introduce these measures into their departments and receive peer assistance and review. The goal is to engage patients as active partners in their care and routinely collect data to improve participation and outcomes for patients with chronic kidney disease.
Evaluation of the Integrated Care and Support Pioneers ProgrammeNuffield Trust
This document summarizes the findings of evaluations of the Integrated Care and Support Pioneers Programme in the UK. The evaluations found that while Pioneers aspired to comprehensive system change, their activities focused more narrowly on initiatives like risk stratification and care coordination teams. Progress was difficult to measure against indicators and Pioneers faced challenges from financial pressures and competing priorities. The evaluations concluded that further integration will be challenging under increasing demands on the health system.
Improving mental health through patient and professional partnershipAmarShahELFT
Slides from the session at the International Forum on Quality and Safety in Healthcare 2016 (Gothenburg) - Improving mental health through patient and professional partnerships
Young people's mental health - where we have been and where we are going - Ma...NIHR CLAHRC West Midlands
Prof Max Birchwood's presentation on early interventions in youth mental health for the CLAHRC WM Scientific Advisory Group meeting, 9th June 2015, Birmingham, UK
Quality, Innovation, Productivity and Prevention in Primary CareNHSScotlandEvent
What do the Quality Ambitions mean for Primary Care? This session describes the ongoing innovative local improvements and national work with NHS
Boards and Primary Care contractors to improve quality, efficiency and outcomes as well as the future plans for Primary Care.
Professsor John Gladman - Caring for older people and stroke survivorsCLAHRC-NDL
Caring for older people and stroke survivors theme presentation by Professor John Gladman, delivered at the NIHR CLAHRC East Midlands launch event on 14 February 2014, Loughborough.
The document discusses a webinar series from the Patient Experience Network (PEN) focusing on what is working well in patient experience. The webinars will cover various initiatives and case studies from the UK that have improved patient experience. They will discuss topics like initiatives driven by passion, the importance of organizational support, measuring impact, and partnership working. The webinars are part of promoting the PEN National Awards which recognize excellence in patient experience.
The Research Design & Conduct Service recently gave a presentation to staff at the Cardiff School of Medicine to let people know about their services, advice and support, which they offer to health professionals who are in the process of developing research projects. The RDCS was funded in 2010 by the National Institute for Social Care and Health Research (NISCHR), part of the Welsh Assembly Government. Their partner organisations are Cardiff and Vale University HB, Cwm Taf HB, Aneurin Bevan HB and Powys Teaching HB.
Learn more about the RDCS by viewing the presentation below and by visiting their website: http://medicine.cf.ac.uk/rdcs/
This document discusses physical activity promotion in primary care. It finds that the UK has high rates of physical inactivity compared to other countries. Regular physical activity can significantly reduce the risk of diseases like cardiovascular disease, diabetes, and cancer. However, getting patients more active is challenging for general practitioners due to time constraints, lack of knowledge, and limited local exercise options. The document recommends solutions like educational toolkits, social prescribing programs, and designating practices as health and wellness centers to address these barriers and better promote physical activity.
This document provides guidance for the Clinical Outcomes Publication (COP) program, which publishes quality measures from National Clinical Audits at the consultant, team, and unit level. It covers topics like quality measures, data quality, outlier identification and management, legal considerations, and more. The goal of COP is to improve clinical quality and support transparency by learning from high performers and celebrating excellence. Participating audits are expected to report risk-adjusted mortality as well as additional specialty-specific quality measures of importance to patients.
The New Blueprint: challenging the comfort zoneMedCouncilCan
This document outlines the progress of the Blueprint Project since 2013. It proposes common frameworks to assess physicians for high-stakes decision making at two points: entry into residency and independent practice. Stakeholder consultations provided feedback on proposed assessment dimensions and definitions. Gap analyses found MCC exams currently underrepresent chronic illness and psychosocial aspects. Future work includes developing additional assessments through opportunities like e-portfolios and item banks to fully address the blueprint. Workshops will discuss including various assessments in an e-portfolio and sharing assessment data between organizations. The project aims to ensure physicians are qualified for practice through a rigorous yet evolving assessment system.
This document outlines the progress of the Blueprint Project since 2013. It proposes common frameworks to assess physicians for high-stakes decision making at two points: entry into residency and independent practice. Stakeholder consultations provided feedback on proposed assessment dimensions and definitions. Gap analyses found MCC exams currently underrepresent chronic illness and psychosocial aspects. Future work includes developing additional assessments through opportunities like e-portfolios and item banks to fully address the blueprint. Workshops will discuss including various assessments in an e-portfolio and sharing assessment data between organizations. The project aims to ensure physicians are qualified for practice through a rigorous yet evolving assessment system.
This document outlines plans for quality improvement (QI) initiatives across Luton and Bedfordshire. It discusses:
1) Developing a QI culture through leadership, empowering frontline staff, increasing transparency, and balancing quality control and improvement.
2) Aligning QI projects to aims of reducing harm by 30% annually and improving access to the right care, in the right place, at the right time.
3) Examples of QI work in other regions to reduce violence and improve access, and how the lessons learned could be applied in Luton and Bedfordshire.
Undergraduate nurses year three FINAL reviewed October 2020Renal Association
This document provides an overview of acute kidney injury (AKI) for undergraduate nurses. It defines AKI, discusses risk factors and causes, and outlines steps for identifying, managing, and referring patients with AKI. Key points include:
- AKI is a spectrum of injury that can lead to renal failure if unrecognized. It is identified by rises in creatinine and decreases in urine output.
