harrogate international onference entre, yorkshire, uk

09.00 Registration & poster set up

10.15

-

10.45

The science and art of improvement: shifting the balance from evangelism to evidence

John Wright, Director Bradford Institute of Health Research & Clinical Director Improvement Academy

11.00

-

12.15

Breakout sessions (choose one session below)

A1. ‘Changing behaviour one conversation at a time’

A2. QI Basics workshop

A3. Return on Investment and the cost effectiveness of improvement

A4. PRASE: Patient Reporting and Action for Safer Environment

A5. Patient Engagement in Improvement and Patient Safety

A6. Patient Safety and Human Factors

A7. Developing, evaluating and improving healthcare quality

improvement

12.15 Comfort break

12.30

-

13.00

Are we really improving the safety of our patients? The national picture

Mike Durkin, Director of Patient Safety, NHS England

13.00 Lunch & poster viewing

14.15 – 14.45

To do the service no harm: assessing the quality of health care

Nick Black, Chair, National Advisory Group for Clinical Audit and Enquiries & Professor of Health Service Research

14.45

–

15.15

Why is it so difficult to stop making mistakes and harming patients?

Henry Marsh, Neurosurgeon, Patient Safety Expert and author of ‘Do No Harm’

15.15 Refreshments & poster viewing

15.45

-

17.00


B1. Lego workshop: how to involve people in authentic and meaningful co-production

B2. Innovative approaches to improvement

B3. Using data to drive improvement and improve care: the Falls and Fragility Fracture Audit Programme

B4. How can I make patient safety huddle work for my area?

B5. Measurement and Monitoring of safety: using the Vincent framework

B6. Learning from hospital deaths: from case note review to improvement

B7. Improvement Labs

17.00 – 17.30

The National Mortality Case Record Review Programme: From Mortality Review to Quality Improvement

Dr Kevin Stewart, Clinical Director CEEU and Dr Andrew Gibson, Clinical Lead for the NMCRR Programme RCP

The National Mortality Case Record Review Programme: The Official National Launch.

Hosted by the Royal College of Physicians

“The UK’s first national conference about evidence-

based Improvement in Healthcare”

Day 1—Monday 21st November 2016

Harrogate International Conference Centre, Yorkshire,

UK

A1. Changing behaviour one conversation at a time

A2. Building QI capacity across the region: the Im-provement Academy’s story so far

A3. Return on Investment, cost effectiveness of

improvement

A workshop to explore different methods to create

‘safe’ safety conversations.

Suzette Woodwood, Director—Sign up to Safety

campaign

This workshop is an opportunity to share examples of

methods, tools and techniques that engage multidiscipli-

nary teams in Quality Improvement initiatives.

Dr John Bibby, Quality Training Advisor

Building Quality Improvement capacity & capability

through an improvement movement in an Acute Hospital

setting

Andrew Seaton, Director of Safety, Gloucestershire Hospitals

NHS Foundation Trust. UK

Victoria Collins, Safety Improvement Practice Educator,

Gloucestershire Hospitals NHS Foundation Trust. UK

Improving the care of osteoarthritis in primary care: An

evaluation of a new practitioner role

Andrew Walker (Innovation Fellow) Health Innovation Network

(South London’s AHSN), St George’s, University of London & King-

ston University et al

Economics of implementation based quality improvement

in healthcare for non-economists.

Professor Carl Thompson, Chair in Applied Health Research, School

of Healthcare, University of Leeds.

Social Return On Investment (SROI): An approach to cost-

benefit analysis for improvement in health and social care?

Fay Sibley (Darzi Fellow), Health Innovation Network (South Lon-

don’s AHSN) et al.

A7.Developing, evaluating and improving healthcare quality improvement

This workshop will how Social science can contribute to developing, evaluating and improving healthcare quality improvement.

Explore the current state of the evidence base for healthcare improvement,

Discuss the consequences for efforts to improve quality,

And look at what we should do about it.

