Workshop 4 Sustainability Creativity Final for Upload

8/12/2019 Workshop 4 Sustainability Creativity Final for Upload

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Quality Education for a Healthier Scotland

Quality Improvement Development for

NHSScotland Organisational Development LeadsWorkshop 4

Sustainability for QI

Creativitynew ways of thinking


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Agenda

Sustainability for QI projects

Creative thinking


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What is sustainability

wh

en new ways of workingand improved outcomes

become the norm

to keep something

going over time andcontinuously

maintaining the gains andevolving as

requireddefinitely notgoing back to the old way


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Evidence for sustainability

33% of improvement projects had reverted totheir previous way of working after a year

33% had maintained the improvement but it

had not been adopted by others in theorganisation

33% had maintained the gain and there was

evidence of adoption outside of the corechange area

Data from NHSI 2010


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Key considerations


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Sustainability and project stage

Stage Potential role of sustainability model

1 Start out

2 Define & ScopeTo identify and improve areas that require

strengthening right away

3Measure &

Understand

4 Design and plan

5

Pilot and

implement For full confidence during implementation phase

6Monitor and

sustain

To maximise chance for sustainability and

continual improvement



Questions for sustainability

Training and involvement

Are key stakeholders involvedin design, trial and implementation of project?

Has a skills analysisbeen carried out to identify skills and knowledge gaps?

Have key staff been trained in the knowledge and skills required to implement the new project?

Behaviours

Are staff encouraged to express their ideas?

Are staff encouraged to run small scale PDSAsto implement change?

Are staff encouraged to believe that change will result in an improvement?

Leadership

Are senior leadersrespected and believable?

Are senior clinical staff respected and believable?Are clinical staff involved in the initiative?

Goals and Cul ture

To what extent have you incorporated the "Voice of the Patient"into your project?

Are the goals clear and shared

Is the project contributing to the overall aimsof the organisation?

Infrastructure

Do you have the resourcesto support the new project?

Have new policies and proceduresbeen written?

Is a communication systemin place?

Benefi ts

Are their benefits beyond helping the patient?

Are the benefits credible?

Will staff notice a difference to them (WIFM)?

Moni tor progress

Does the change require new monitoring systems?

Is the data readily accessible?

Will the change be easily communicatedto a wider audience?



0

20

40

60

80

100

Project A Project B

Training &

Involvement

Benefits beyond

helping patients

Monitoring

progress

Behaviours

Leadership

Infrastructure

Fit with goals &

culture

Sustainability model



Innovation

Effective innovation requires a systematicprocess?

Think of a new idea for delivery of healthcare

that will improve the patient experience in waiting rooms.



IDEO

http://www.youtube.com/watch?v=M66ZU2PCIcM



Process for innovation

Define the

problem/

situation

Create newideas

Act on it

Select best

option(s)

Stretch theidea



Define the problem

OriginalProblem

BroaderProblem

NarrowerProblem

Why do I want tosolve this problem?

What is stopping

me solving this

problem?

Are we solving the right problem?



Define the problemWhy do I want to

solve this problem?

What is stopping

me solving thisproblem?Original problem

Low staff

morale

Broader problem

Need for improved

productivity

Morale affectsproductivity

Narrower problem

Find timeAdaptive procedures

Insufficient time

Procedures too rigid

Need for

improved level

service

Broader problem

Need for better

patient care

Narrower problem

Better time management

Overcome cynicism

Too much work

Staff cynicism


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Problem hierarchy explorer

10 minutes

Poor communication

-1- True North Innovation Ltd 2006

WHAT IS THE PROBLEM?

Original Problem (start here)

Broader Problem

Narrower Problem

Why do I want to solve thisproblem? Why else?

Whats stopping me solvingthis problem? What else?

Note that the questions can be repeated toidentify new layers.


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De Bonos Mental Valleys

Adapted from HM Government Department for business innovation and skills

Separation in:-

Time Space

Conditions

Fresh eyes


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Ideas funnel

Time

100

ideas

generated

2

ideas

tested

5

ideas

developed

10

ideas

selected

1

Idea

launched

ss

s


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Tools for creativity

1. Reverse brainstorming2. Fresh eyes

3. SCAMPER

4. 9-windows resources5. De Bonos 6 hats

Also:

6. Knowbrainer

7. TRIZ contradiction matrix


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1. Reverse brainstorming

Clearly identify the problem or challenge

Reverse the problem or challenge by asking:"How could I possibly cause the problem?", or"How could I possibly achieve the oppositeeffect?".