- Patients with chronic conditions, sepsis, hypotension, or those on certain medications are at higher risk. Causes include reduced renal blood flow (pre-renal), direct kidney damage (intrinsic), or urinary tract obstruction (post-renal).
- For patients with AKI, nurses should monitor vital
Year One Undergraduate Nurses AKI Education UPDATED 2020Renal Association
This document provides an overview of acute kidney injury (AKI) for undergraduate nurses. It begins with basic anatomy and physiology of the urinary system and kidneys. It then introduces AKI, covering risk factors, causes, signs, and importance of prevention through adequate hydration. Key points are that AKI can often be prevented, those with chronic diseases are high risk, and causes may relate to problems with blood flow, the kidneys themselves, or urinary drainage.
Oxford and Thames Valley Region KQuIP day 2018 MAGIC projectRenal Association
This document discusses the Managing Access by Generating Improvements in Cannulation (MAGIC) program. MAGIC aims to improve vascular access rates for hemodialysis patients by improving cannulation practices. It does this through a quality improvement program with a core structure that can be adapted locally. The program involves leadership, education, competency assessment, patient materials, and ongoing measurement to promote best practices in vascular access care and preservation through improved cannulation. The goal is to make arteriovenous fistulas and grafts the preferred access by providing better patient experiences and longevity through better cannulation.
Oxford and Thames Valley Region KQuIP day 2018 Vascular Access DataRenal Association
The document summarizes data from the UK Renal Registry's (UKRR) Vascular Access Audit on the type of vascular access used by dialysis patients in several renal centers in the UK. It provides data from 2011-2016 on the percentage of incident and prevalent dialysis patients using arteriovenous fistulas/grafts (AVF/AVG) or other access types at various centers, and compares the rates to UKRR standards of 60% AVF/AVG use for incident hemodialysis patients and 80% definitive access (AVF/AVG or peritoneal dialysis) for prevalent patients. The document acknowledges the UKRR and renal units for providing and compiling the vascular access data.
Oxford and Thames Valley Region KQuIP day 2018 Home Therapies ProjectRenal Association
This document discusses increasing home dialysis therapies in England. It outlines a change model with elements like leadership, organizational culture, expertise, patient selection processes, training, and infrastructure. Key actions proposed include:
1) Forming regional and local project teams to coordinate efforts using a monthly review process and patient involvement.
2) Defining measures like home therapy rates, patient reported outcomes, activations levels, and clinical data to track progress.
3) Testing solutions through a cyclical process of research, idea generation, testing, evaluation and reporting to drive continuous improvement across the region.
Oxford and Thames Valley Region KQuIP day 2018 Home Therapies DataRenal Association
This document summarizes home therapy data from the UK Renal Registry (UKRR) and Key Performance Indicators (KQuIP) for the Oxford and Thames Valley region. It includes statistics on:
- The percentage of dialysis patients by treatment modality (in-center hemodialysis, home hemodialysis, peritoneal dialysis) and center from 2011 to 2016.
- The median age of dialysis patients by treatment modality and center from 2011 to 2016.
- The percentage of dialysis patients by treatment modality, age, gender, ethnicity, social deprivation, and comorbidities for various centers in 2011 and 2016.
This document summarizes living kidney donor transplantation rates and outcomes in various countries. It finds that living donor kidney transplants have higher graft survival rates than deceased donor transplants, with median survival estimates of 27 years for living donors versus 23 years for deceased donors. However, access to living donor transplants varies between regions in the UK. The ATTOM study found lower rates of living donor transplants referred from dialysis units compared to transplant centers. To improve access, centers should assess barriers to living donation in their local communities and take steps to reduce problems in their living donor pathways.
Oxford and Thames Valley Region KQuIP day 2018 Transplant FirstRenal Association
Transplant First was a quality improvement initiative across multiple renal units in the West Midlands to address inequality in access to renal transplantation. It found significant variability in median time to transplant listing across units. The initiative included pathway redesigns, data collection on reasons for missed listings, and educational events. Lessons learned included common causes for missed listings like failing transplants and delays in referrals to other specialties. The data collection tool provided insights into local barriers to be addressed to improve pre-emptive transplant listing.
KQuIP presentation Yorks & Humber regional day 060717Renal Association
On 6th June, Louise Wells, Co-chair of KQuIP - the Kidney Quality Improvement Partnership presented at the Yorks and Humber Network KQuIP UK Renal Registry Support day. You can see her slides here.
At UK Kidney Week, Graham Lipkin from the Kidney Quality Improvement Partnership (KQuIP) gave a presentation on
Working in partnership with ARI to Improve Quality & Safety through eLearning
Paul Bristow, BKPA, and Karen Thomas, UKRR gave a presentation at BRS2017: Embedding patient reported experience into future QI - 1st National PREM Pilot Survey 2016
This document provides information about acute kidney injury (AKI) for undergraduate nurses. It defines AKI and explains that it is a spectrum of injury that can lead to renal failure and death if unrecognized. The document outlines objectives related to understanding AKI, reviewing kidney anatomy and physiology, establishing the causes and risk factors of AKI, and understanding the role of the multidisciplinary team in diagnosis and management. It then provides details on identifying and staging AKI, discussing causes and risk factors, and outlines recommendations for plans of management for patients with AKI.
