building capacity & capability for innovation & improvement carrie marr director tayside...
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Building Capacity & Building Capacity & Capability for Innovation & Capability for Innovation &
Improvement Improvement
Carrie MarrDirector
Tayside Centre for Organisational Effectiveness
Building Capacity & Building Capacity & Capability for Innovation & Capability for Innovation &
Improvement Improvement
Carrie MarrDirector
Tayside Centre for Organisational Effectiveness
Our Journey So Far…..Our Journey So Far…..
Source: System thinking and spreading knowledge, Bojestic M., Henriks, G., Provost L. IHI European Forum, Prague 2006
Awareness•Safer Patient Initiative•Change & Innovation Plan
Education•Learning from Qulturum and IHI•Patient Safety Officer training•Improvement experts and practitioners training •Board Effectiveness Development Programme
Process Thinking•Lean and Rapid Improvement work•Real time data and measurement for improvement
Redesign•Improvement as a Systems Property•Steps to Better Healthcare•Triple Aim
Movement•Triple Aim •System Infrastructure - TCOE•Creating Breakthrough and Leverage
Scaling Up•Public Service•Working with Communities•Mobilising and deploying shared resources
2006 2007 2008 2009 2010 2011 Beyond
Creating the ConditionsCreating 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”•Realtime measurement and Information systems
Shaping the Culture:• Will and commitment• Quality reinforced at
every level by behaviour, action and communication.
• The patient and the family are the focus of attention at all times
Ref: Staines 2009
Building Local Capacity & Building Local Capacity & CapabilityCapability
Building Capacity
& Capability
Improvement AcademyeLearning PortalTools and Techniques
Clearing the way!!Experiences of care, compassion and respect
Mobilising & deploying expert support “through the line” – 2 step challenge
• Real time information and measurement systems
• Sharing evidence of improvement
• Staff engagement
• Data for discussion not judgement
Shaping the Culture• Permission and space• Evidence based approach• Facing the Future – shared
ethical responsibility• Board Effectiveness
Programme• User and community voice
Leadership and Management DevelopmentVirtual learning environment
Experts Senior
Leaders& Boards
ChangeAgents
(Middle Managers,
project leads)
Everyone
Staff
Teams
Continuum of PI Knowledge and Skills
Deep Knowledge
Many People Few People
What Skills Do We Need?
Source: Kaiser Permanente, 2008
SharedKnowledge
What data do we need?What data do we need?
Board
ET
EMT
Directorate / CHP
Ward / Team Level
Patient / Practitioner Level
ASSURANCE
Validated Data for 6 domains: Access, Efficiency, Infection & Prevention, Quality & Patient Experience, Patient Safety and Data Quality
PERFORMANCE
Validated and un-validated data across 6 domains:Clinical Excellence, Finance & Activity, Valuing Staff, Capacity & Activity Planning, Patient Experience and
Patient Safety
Imp
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“focusing on information and data to provide assurance on improvement and quality to deliver better services”.
Pe
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IMPROVEMENT
Un-validated data provided in real time through Unified Patient Tracking, Clinical Portal and operational
dashboard with metrics covering Patient Flow, Inpatient Activity, Out Patients, Waiting Times, Patient Safety,
Infection Control, Clinical Outcomes
What Knowledge Do We Need?What Knowledge Do We Need?The Shift to “All Learn : All Teach” as a MovementThe Shift to “All Learn : All Teach” as a Movement
Developing local
improvement stories
Widening our improvement conversations and networks
ProfoundKnowledge
&Evidence of Standards
Adopt & Adapt Improvement Tools and Technology
Harvest andshare and
enable new ideas
Sharing experiences and embedding the improvement
cultureMeasuring the effectiveness
of improvement activities
Individual Microsystemfrontline
MesosystemMiddle mgrs
Macrosystem Policy
Real time tests of change
Improvement Evidence
• Workplace VLE• Communities of Practice
Developing a culture of
improvement
Steps to Better Care
Mental Health
OlderPeople
Planned Care
Workforce Integrated care
communities
Child health
Optimisation of Health Facilities across Tayside
Prescribing and
Medicines
Finance Support
Workforce Support
Scenario Planning, Financial Baselines, Benefits Tracking, Business Cases
Workforce Modelling, Engagement & Communications with staff
Comms SupportCommunications with public and staff
Other
OE SupportImprovement & Development Support
Labs
Maternity
Develop an innovative education and training resource to build further out capacity and capability in improvement science.
Tayside Centre for Organisational Effectiveness
Real time information and measurement resources to support quality improvement of clinical services.
Enhance spread and share of good practice through use of technology e.g. Clinical Portal, Clinical Dashboards.
Mobilisation of trained experts in quality improvement organisational development and leadership to support improvement work.The focus of this expertise will be mobilised to support front line staff and clinicians to build capability in improvement methodology and support key improvement programmes
A dynamic approach to knowledge transfer which supports our “All teach: All learn” philosophy in support of quality improvement.
Knowledge Management
Improvement Academy
Improvement &
DevelopmentSupport
Technology Enabling
Health
Research & Developmen
t
Table Top DiscussionTable Top Discussion
Where should our focus be to create the necessary capacity and capability required to
support our improvement and innovation ambitions?