Graham Martin, Professor of Health Organization and Policy,

SAPPHIRE Group, Department of Health Sciences, University of Leicester,

Breakout Session A

Day 1, Monday 21st November, 11.00 – 12.15

Format: Workshops Format: Workshop and Case Study Format: Presentation sessions

A4. PRASE: Patient Reporting and Action for a Safer Environment

A5. Patient Engagement in Improvement and Patient Safety

A6. Patient Safety and Human Factors

This workshop will present the development, testing and

evaluation of the PRASE intervention (Patient Reporting

and Action for a Safe Environment).

We will describe the co-design of theory-based measure-

ment tools to capture the patient perspective of the safety

of care. Following this, we will present the results of a large

randomised controlled trial across 33 wards in three NHS

trusts within the north of England.

Finally, we will discuss the findings from the qualitative pro-

cess evaluation, including staff engagement with the inter-

vention and challenges of making patient-centred service

improvement.

Jane O’Hara, Lecturer in Patient Safety and Improvement Sci-

ence, Bradford Institute for Health Research/University of Leeds,

UK

Laura Sheard, Senior Research Fellow, Bradford Institute for

Health Research

Rebecca Lawton, Director of Yorkshire Quality and Safety Re-

search Group

Sally-Anne Wilson PRASE Dissemination Manager

Making use of patient experience feedback data: perspec-

tives of ward based staff

Rosemary Peacock, Senior Research Fellow, Bradford Institute for Health

Research, et al.

Can Patients be the ‘smoke detectors’ for the NHS? What

Patients tell us about safety within 3 Yorkshire and Humber

NHS Trusts

Sally Moore, Patient Safety Research Nurse, Bradford Institute for Health

Research, Temple Bank House, Bradford Royal Infirmary et al.

Enhancing safety in maternity care: using social media to

tackle maternal obesity

Michaela Senek, PhD Researcher, Hora Soltani, Professor in Maternal and

Infant Health, Madelynne Arden, Professor of Health Psychology, Tom Far-

rell Professor, Consultant Gynaecologist, David Rogerson, Phd Sport Nutri-

tionist

Patient involvement in diagnosing cancer earlier in primary

care: potential strategies and key components

Dr Jane Heyhoe, Senior Research Fellow,, Bradford Institute for Health Re-

search, et al.

Preventing dehydration by the early identification of

patients with low fluid intake: The Jug Round.

Emma Cullingworth (HCA), William Lea (Clinical Leadership Fellow),

Janet Meggitt (ACP), Elaine Wagg (HCA), Amanda Ward (Sister), York

Teaching Hospital NHS Foundation Trust

Using Behavioural Theory to improve Sepsis 6

Improvement

Caitriona Stapleton- Patient Safety Programme , RFL Foundation

Trust et al.

How can I implement human factors into practice

Wayne Robson (Patient Safety Lead – Barnsley Hospital NHS Founda-

tion Trust)

Breakout Session A

Day 1, Monday 21st November, 11.00 – 12.15

Format: Themed Parallel Session Format: Presentation sessions Format: Presentation Sessions

B1. Lego workshop: how to involve people in au-thentic and meaningful co-production

B2. Innovative approaches to improvement

B3. Using data to drive improvement and improve care:

the Falls and Fragility Fracture Audit

Co-production is a Zeitgiest theme within Healthcare inno-vation work from a policy level, to research and right onto frontline service improvement work. Many different terms are associated with it; PPI, participation, co-design, co-creation. Yet much of the activity that comes under this broad umbrella could probably be defined as tokenistic in the worst case scenarios and in the best and most well in-tentioned cases, not achieving its full potential.

We will use Lego and the Lego Serious Play Methodology to demonstrate creative, participatory ways of involving peo-ple in research and improvement work. Through the ‘doing’ of a Lego Serious Play workshop you will experience the benefits of co-production conducted in this way. You will also get to keep a small Lego kit! Who says work, learning and conferences aren’t fun?