This document provides information about acute kidney injury (AKI) for undergraduate nurses. It begins with the aims and objectives of reviewing kidney physiology, identifying diseases that affect renal function, causes of AKI, and nursing interventions. It then discusses media reports on dehydration-related deaths and the financial burden of AKI. Poll findings show low public awareness of kidney function. The document reviews kidney anatomy and functions, AKI risk factors and definitions, causes including pre-renal, intrinsic renal and post-renal, identification using creatinine and urine output, complications, and management including fluid therapy, treating hyperkalemia and acidosis, and renal replacement therapy. It emphasizes the importance of prevention through careful monitoring, fluid maintenance
This document provides information about acute kidney injury (AKI) for undergraduate nurse education. It begins with an overview of the basic anatomy and physiology of the urinary system and kidneys. It then introduces AKI and discusses risk factors, causes, signs, and prevention. Key points are that AKI is the sudden deterioration of kidney function over hours or days, it is often preventable, and older patients and those with chronic diseases are most at risk. Dehydration is identified as a major cause of AKI.
How supportive are clinical teams of patients self-managingRenal Association
The document discusses a study that measured how supportive clinical teams are of patients with chronic kidney disease developing skills to self-manage their condition. A survey was given to 358 staff across 10 renal units to measure their support using the Clinical Support for Patient Activation Measure. The results found that most staff support self-management, though some barriers like time constraints and lack of support services were noted. Overall, the study provides a snapshot of attitudes around patient-centered care and highlights the need to further develop healthcare professionals' skills in partnering with patients.
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...Pristyn Care Reviews
Precision becomes a byword, most especially in such procedures as hip and knee arthroplasty. The success of these surgeries is not just dependent on the skill and experience of the surgeons but is extremely dependent on preoperative planning. Recognizing this important need, Pristyn Care commits itself to the integration of advanced imaging technologies like CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) into the surgical planning process.
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
More@: https://tinyurl.com/2shrryhx
More@: https://tinyurl.com/5n8h3wp8
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...Kumar Satyam
According to TechSci Research report, “India Medical Devices Market Industry Size, Share, Trends, Competition, Opportunity and Forecast, 2019-2029,” the India Medical Devices Market was valued at USD 15.35 billion in 2023 and is anticipated to witness impressive growth in the forecast period, with a Compound Annual Growth Rate (CAGR) of 5.35% through 2029. This growth is driven by various factors, including strategic collaborations and partnerships among leading companies, a growing population, and the increasing demand for advanced healthcare solutions.
Recent Trends
Strategic Collaborations and Partnerships
One of the most significant trends driving the India Medical Devices Market is the increasing number of collaborations and partnerships among leading companies. These alliances aim to merge the expertise of individual companies to strengthen their market position and enhance their product offerings. For instance, partnerships between local manufacturers and international companies bring advanced technologies and manufacturing techniques to the Indian market, fostering innovation and improving product quality.
Browse over XX market data Figures and spread through XX Pages and an in-depth TOC on " India Medical Devices Market.” - https://www.techsciresearch.com/report/india-medical-devices-market/8161.html
Fit to Fly PCR Covid Testing at our Clinic Near YouNX Healthcare
A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.www.nxhealthcare.co.uk
Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
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Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
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3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
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Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
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7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
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4. Programme for the Day
| 4
11:00
- Welcome and Housekeeping
- Aims of the Day and overview of programme to date
11:25 Ice Breaker
11:35
- PAM / PROM / CS-PAM Data
- Cohort 1 Presentations and Experiences
- Q&A Session
13:15 Lunch Break
13:45 - The Importance of Communication
14:05
- Quality Improvement and Change management
- The importance of starting small
14:35
- Group Work – Your Health Survey
- 30-60-90 Day Plans
- Feedback of Implementation Plan
15:50 - Next Steps and Close
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
7. NHS England is required by the NHS Mandate
‘to involve patients and their carers, and empower them to
manage and make decisions about their own care and treatment’
‘enhance quality of life for people with long term conditions’
and ‘embrace opportunities created by technology’
All people with a long term condition to have a personalised
care plan by 2020
Context for TP-CKD Programme
| 7Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
8. We know that…………..
| 8
• People who have the knowledge skills and confidence to be involved in their
health care have:
• Better health outcomes
• Improved quality of life
• Increased independence and control (decision making, informed choice, better
support)
• Increased knowledge and understanding
• Understanding the impact of CKD on the other 95% of life – not just when in clinic
Source: Coalition for Collaborative Care. Personalised care and support planning handbook. NHS England 2015
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
9. Many of the behaviours we are asking of people (staff and patients) are
only realised by those with greater levels of knowledge, skills and
confidence ( highly activated)
When we focus on the more complex and difficult behaviours– we
discourage those who have less skills, knowledge and confidence
If we start with behaviours more feasible for staff and patients to take on -
it increases individual’s opportunity to experience success
Why person centred care?
| 9Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
10. The Passive Patient
| 10
• Healthcare can be profoundly
disempowering
• But most patients want to be
treated as active participants –
as co-producers of health
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
11. To a person centred approach….
| 11Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
12. A developmental scale
| 12Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
13. What are the questions the TP – CKD programme is asking?
| 13
Can ‘person centred care’ measures be collected routinely
within renal units?
