QExchange 2019 July 2019 Welcome Everyone National Context amp Approach Suzie Bailey Director of Leadership and OD The Kings Fund July 2019 National context and approach ID: 799989
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Slide1
Building Improvement Capability Across Boundaries
QExchange 2019
July 2019
Slide2Welcome Everyone
Slide3National Context & Approach
Suzie Bailey – Director of Leadership and OD
The King’s Fund
July 2019
Slide4National context and approach
Recent history
What is the current national approach?
Early learning from Integrated Care Systems (ICSs) Sheffield example
Slide5Imperatives for improvement 2014-15
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Slide6Working together to support improvement
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Slide7National framework – December 2016
https://improvement.nhs.uk/uploads/documents/Developing_People-Improving_Care-010216.pdf
Slide85 conditions
Knowledge of improvement methods and how to use them at all levels
Enabling, supportive
and aligned regulation
and oversight
Leaders equipped to develop high quality local health and care systems in
partnership
Compassionate, inclusive
& effective leaders at
all levels
Support systems for
learning at local, regional
and national levels
Slide9Three national pledges
Pledge 1: We will support local decision-makers through collectively reshaping the regulatory and oversight environment
. In particular, we owe local organisations and systems time and space to establish continuous improvement cultures
Pledge 2: We will model in all our dealings with the sector and in our own organisations
the inclusive, compassionate leadership and attention to people development that establish continues improvement culturesPledge 3: We will use the framework as a guide when we do anything at a national level concerning leadership, improvement and talent management so we engage across the sector with one voice.
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Slide10Progress against national framework 2019?
‘…has made some impact, it has not led to the widespread culture change it set out to deliver.
In part, this is because the national bodies have not visibly demonstrated the importance of the framework and in part because a framework alone is not enough to bring about this change’
https://www.longtermplan.nhs.uk/publication/interim-nhs-people-plan/
Slide11Relational, relational, relational…
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Slide12Early lessons from ICSs?
Invest in building collaborative relationships at all levels of the system
– this can only be done locally and takes time and commitment.
Promote and value system leadership
–continuing emphasis on collective and distributed leadership, ensuring leaders have dedicated time to fulfil their roles.Draw on the skills and leadership of frontline staff – staff should be front and centre of plans to redesign services, with clinical leadership at the fore. https://www.kingsfund.org.uk/publications/year-integrated-care-systems
Slide13Sheffield– improvement across boundaries
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Slide14‘Let’s try changing something tomorrow’
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Slide15A cheap day return ticket to Reading
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Slide16The Big Room approach
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Slide17The Big Room in practice
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Slide18Collective Leadership
Leadership is the responsibility of all -
anyone with expertise taking responsibility when appropriate
Shared, inclusive leadership in teams and across teamsInterdependent, collaborative leadership – across the system/organisationConsistent approach to leadership – authentic, open, curious, appreciative, compassionatehttp://www.kingsfund.org.uk/publications/developing-collective-leadership-health-care West, M. A., Lyubovnikova, J., Eckert, R., & Denis, J.L. , (2014),Collective leadership for cultures of high quality health care.
http://dx.doi.org/10.1108/JOEPP-07-2014-0039
Slide19What’s your burning ambition?
Motivation is a fire from within. If someone else tries to light that fire under you, chances are it will burn very briefly”
― Peter Fudahttp://www.peterfuda.com/
Slide20Building Improvement Capability Across Boundaries
Andrew Seaton – Quality Improvement & Safety Director, GSQIA – Gloucestershire Hospitals
July 2019
Slide21Building for Improvement
Building Improvement Capability Across Boundaries
Delivery of widespread Improvement
Programmes of ImprovementSocial Movement, Adult learning, Recognition & Reward, What’s in it for you?
Slide22“Theory is splendid but until put into practice it is valueless”
James Cash Penny
Slide23Quality Improvement Pathway
Slide24Improving effectiveness of delivery – Quality Framework
Quality Management
“What’s important for your patients and service”
Are we meeting standards?
What are we learning?
What do we need to improve?
Are we ready to provide quality care today?
Specialty based Gold Quality Improvement Coaches
Slide25Designed for cross boundary working
Building Improvement Capability Across Boundaries
Slide26Building a brand - joining a club
Slide27Working across boundaries
Building Improvement Capability Across Boundaries
West of England AHSN
GSQIA
ICS
Website & Intranet
#QIHour
Delivering Improvement Network
Academy of Fab NHS Stuff
Slide28The second #QIHour tweet chat focused on Measurement for Improvement
with special contribution from @samriley #PlotTheDots
There were
1,766,000 impressions
(the number of times a #QIHour tweet was shown in a twitter users feed).180 participants sent out 997 tweetsThank you to everyone contributed using #QIhour
Slide29One Gloucestershire
Slide30Gloucestershire Health Care Task Group
Glouce-ster Acute
Glouce-ster Care Services
2Gether Trust
General Practice
Nursing Home
Out of Hours GP
CCG
SWAST
Using NEWS
Deteriorating Patient
Slide31Andrew Seaton Quality Improvement & Safety Director
Twitter @GSQIA @Seaty63
Slide32RUBIS.Qi Northumbria Healthcare
Scaling Up: supporting early adopters
July 2019
Slide33What is HIP QIP Scaling Up?
