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Strategies in knowledge transfer workshop by Maureen Fallon, Assistant Director, Continuous Service Improvement, Cardiff and Vale University Health Board. Presented at "Using Research Evidence to Improve Health and Social Care". A NISCHR AHSC Workshop to Explore Strategies in Knowledge Transfer. 6th May 2014 – Cardiff
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Strategies in knowledge transfer workshop
Faculty for Quality ImprovementCardiff & Vale UHB and Cardiff University
Maureen Fallon
Background:
• A joint venture between Cardiff University and the Cardiff and Vale UHB
• Critical mass of clinical and academic staff working together – the most research active site in Wales
• Bedside to Bench and Bench to Bedside (education, training and CPD)
• Currently ‘virtual’ and working to a physical site in 2014/15
Why set up the Faculty?
• Share good practice• Support• Signpost• Success
Faculty For Quality Improvement- what is it?
Established in 2011 the ambition for the Faculty is:
“to play a major role in fostering a quality improvement and innovation culture by creating a dynamic environment where excellence comes as standard”
Key to the Faculty’s success is harnessing the tremendous potential and energy of our staff; particularly by engaging, encouraging and empowering them.
As a result, the Faculty embraces everyone, whatever their role, on the basis that every member’s contribution is essential to care quality.
Faculty aims:
1. Increase the quality, reliability and effectiveness of care (Best Care)
2. Develop a culture of 'continuous improvement' through developing a
programme to support capacity and capability in healthcare improvement
methodology and delivery at the coal face and in the educational settings
(Best Place to Work)
3. Build and maximise collaborative relationships with partnership
organisations that seek to advance and promote innovations in promoting
and delivering health care (Best Health)
4. Add value and improve efficiency by focussing efforts that tackle Harm,
Waste and Variation (Best Value)
Eliminate harm, variation and waste
Develop a culture of continuous improvement and capacity building
Increase quality reliability and effectiveness of care
Collaborative and partnership relationships, to advance and promote innovation
Best for Patients
& Citizens
Best health
Best care
Best value
Best place to work
Adapted from AQuA Alliance 2010
Secondary DriversPrimary DriversAim & Measures
Aim
To establish a framework to motivate and build with, enthusiasm and drive for delivering high quality care across the UHB
MeasuresBy March 2016
· Be recognised as an International centre
of excellence
· Delivery of 1000 Lives+, AQF and intelligent targets
· Develop and support 100 Improvement Advisers (IQT Silver Practitioners)
· Develop and support 1000 Improvement Practitioners (OD Programme; LQI; Yellow Belt; RCN leadership programme
· Implement real-time business intelligence to capture quality outcomes, efficiencies and financial savings
Best HealthCollaborative and partnership relationships, to advance and promote innovation
· Establish strategic alliances and partnerships with Cardiff
University Health Care Related Schools and other external influential organisations· Work with the Welsh Public Health UKCRC to tackle
the underlying determinants of poor physical and mental health· Build on the work of Magic & Expert Patient initiatives to
incorporate shared decision making as part of the UHB’s Strategy
· Establish clinical and governance dashboards· Build on the work of the Pt Experience Team to
incorporate signposting of services & capture outcomes of Exec Walkrounds & HCS
· Promotion of a culture of improvement that has the patient/citizen at its centre e.g. Transforming Theatres, ERAS and the Patient flow collaborative
Best CareIncrease quality reliability and
effectiveness of care
Best PlaceCulture of quality improvement: Can Do
· Establish faculty expertise across the key themes of improvement, education & management
· Delivery of core curriculum to support quality improvement via OD/ IQT training & Breakfast club and web-ex methods
· Develop positive staff engagement activities: Chairman’s Award; competitions & ATP
· Establish a business intelligence for real time information and measurement systems
· Working with the SPN collaborative develop a quality cost matrix to pinpoint savings
· Improved performance against productivity benchmarks: CHKS, WAMI & Intelligent Targets
Best Value Eliminate harm, variation and waste
Creating the Conditions
Build Infrastructure
& Capacity
Formal programmes of QI education Embed QI into all development work e.g. leadership and management development
Enabling people to lead improvement in their daily work processes • Tools, techniques, support
“Data is our vision - we must learn from it”• Real time
measurement and Information systems
Shaping the Culture:• Will and commitment• Quality reinforced at
every level by behaviour, action and communication
• Patient/Family/Carer centredness at all times
Creating the conditions:
•Academic•Clinical•Research
•Partnerships•Networks
•Training/education•Bench to Bedside
•Culture - 2 jobs• Celebration• Recognition• Dissemination
Growth
CapacityExpertis
e
Capability
Our Journey So Far…..