What level of knowledge, skills and confidence do people with CKD
have to manage their own health care – This is known as Patient
Activation
Does somebody who is activated have better QOL outcomes and
clinical outcomes
Can we improve a persons knowledge, skills and confidence with
targeted interventions
Co-Production underpinning the whole programme
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
14. Knowledge, skills and Confidence Cube
| 14Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
15. Patient Activation Measure (PAM) – 13 questions to assess a person’s knowledge, skills
and confidence in managing their own health and healthcare.
Patient Reported Outcome Measure (PROM) – What is really important to you as a
person with CKD
5 questions to assess a person’s overall health. E.g. problems performing usual
activities, self-rating their health by assessing between 0 (worst imaginable
health state) and 100 (best imaginable health state)
11 questions on how bothered you might be by the most common symptoms
renal patients experience.
CS-PAM –To assess how supportive HCP are to patients gaining knowledge, skills and
confidence to self manage
Phase 1 – Measurement with cohort 1
| 15Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
16.
17.
18. Lessons Learned
| 18
• Involve patients from the beginning – working group
• Clinical champion – patient champion
• Start small and build – QI cycles
• Engagement of whole team
• Leadership
• Different ways of working – volunteers – IT - process
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
19. What next……………..Phase 2 Cohort 1
| 19
Use data to understand where you are as a
team
Use it to begin to change behaviours and
conversations
HOW?
We will facilitate workshops + introduce
interventions
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
20. What next……………..Phase 1 Cohort 2
| 20
Implementation plan – 30-60-90 day
Develop implementation working group
Engage with larger team in unit
Start measurement in January 2017 – small
cycles
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
22. Ice breaker – “I bet you’ve never…?”
| 22
Think about something you have done or experienced that
no one in the room knows or would guess about you.
When everyone has one, share them on your table and
select the most interesting, unlikely or bizarre, and we’ll
share them.
The aim is to move beyond the value judgements we
sometimes make without thinking, and start the day as
equals bringing different qualities and experience to the
event.
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
24. • Key aim of TP-CKD: empower patients to take greater
control of their health and wellbeing - leading to better
outcomes
• Clinical teams also have a key role in patient activation, but
they are variable in their level of support for patient
activation: CS-PAM
Aim of TP-CKD
| 24Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
25. • Aim of CS-PAM: understanding staff attitudes and beliefs to
person centred care within each renal centre with the
intention that once fed back acts as a catalyst for change
• Ten renal centres submitted data as part of cohort 1, with
358 staff members completing the survey
CS-PAM
| 25Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
26. CS-PAM: clinical staff demographic results
| 26
Staff Number % Staff Number %
Number of staff 287 Gender
Male 60 20.9
Staff type Female 200 69.7
Doctor 50 17.4 Missing 27 9.4
Nurse 148 51.6 Ethnicity
AHP 45 15.7 White 182 63.4
Other 27 9.4 Black 9 3.1
Missing 17 5.9 Asian 49 17.1
Age group (years) Other 12 4.2
<=24 5 1.7 Not applicable 4 1.4
25-34 46 16.0 Missing 31 10.8
35-44 96 33.4 Regularly work with
45-54 88 30.7 long term conditions
55+ 25 8.8 Yes 255 88.9
Missing 27 9.4 No 5 1.7
Years in practice Sometimes 10 3.5
0-5 26 9.1 Missing 17 5.9
6-10 42 14.6 Clinical setting
11-15 41 14.3 Within acute hospital setting 199 69.3
16-20 38 13.2 Outside hospital setting 36 12.5
21-30 70 24.4 Other 18 6.3
30+ 22 7.7 Missing 34 11.8
Missing 48 16.7
27. CS-PAM: Percentage of staff per activation level
| 27Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
28. CS-PAM: Activation level by staff type and age group
| 28Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
29. CS-PAM: Activation level by clinical experience & gender
| 29Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
30. CS-PAM: Renal centre and staff activation level (%)
| 30Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
31. • 30% of staff highly activated
• Wide range of individual CS-PAM scores: 22.6-90.6
• The variability in support for patient activation also reported in other studies
• The mean activation score of 72.0 (range 22.6-90.6, median=71.6) was
similar to results in the NHS England CS-PAM report, indicating that clinical
support for patient activation has not changed substantially over the last 6
years
CS-PAM: Summary findings
| 31Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
32. • There was evidence of a significant difference in the support for
patient activation between genders and staff type: female staff
were more activated than males, nurses and AHP were more
activated than doctors
• There was no significant difference found between activation
and age and years’ clinical experience
• Independent actions and judgements by patients were
supported to a lesser degree by staff
• Least supported was patients seeking information
independently
CS-PAM: Summary findings - continued
| 32Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
33. PAM and PROM
| 33
The TP-CKD measurement work stream developed a tool known
as ‘Your Health Survey’ using previously validated surveys:
•5 questions on overall health (EQ-5D-5L)
•17 questions on symptoms (iPOS-S renal)
•13 questions on the ability of the patient to manage their
health (Patient Activation Measure (PAM))
The PAM is calculated as a score which corresponds to a PAM
level
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
34. PAM levels explained
| 34
PAM level 1: Disengaged and overwhelmed. Individuals passive & lack self-
confidence, knowledge low, goal-orientation weak, adherence low.
PAM level 2: Becoming aware but still struggling. Have some knowledge but large
gaps remain, believe health is largely out of their control
PAM level 3: Taking action. Individuals have key facts, are developing self-
management skills and are goal orientated.