Brainstorm the reverse problem to generatereverse solution ideas.

Now reverse these into solution ideas for theoriginal problem or challenge.

Evaluate these solution ideas. Can you see apotential solution? Can you see attributes of apotential solution?


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2. Fresh eyes

Age 5, 10? Colleague, spouse?

Airline?

Bank?

Patient?


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3. SCAMPER

SSubstitutecomponents, materials, people CCombinemix, combine with other assemblies

or services, integrate

AAdaptalter, change function, use part of

another element MModifyincrease or reduce in scale, changeshape, modify attributes (e.g. colour)

PPut to another use

EEliminateremove elements, simplify, reduceto core functionality

RReverseturn inside out or upside down, oruse Reversal


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4. Resources

Substancematerial (equipment, materials, software,

waste) within the system or systems surrounding

Peoplewithin and around system

Financial - (budgets, grants, funding)

Informationtacit and explicit knowledge, IntellectualCapital, other sources e.g. books, internet

Energy Resourcessources of energy available within

the system or systems surrounding, which are not used

fully

Space Resourcesany unused space

Time Resourcesany spare time slots in between,

before or after technological processes


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Resources - example

Making use of unused space

Unexpected skills in the team

Making use of what would otherwise be

waste Allocation of unused time, e.g. patients

waiting


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Tangible resources

PAST FUTUREPRESENT

Around system

e.g. External

Within system

e.g. Team

System

e.g. Company

Tangible Resources (people, materials, equipment)


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PAST FUTUREPRESENT

Around system

e.g. External

Within system

e.g. Team

System

e.g. Company

Intangible resources

Intangible Resources (information, energy, space, time)


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5. De Bonos 6 Hats

From Edward De BonoSix Thinking Hats 1985 / 1999


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Exercise

2 minutes big picture (blue hat)

2 minutes positive (yellow hat)

2 minutes negatives (black hat)

2 minutes to expand idea (green hat) 2 minutes feelings (red hat)


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Triz contradiction matrix


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Knowbrainer Innovation Tool

Investigate needs

Create ideas

Evaluate solutions

Activate plans

From Solutionpeople


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Tools for selection

1. By criteria2. By dot voting

3. By matrix selection


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Tools for selection

1. By criteria2. By dot voting

3. By matrix selection

Easy

Difficult

Low impact High impact


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Tools for stretching idea

Ideal Final Result

Current

Situation

Ideal

Final

Result

Start hereDont start here

Intermediate

solutions

X


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Tools for stretching idea

7 dimensions of performance

1. Safety Absence of errors

Prevention of harm

Conformance to standards

Reliability

2. Effectiveness Clinical outcomes

Improved quality of life

Free from complications

3. Timeliness Waiting time

Time to treatment Time to complete a task

4. Efficiency Cost

Use of resources

5. Equity Cultural sensitivity

Greater access and availability

6. Co-ordination (across all system) Flow across system/journey

Integration of care plans Shared information

7. Patient-centredness Ease of use

Convenience

Portability

Choice

Ease of understanding

Engagement/involvement in care

Self-management

Fit to needs

Experience of care


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Process for innovation

Define the

problem/

situation

Create newideas

Act on it

Select best

option(s)

Stretch theidea


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Quality Education for a Healthier ScotlandGood idea

Testing andrefining systems

Implementing new

procedures & systemssustaining change

PDSAs for Quality Improvement

Ideal Final

Result


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Innovation and project stage

Stage Potential role of creativity

1 Start outHelp generate and stretch ideas for improvement

and transformation

2 Define & ScopeHelp generate ideas of how goals and objectives

may be achieved

3Measure &

UnderstandHelp discover new ways of gathering information

4 Design and plan Help find solutions to design and planning issues

5

Pilot and

implement Help identify optimum methods of implementation

6Monitor and

sustainHelp identify ideas to reignite flagging projects


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Resources

Thinking Differently (NHS Institute)

Making a Bigger Difference (NHS Institute)

Creativity, Innovation, and Quality Quality Press

by Paul Plsek

The 7 Levels of Change: Different Thinking for Different

Results by Rolf Smith

www.directedcreativity.com

www.solutionpeople.com
http://www.directedcreativity.com/http://www.solutionpeople.com/http://www.solutionpeople.com/http://www.directedcreativity.com/

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Workshop 4 Sustainability Creativity Final for Upload