Programme aim:
To improve safety and care for patients with hip fracture via a multidisciplinary, pathway approach across 6 NHS organisations in England and Scotland and save 100 lives by December 2018.
https://dms.licdn.com/playback/C5605AQGh69UALXx7-A/c48c8dde359e4092aa564832299c3714/feedshare-mp4_3300/1488578169071-zmy00q?e=1562832000&v=beta&t=xD1SE1F8M73N_f8CDq9nN7U_wXZn8fwHypnWQXb8Sj4
Slide34Working Groups
Care coordination / flow through pathways to base site
A&E and pre op assessment
Personalised end of life care Pain management Real time measurement and reporting Nutrition and hydration Mortality
Patient information and mobility
Slide35Collaboration and Shared Purpose
Slide36Building Capability
6 organisations
5 learning events
Monthly improvement coaching
6 peer reviews by BOACollective leadershipAll teach, all learnSharing innovationsEmbedded real time patient experience data reporting and co-production5 nutritional assistants recruited and trained
Slide37The Results So Far
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119 lives saved so far
100 extra patients returning to their own homes
Length of stay reduced by 2 days29,000 extra meals10% increase in patients mobilised on the day of or after surgery
Watch the film:
https://youtu.be/SqBOCB5wWy8
Slide38Slide39Visit us online:
https://nhsrubisqi.co.uk/Phone us: 01670 529650
Follow us on Twitter:
@RUBISQi @annaburhouseConnect with us on LinkedIn
Slide40RCP Quality Improvement
Collaboratives: building the teams and skills for improvement
July 2019
Slide41Royal College of Physicians Quality Improvement Programme (RCPQI)
RCP QI Faculty
Building capacity
Equip the healthcare workforce with skills and expertise to continuously improve services
Breakthrough collaboratives
6-9 month, topic specific, quality improvement course for clinicians and their teams
Virtual hub
Connecting people, best practice, tools and evidence
Leadership for improvement
Develop medical leaders who can influence and embed a culture of quality and continuous improvement
Research and development
Develop, adapt, design new improvement methods and knowledge
Bespoke support
Provide expert assessment and support in tackling particular organisational and service challenges
Aims
to make quality improvement easily accessible to all doctors and support physicians in developing and providing safe, timely, evidence-based, efficient and patient-centred care to achieve the RCP’s strategic aim of improving quality
Delivered through 6 work streams, supported by a faculty of quality improvement experts
Slide42RCPQI Collaboratives
RCPQI: Breakthrough Series Collaborative
Based on the Institute for Healthcare Improvement breakthrough series methodology
8-10 healthcare teamsDedicated time to work towards improvement goalsSupported by an expert teaching facultyModel for Improvement allows teams to have a structure to follow throughout the process to make their projects as successful as possible, and ensures attendees are learning more about QI theory rather than just running a project.RCPQI hosted collaboratives: IBD (x2), inpatient diabetes (x 2), smoking cessation, preventing secondary fractures
What are we trying to accomplish?
(aim)
How will we know that a change is an
improvement?
(measurement)
What change can we make that will result in an improvement?
(ideas)
Model for Improvement
Act
Plan
Study
Do
Slide43Month 0 1 2 3 4 5 6 7 8 9 10 11 12
Team call with RCPQI project manager
Agree proposed aim
Expectations & objectives
Learning session 1
Introduction to QI, setting your aim, driver diagrams
Action period 1
Coaching calls, collecting baseline data, P D S A
Learning session 2
Involving patients in QI, measurement, team presentations
Learning session 3
Team poster presentations, scale up and spread, publication
Action period 2
Coaching calls, measurement, P D S A
Action period 3
Measurement, scale up
of
improvements, publication
Evaluation webinar
Final feedback from teams on scale up
Slide44Participant feedback
Slide45“Last year, prior to this [breakthrough series collaborative], we lost the will
for this work, so
thank you for getting us to prioritise improvement”Preventing secondary fractures cohortLearning session 2, 17 May, Liverpool
Slide46Visit us online: www.rcplondon.ac.uk/quality-improvement
Email us: rcpqi@rcplondon.ac.uk
Follow us on Twitter:
@RCP_QIPS
Slide47Questions, Thoughts and Reflections
Slide48