PAM level 4: Maintaining behaviours, adopting new behaviours but may struggle in
times of stress and change. Maintain a healthy lifestyle.
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
35. PAM/PROM patient demographics
| 35
Patient demographics Number Percentage
Assistance with survey completion
Own 619 58.8
Staff 219 20.8
Friend/relative 160 15.2
Unknown 55 5.2
All 1,053 100.0
Completion of survey
At home 255 24.2
Renal unit 643 61.1
Clinic 107 10.2
Unknown 48 4.6
All 1,053 100.0
Age distribution
18 to 24 27 2.6
25 to 34 56 5.3
35 to 44 80 7.6
45 to 54 162 15.4
55 to 64 217 20.7
65 to 74 234 22.3
75+ 274 26.1
Unknown 3 0.3
All 1,053 100.0
39. Patient symptoms
| 39
Prevalence of patient symptoms determined as the proportion of patients with moderate,
severe or overwhelming symptoms, with the 5 most prevalent symptoms:
•58% of those surveyed experienced weakness and lack of energy
•49% of patients surveyed reported having poor mobility
•39% of those surveyed experienced pain
•38% of those surveyed reported difficulty in sleeping
•36% of those surveyed experienced shortness of breath
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
40. Patient symptoms by age group
| 40Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
42. Summary findings PAM/PROM
| 42
• Many people living with CKD completed the survey, more than half doing it
themselves, without needing help from others. This is a promising starting
point for using the survey on a wider scale.
• One in three patients reported to feel overwhelmed by their illness, and
preferred that their doctor to make the decisions about their health.
• At the same time, a similar proportion said that they had the knowledge,
skills and confidence to be part of their health care team.
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
43. Summary findings PAM/PROM - continued
| 43
• Many participants felt they lacked the confidence to work out solutions when new
health problems would arise, and did not feel able to maintain lifestyle changes.
• More than half of all people who completed the questionnaire reported to be
bothered by lack of energy.
• Poor mobility, pain and difficulty sleeping were also very common.
• Half of all participants had at least moderate problems with mobility and with
carrying out their daily activities.
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
44. Lessons learned from cohort 1
| 44
• Response rates for CS-PAM were low: varied from 3% to 30%, overall response rate of 14.3%
for all staff
• Respondents completing the survey are self-selective: don’t know if respondents are
representative of the staff/patients in each renal centre and staff in the wider kidney
community
• CS-PAM: big differences in response rates between renal centres
• There is likely biases: possibly be more towards respondents that are activated and staff that
support person centred care completing survey
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
45. Lessons learned from cohort 1 - continued
| 45
• Feedback of CS-PAM results to individual staff members severely hampered by staff not
providing identifiers
• Due to low numbers of staff participating in some renal centres, detailed centre level reports
only possible in 2 centres (CS-PAM)
• The problem with small numbers:
•Could result in the identification of respondents
•Limits generalisability of survey results at centre level
• An increase in the number of respondents at centre level is needed to report meaningful
statistics back to centres and for results to useful in affecting clinical change
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
46. Lessons learned from cohort 1 – small numbers
| 46
Demographic characteristics
Centre X Centre X + 6
Number % Number %
All staff 14 20
Age group (years)
<=24 1 7.1
25-34 3 21.4
35-44 4 28.6
45-54 4 28.6
55+ 1 7.1
Missing 1 7.1
PAM level
High 4 28.6 8 40.0
Low 6 42.9 6 30.0
Medium 4 28.6 6 30.0
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
47. Conclusion
| 47
• It is possible to routinely gather clinician support for patient
activation as well as a patient’s level of knowledge, skill and
confidence, quality of life and experience of healthcare using
data collection methods
• Thanks you for listening
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
48. TP-CKD Cohort 1 Experiences
Bradford
Presented by Dr Ramla Mumtaz ,Clinical Staff Lead &
Peter Forrest ,Patient Lead
49.
50. Bradford’s identified pilot survey patient group was “Haemodialysis patients”. Surveys
completed in January-February 2016.
Bradford Project Strengths ;
A. Successful 50: 50 partnership (Patient and Staff managing project) - 3-4 monthly progress
review meetings
B. Local press release, media coverage and utilization of Trust wide available resources.
C. Targeted use of staff and patient group meetings.
D. Timely discussions of challenges and progress reports.
Challenges faced and dealt by Team Bradford ;
A. Non-engagement (Analysis done ,barriers identified both for staff and patients)
B. IT , Admin and Clinical support Co- ordination ( support identified and co ordinated)
C. Staff and Patient Coaching initiatives ( coaching session planed, first one by RR on 25/11)
D. Sustainability ( to discuss after CQUIN Completion)
Implementation
| 50Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
51. Pilot data returns from Renal Registry for 148 patients , transferred to BHLY (vital
data)
Available to use during clinical interactions. Patient informed of their activation level
during consultations.
Staff acknowledging it in care plans and are trying to agree shared goals based on
activation level ranging from low to high , 1-4.
Local pilot data provided by Renal Registry was analysed by Trust C QUIN team to
take up - C QUIN scheme offered by NHS England.
Data Handling
| 51Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
52.
53. CQUIN ; Activation System for Patients with Long Term Conditions Scheme Name:
GE2: Activation System for Patients with Long Term Conditions (LTCs)
Duration ; April 2016 to March 2018,
Focus Group ; Pre- Dialysis, Failing Transplant ,CKD4- 5 Patients
Target Number ; 500 patients.
