Implementing the National Action Plan The Wheelchair &
Seating Services Approach John Colvin
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Introduction & Background Moving Forward March 2006
Scottish Executive Response to Moving Forward January 2007 Funding
announced following National Spending Review November 2007 Business
Case Submission September 2008 National Action Plan February
2009
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What have the Centres done to implement the Action Plan?
Implementing our specific actions on the National Action Plan
Implementing our local business cases Participating in national
work streams National Performance Indicators We are currently half
way through a 2 year planned, funded project
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How have we done this? Project Management Governance Planning
Risk Management Responsibility Charting Kaizen/Rapid Improvement
Events Continuous Improvement Change Management A ridiculous amount
of meetings
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User Satisfaction Survey
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WoS WSS RTT High Level Pathway Referral To Provision
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Users and Carers Forum Established Steering group established
Forum established (60 members) Inaugural meeting held October 2009
1 st newsletter issued (Feb 2010) 1 st Open day planned for May
2010 Identified as a priority group by NHS Tayside
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Project Managers
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Risk Management
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In April 2009, as part of NHS Highland shifting the balance
strategy the Wheelchair and Seating Service began a pilot scheme
working with a local not for profit organisation called ILM
Highland. ILM offer a repair and delivery service to wheelchair
users living in Ross-Shire, Sutherland and Caithness who in the
past would have received their equipment via a courier. They have
carried out over 400 visits since the beginning of the pilot in
April 2009 Operatives are trained to set up the chair correctly and
are able to identify patients that have postural and pressure
issues that may require a follow up visit by one of our
occupational therapist and rehabilitation teams. WORKING WITH ILM
HIGHLAND HIGHLAND WHEELCHAIR & SEATING SERVICE
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NHS Lanarkshire WSS Centre - Floor Layout Stores Workshop Wheel
chair Skills Area Clinic Rooms Office Area Reception Goods In Staff
Toilets, Changing, Showers Break Area
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Southeast Mobility and Rehabilitation Technology (SMART)
Services Fife Satellite Clinic Lynebank Hospital, Dunfermline
Service Users involved in Design Large Clinic Room with overhead
hoist Workshop for minor repairs and adjustments Wheelchair Shop
storage for selection of chairs and equipment Looking at developing
a similar clinic in NHS Borders
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Root Cause Analysis
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1. PROBLEM STATEMENT Most of the patient referrals to Westmarc
WSS require at least one follow up appointment before the patient
is equipped with a safe and useable device This results in: -
discomfort and frustration for the patient due to (potentially
unnecessary) delays in receiving the prescribed device. - secondary
appointments being necessitated for fitting and fixing. - an
exacerbation of the waiting-list back-log - double-handling by
Clinicians, Workshop & Admin Staff. 4. GAP ANALYSIS7.
IMPLEMENTATION PLANS 2. THE PRESENT STATE (@ October 2009)
Jan01-Dec31, 2009 Data: Clinical Appointments held at Westmarc=
1202 Assessments at WestMARC clinics = 100 per month Current
One-Stop-Shop Appointments= 0 5. SOLUTION APPROACHES8. THE
CONFIRMED STATE At 31 March 2010: To date, >60 OSS Clinics were
successfully held This comprises an average of 15 OSS Clinics/Month
A ramp up of >3x is required to achieve the Target State Ramp-up
Measures: The capacity for OSS clinics was increased by opening the
scope to ALL clinicians in March (was only 2 x OTs for 3 months)
Data collection measures being introduced for reasons for NON OSS
clinics 3. THE TARGET CONDITION6. PROVING TRIALS9. LESSONS LEARNT
Dont assume check, quantify and check again. Involve the staff who
are essential to the process, to gain their buy-in. Dont be afraid
to experiment (in a controlled environment). Dont rush in Do the
homework and preparation. Choose the correct tools/techniques for
the task. Westmarc Lean Programme: ONE-STOP-SHOP Start Date: 2
October 2009 Last Update: 7 April 2010 Team Members: S.Gold,
R.Fiskin, A.Oliver, E.Beattie, A.Love, W.Forsyth, K.Lees, P.Greene,
D.Devlin, I.Mackay, H.Collin Review Team: Westmarc Senior
Management Team Process Owner: Bill Forsyth A3 Compiler: Henry
Collin Decision by Review Team : GO Target OSS Appointments = 50%
of total appts within, say, 6 mths = 50 Appts/month Decision by
Review Team : GO Decision by Review Team : WIP Decision by Review
Team : G0 Decision by Review Team : GO However, for many clinical
appointments, the patients needs can be satisfied - within a single
appointment - with a ONE-STOP-SHOP service, - with minimal or no
extension to the allotted appointment times, - by a planned
approach to at-hand inventory holdings, - and by an orchestrated
interaction between the different staff groups involved in the
Patient Journey (Clinicians, Technicians, Stores and Admin). This
method of data collection will continue, while establishing the
robustness of the OSS process and system requirements, prior to
agreeing a bespoke ReTIS report which can track the progress
towards achieving the One-Stop- Shop targets. A Clinician Request
to Workshop form A was created which also enables data collection.
This data is currently, manually entered into a register B in order
to permit the metics on OSS throput and inventory usage. A B