Awareness• Safer Patient Initiative• Change & Innovation Plan• Faculty for Quality Improvement
Education• Learning from 1000 Lives+, Qulturum, Tayside and the IHI• Links to Harmonisation; C21 and HEI programmes• Improvement experts and practitioners training – LQI/IQT• Board Effectiveness Development Programme
CSI• Lean and Rapid Improvement work• Real time data and measurement for improvement
Redesign• Improvement as a Systems Property• Triple Aim – Excellence at a lower cost per capita• Co-production / Prudent Healthcare
Movement• Task force • System Infrastructure - IQT and LIPS• Creating Breakthrough and Leverage
Scaling Up• Public Health• Working with Communities• Clinical innovation centre
2010 2012 2016 and Beyond
Faculty outputs – improvement and innovation in action
Faculty outputs in action (clinical training)
WillNCEPOD Report ‘ Caring to the End’ (2009) highlighted that poor communication between teams at handover contributed towards 13.5% of adverse outcomes in Acute Hospitals.
Innovation
Ollie
Tan
Rob
Delivery ~ what we Did• 13th Aug – 15th Sept
e-learning package
• 17th Sept – 4th Nove-handover training
Support- HANDS ON)
• …….PDSA……. Feedback from Junior Doctors
5th Nov……….Software updated
Engagement…….Enduring
E
SpRs/Jnrs
PostGraduate
Dept
Directorate Mgt
Team
IM&TClinical &MGT Lead
Medical Director
SNPs
e- Handover – screen shot
Sustainability
UHL UHW
1 4 7 10 13 16 19 220
20
40
60
80
100
120
140
number of requestsrequests on w/e& BH
1 4 7 10 13 16 19 220
20
40
60
80
100
120
140
160
number of requestsrequests on w/e& BH
Mean: 88/week; 70 at w/ends
Mean: 94/week; 68 at w/ends
SpreadI am moving to Surgery next month....I can’t believe that they don’t use e-handover………what can we do?
F2 - Catherine
I am moving to Surgery next month....I can’t believe that they don’t use e-handover………what can we do?
F2 - Catherine
Emma F1 – Medical Assessment UnitWhy can’t we use e-handover……..it would be much safer and easier to keep a track on patients
Emma F1 – Medical Assessment UnitWhy can’t we use e-handover……..it would be much safer and easier to keep a track on patients
- Emergency Unit- Paediatrics- Surgery
- Emergency Unit- Paediatrics- Surgery
Visit by Cwm Taf…………..Visit by Cwm Taf…………..
Standard map. Service nodes in blue, demand nodes in yellow.
Heat map showing demand density. Service nodes in blue. Demand nodes on gradated red (high) – green (low) scale.
In closing
1928: Pencillum discovered by Fleming
1939: Chain and Florey took an interest……..Penicillin
1940’s: Heatley got involved…………..
1945: Nobel Prize for Medicine
Without Fleming, no innovation; without Chainand Florey, no testing, without Heatley, no wide
scale use of penicillin
…but really, we all know it takes more than tools to make real change happen!
InstantSix Pack!
And finally……….if you always do………..