Our Next Step( in progress)
| 53Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
54. TP-CKD Cohort 1 Experiences
Newcastle
Presented by Helen Ritson (Young Adult Kidney Care Co-ordinator)
and Rachel Fraser (Renal Pharmacist)
55. • Education of staff
• Intimidating ? Too much extra work
• Finding someone to take ownership
• Timing of conference calls
• Frequency of repetition
Challenges
| 55Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
56. • Learning and sharing events
• 30-60-90 plan
• Patient support
• Rachel Gair
• Feedback from Sarah about progress
Help & Support
| 56Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
57. | 57
Young Adult Patient Group
• 58 patients
• Aged 18-30
• Young adults publicised via closed groups on Facebook, Twitter
and Instagram to raise awareness
• Surveys given to face-to-face or via post
• Response rate:
• Almost 100% face-to-face (1 patient refused)
• 14/18 post
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
58. | 58
Transplant Patient Group
• > 730 patients
• Posters and leaflets in clinic
• Repatriation project
• Surveys given at outpatient clinic visit
• 20 patients each week
• Response rate good
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
59. | 59
Next Steps
• Intend to repeat after 6 months
• Practicalities
• Roll out to other patient groups
• Using experience from Young Adult/Transplant groups
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
60. • Good response rate to PREM
• MDT task and finish group
• Involvement from TKPA volunteers
• Commitment from all staff (whole unit involvement)
PREM
| 60Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
62. TP-CKD Cohort 1 Experiences
Derby
Presented by Peter Naish & Joanna McKinnell
63. > Developing an implementation working group – How you did it, who
it consists of and how you use reflection at end of each meeting. The
importance of the clinical/patient champion role.
> Development of a patient video
>How you engage the wider team and keep the momentum going
Development of Working Group
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016 | 63
64. • Dissemination across whole workforce by key members with TP-CKD group
• Verbal and email reminders
• Received results in private and confidential envelopes individually named
• Handed out in person and offered the opportunity to discuss the results
• Surprise, competition, debate around questions, discussion over meaning
• Delay in incorporating into appraisal multi factorial
CS-PAM
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016 | 64
65. • Low clearance clinic, real time
• Then rolled out to PD
• Spread sheet useful especially for pd population, allowed targeted
intervention in groups flagged up highly in depression / anxiety based
questions
• Concern over more widespread use before using patient view feature properly
• Communication to patients of their results and what we are doing with them
• Very successful group, clear and united vision...... culture change
• Patient video example.
Small Cycles of Change – The Process
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016 | 65
66. TP-CKD Cohort 1 Experiences
Kings College Hospital
Presented by Eleri Wood & Agnes Gogognon
67. Getting Started
| 67
Challenges to implementing survey How did we overcome them?
Competing demands = lead only able to give
relatively small amount of time/resources
•Everyone else having same problem, but being
less invested, and geographically separate
•Fall off of patient and clinical volunteers who
came to initial event
• Difficulty engaging lots of patient volunteers in
absence of active KPA
Patient reluctance to complete the form
•Competing with other PREM/PROMs.
•Disconnect between completing the survey and
getting results / changing management
• Start small
• Aim to establish practice in areas
where similar data already
collected before spreading
• Patient volunteer meeting clinicians
• Patient volunteer engaging with
and assisting patients
• Replacing or aligning with other
measures
• Using posters, leaflets
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
68. What is the role of patient volunteer?
Introducing the survey to patients, encouraging, assisting to complete, informal
peer support and signposting, provided positive role model.
Advocating for the programme to clinicians
Motivating clinician leads
How does this work and what lessons can be shared?
Initially volunteer and clinician working together
Short frequent visits and contact
Over time volunteer familiar to nurses and patients in the area
We plan to repeat this in each clinical area to engage the wider
team and gain the spread
Role of Patient Volunteer
| 68Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
74. 1. Your team and Trust
2. Your patients
3. The TP-CKD team
Communication – who?
| 74Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
75. Why?
To help people understand
To increase involvement and engagement
To raise awareness and the profile of your work
1. Your team and Trust
| 75Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
76. Why?
To help them understand why you’re doing this
work
To increase involvement and engagement
To encourage to take part
To influence others
To make change and improvement happen
2. Your patients
| 76Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
77. Why?
To help and support you
To increase awareness of the programme and
your part in it
To encourage others to take part
To showcase this work to the NHS and beyond
3. The TP-CKD team
| 77Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
78. Plan how you are going to do it
Talk to people
Create your messages and get them out
Provide regular updates and feedback to people
Use the resources you have
Get help if you need it
How to communicate…..
| 78Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
79. Communication…
Make use of
resources
available –
poster, leaflet,
guidance,
connections,
people,
Find people
who will help
you with this –
someone from
your team,
your Trust
comms team,
me (!)
Important
message from
C1 – “involve
and engage
with everyone
– the better
the comms
the better it
all works”
Essential
element of
comms -
feedback to
everyone
involved
| 79Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
80. Keep a focus on
communication –
your success
depends on it…..
| 80Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
83. • Peer Assist from experts helps you refine your plans and
your overall strategy
• After Action Review – Helps you make the small adjustments
as you go along
• Peer Review helps us all reflect and capture the learning
• Underpin it all with measurement and and co-production to
keep it real and inform decisions
A Simple Model of Change and Sharing
| 83Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
84. • Have a clear idea of what you want to achieve
• Develop a set of plans that describe what you are going to do and
how you will do it
• Identify a peer assist team that will be able to challenge your
plans. This could include
• People who have already done it
• People with expertise from inside or outside your organisation
• IT, etc COMMS, Project Management
Peer Assist
| 84Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
85. • Conduct the session
• Identify a facilitator – role is to keep the workshop open and challenging
avoiding defensiveness and encouraging learning
• Identify a scribe
• Team present their initial plans
• Correct change plans as you go
• Come out with a finalised plan
• Run for no longer than 2 hours
Peer Assist
| 85Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
87. • Learning whilst doing: don’t wait until the end of the project
• A simple process for continuous improvement: learn quickly
and adapt in order to improve
• Introducing the discipline of reflection and learning
• Team building: opportunity for sharing of insights, strengths
and weaknesses of event as equals. Team learning & building
trust.
Why do it?
| 87Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
88. When do you hold a AAR?
| 88
• Events suitable for AARs have a beginning and end, a
purpose and some metrics on which performance can be
measured.
• After the initial pilot – hold one straight after a clinic where
health surveys were handed out
• After a working group meeting
• After each 30-60-90 days of implementation plan
• You can decide how often!
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
89. Hold the AAR immediately
| 89
• Participants still available
• Memories fresh
• Learning can be applied straight away, even on the next day
• Enables build up of knowledge
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
90. Create the right climate
| 90
• Everyone in the event participates on an equal footing
• Completely free to challenge and comment on actions
• Climate of openness and commitment to learning – they are
not critiques or personal performance evaluation
• No spectators or management oversight but sometimes
might require a facilitator
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
91. How do AARs work?
| 91
• It is a pencil and paper or flip chart exercise
• Take no more than 20 minutes
• Open and honest meeting
• Answers 4 questions:
• What was supposed to happen?
• What actually happened?
• Why were there differences?
• What can we learn from that?
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
92. A personal AAR
| 92
• Take a few moments and reflect on something that
happened yesterday – imagine it – remember what you said
and how you feel
• Now answer the 4 AAR questions
• What was supposed to happen?
• What actually happened?
• Why were there differences?
• What can you learn from this?
Just imagine what a team can achieve with a similar reflection
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
93. | 93
What were the objectives of the activity?
•All share understanding of what was supposed to happen
•It does require a clear, well communicated and unambiguous
objective and plan.
•Everyone write down on a piece of paper and feedback to
group or capture on flip chart.
What was supposed to happen
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94. What actually happened – the ground truth
| 94
• Vital part of process – don’t rush it
• Identify problem not culprit
• Establish the facts and encourage personal disclosure – can
‘unblock’ the process
• Challenge people if they start moving on to opinions
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
95. Compare plan with reality
| 95
Why were there differences and what can we learn?
•Successes and shortfalls discussed
•Action plans put in place to sustain successes and improve
shortfalls
•People learn from differences in perspectives
•May need to repeat the question – why was this? To get to
underlying reasons
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
96. Recording an AAR
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• Generate summaries of learning points
• Primarily learning for the team
• Basis for a broader learning programme – ‘is there anyone
else with whom we could share what we’ve learned’
• Capture a record of key learning points and agreed actions &
then refer to as a reminder at beginning of next activity.
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
97. Role of the Person Centred Care Facilitator
| 97
• Monthly calls with TP-CKD lead
• Attend working group meetings
• Support teams with resources and information
• Capture learning – ‘what have been challenges and what has
worked’
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98. Peer Review
| 98
• This mirrors the peer assist event but pulls together the learning
• Identify key results and learning points and present them
• Identify a group that includes
• Stakeholders you may wish to engage and spread
• Experts who can challenge
• People who can commit resources to continue
• Capture the overall learning on a series of agreed templates to share
• Plan for the next phase
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99. Measurement
| 99
• We measure for many reasons
• Judgement e.g. UKRR reports – Test against standards mainly outcomes some
process
• Research – To prove a change in practice has improved before and after
measurement usually outcomes
• Improvement – Need rapid feedback mainly measure processes and feedback
rapidly
• Remember to be clear what you are trying to achieve
• Design measures to measure this
• Remember to put in balancing measures eg increased time
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100. How does this link with AAR
| 100
Measure
Time
AAR
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102. 30-60-90 Day Plan Instructions
| 102
We would like to see you develop a 30-60-90 day plan based on a Quality
Improvement approach – starting with small cycles of change and spreading.
Please use the learning shared from cohort 1 to develop these plans
You will find examples of the 30-60-90 day plans from Cohort 1 on your table to
offer ideas. Please also see the After Action Learning tools.
Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
103. Example of a 30-60-90 Day Plan
Within… We want to achieve… We will achieve this by…
30 Days Engage about PAM, CSPAM & PROM
Who?
By whom?
How?
60 days Pilot PAM, CSPAM & PROM
Who?
By whom?
How?
90 days Roll out routine use of PAM, CSPAM and PROM
Who?
By whom?
How?
| 103Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
104. Within… We want to achieve… We will achieve this by…
30 Days
60 days
90 days
30-60-90 Day Plan Template
| 104Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
105. Feedback of Implementation Plan
| 105
We would like each renal unit team to share 5 minutes feedback at the end of
the session covering the following:
•What group of patients do you propose starting with?
•What do you see as challenges?
•How will these be overcome?
•What do you have in place that you can develop further – links with KPA,
patient + clinical champion, working group etc.
•What support would you like from TP-CKD team?
•What’s your key message to take back to your team following this event?
| 105Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
106. Richard Fluck
Nephrologist, Derby and Co-Chair
of TP-CKD Programme
Richard.fluck@nhs.net
Jonathon Hope
TP-CKD Patient Co-Chair
jonathonhope@msn.com
How to find out more
Karen Thomas
Head of Programmes
UK Renal Registry
Karen.thomas@renalregistry.nhs.uk
Sarah Evans
TP-CKD Programme Coordinator
UK Renal Registry
Sarah.evans@renalregistry.nhs.uk
Rachel Gair
Person Centred Care Facilitator
UK Renal Registry
Rachel.gair@renalregistry.nhs.uk
Ron Cullen
CEO
UK Renal Registry
Ron.cullen@renalregistry.nhs.uk
Contact Think Kidneys
www.linkedin.com/company/think-kidneyswww.twitter.com/Thin
www.youtube.com/user/thinkkidneys
www.slideshare.net/ThinkKidneys
www.thinkkidneys.nhs.uk/CKD
| 106Transforming Participation in CKD | Cohort 2 Event | 08 November 2016
Editor's Notes
… but not so far to the extreme as to make the arrival at a decision unlikely! Many patients now have access to a lot of information on the internet – not all of it reliable or balanced. The challenge is to ensure we are working with patients as partners but ensuring they have good information on which to base their decisions.
Developing knowledge, skills and confidence to become partners in managing their own health
Surveys of staff with an activation score of 100 was excluded (n=41) and some surveys were excluded due to severe incompleteness (n=30).
The majority of doctors completing the survey were consultants (72.0%), with some trainee and speciality clinicians.
The ‘other’ staff category comprised of administrative and clerical staff, health care assistants, technicians, social workers, support workers, care co-ordinators and other non-clinical staff.
Three activation levels were calculated by grouping the range of activation scores into thirds to determine the activation levels low, moderate and high. Staff in lower activation levels show lower rates of patient centred behaviours.
About 54% of doctors were on the lowest activation level compared to 34% for nurses and 22% for AHP. AHPs had the largest proportion of moderately activated staff as well as the smallest proportion of staff on the lowest level of activation.
Variability in activation level by age group, with the highest activation level in younger staff members, aged ≤34 years.
The biggest proportion of staff members on the lowest activation level were in age group 55+ years, followed by age group 35-44 years.
Despite apparent differences in activation by age group, there was no evidence of a significant difference between age groups and activation.
The proportion of staff on the lowest level of activation increases as the number of years of experience increases.
Staff with experience between 21 to 30 years have a high proportion on the lowest as well as the highest levels of activation.
As the CS-PAM survey is self-reported, it is possible, for example, that more experienced staff are more self-critical of their activation status and score themselves lower.
Female members of staff have a much higher median activation score than male staff members.
Fifty percent of male staff members were on the lowest activation level, whereas 68% of female members of staff were moderately or highly activated .
There is evidence that this difference is statistically significant.
Staff on the lowest activation level ranged from 21.7% to as high as 46.4% at renal centre level.
The percentage of staff in each renal centre on the highest activation level ranged from 20.0% to 66.0%.
Similar findings were reported in the CS-PAM development paper and the NHS England CS-PAM report
Highly activated patients are more likely to adopt healthy behaviour, to have better clinical outcomes and lower rates of hospitalisation, and to report higher levels of satisfaction with services.
Patients with low activation levels are more likely to attend accident and emergency departments, to be hospitalised or to be re-admitted to hospital after being discharged. This is likely to lead to higher health care costs.
Highly activated patients are more likely to adopt healthy behaviour, to have better clinical outcomes and lower rates of hospitalisation, and to report higher levels of satisfaction with services.
Patients with low activation levels are more likely to attend accident and emergency departments, to be hospitalised or to be re-admitted to hospital after being discharged. This is likely to lead to higher health care costs.
Just over 30% of patient’s surveyed self- assessed as being on the lowest activation level (level 1,)suggesting that they feel overwhelmed and passive with no understanding of their role in taking responsibility for their own health care.
Nearly 19% of patient’s surveyed self –assessed as level 2 showing they have some knowledge and understanding about their role and responsibilities in their own healthcare but large gaps remain in skills and confidence.
Thirty-two percent of patients surveyed self-assessed as level 3 meaning that they possess key knowledge and skills and confidence to be part of the health care team.
Just over 15% of patients self-assessed as level 4 thus possessing knowledge, skills and confidence to participate in and sustain behaviours and partnerships to maintain health (see figure 4 and table 2).
Centre 7 have the largest proportion of patients on activation level 3 and activation 4 (higher activation levels): nearly 64%.
In contrast, C2 & C5 have the largest proportion of patients on level 1 and level 2 (lower activation levels): totalling 64% and 70% respectively.
There was evidence that the difference in the median activation score by renal centre was statistically significant.
60% surveyed in &gt;65 age group reported moderate to extreme mobility problems.
Nearly 60% of those surveyed in the &gt;65 age group also reported moderate to extreme problems in carrying out activities of daily living.
Prevalence of pain or discomfort was similar between younger and older patients
Patients in the &lt;65 age group experienced more feelings of anxiety and depression than older patients.