Dr Joe Langley Engineering Design Research Fellow at Sheffield

Hallam University

NIHR Knowledge Mobilisation Research Fellow, hosted by NIHR CLAHRC YH

Daniel Wolstenholme Visiting Research Fellow at Sheffield

Hallam University and Associate of Lab4Living

NIHR CLAHRC YH Theme Manager for Translating Knowledge to Action

The Airedale Vanguard project to enhance healthcare

in Care Homes using telemedicine: Early insights from

a novel developmental evaluation framework

Ms Rose Dunlop, Vanguard Evaluation Lead, Airedale NHS Trust, Dr

Eileen McDonach, Senior Researcher, on behalf of Yorkshire and

Humber Academic Health Science Network et al.

Using IHI Breakthrough Series Collaborative approach

to reduce in patient harm from falls

Mrs Geetika Singh, Patient Safety Programme Manager, Royal Free

London NHS Foundation Trust,

An innovative approach to fracture prevention using a

Mobile Bone Density Service

Hollick, RJ Health Services Research Unit et al.

Improving the meal time experience for inpatients

using dietetic students as meal volunteers

Vee LeBrunn, Clinical Nurse Educator and Helen Christodoulides

Head of Nursing, Acute Medicine CSU, Leeds Teaching Hospitals

Trust

This workshop from the Royal Collage of Physicians will demon-

strate a range of ways that data from a national clinical audit can

be used to support quality improvement activity in healthcare,

including

Informing commissioning: instigating change in the commis-

sioning of fracture liaison services utilising clinical champions

and data driven decision tools for commissioners.

Making quality improvement easy: data from the national audit

of inpatient falls driving QI in a secondary care setting

Monitoring continuous improvement: using the National Hip

Fracture Database

Empowering the patient: what do patients want from clinical

audit?

Chair: Dr Roz Stanley, CEEU operations director,

Speakers: Chris Boulton Project Manager, Vivienne Burgon Project Co-

ordinator RCP, Dr Shelagh O’Riordan Clinical Lead NAIF, Dr Kassim Javaid Clin-

ical Lead FLS-DB, Naomi Vasilakis Project Manager NAIF and FLS DB, Royal

College of Physicians, UK

Breakout Session B

Day 1, Monday 21st November, 15.45-17.00

Format: Workshop Format: Presentation sessions Format: Workshop

B4. How can I make patient safety huddle work for my area?

B5. Measurement and Monitoring of safety: using the Vincent framework

B6. Learning from hospital deaths: from case note re-view to improvement

This workshop will;

introduce participants to the key components of

patient safety huddles.

Present examples of how to tailor the core compo-

nents to bespoke harms in different areas of

healthcare.

Raise awareness of the innovative approaches tak-

en thus far across Yorkshire.

Share enablers and barriers to measurement of

bespoke harms.

To empower teams to take this approach in their

own area

Chairs: Dr Anna Winfield (PSQM LTHT), Dr Victoria Corkhill (Clinical

Leadership Fellow LTHT)

Speaker: Dr Alison Cracknell, Consultant in Elderly care, Head of Pa-

tient Safety

Measurement and monitoring of Patient Safety in

practice: Evaluation of a multi-site project

Ms. Eleanor Chatburn, Research Psychologist, Risk and Safety Re-

search Group, University of Oxford;

Application of the safety measuring and monitoring

framework

Lynn Pearl – Project Manager for the Measurement and Monitoring

of Safety (Y&H Improvement Fellow), Katie Eacret – Clinical Safety

Lead for the Measurement and Monitoring of Safety

Measuring & Monitoring Quality & Safety across the

RFL Patient Safety Programme

Margaret Mary Devaney, Head of Patient Safety, Royal Free London

NHS FT, Hester Wain, Deputy Director Safety & Risk, RFL Foundation

Trust

With the launch of a national mortality review programme, an

opportunity for acute trusts to deliver improvements to front-

line care, this workshop will explore how to analyse case note

reviews and turn data into usable information.

Kevin Stewart, Clinical Director of the RCP’s Clinical Effectiveness and Evalua-

tion Unit (CEEU)

Andrew Gibson, Clinical Lead for National Mortality Case Record Review,

Consultant Neurologist, Deputy Medical Director, Sheffield Teaching Hospitals

Prof Allen Hutchinson Section of Public Health, School of Health and Related

Research (ScHARR), University of Sheffield, Sheffield, UK

Dr Michael McCooe Consultant Anaesthetist, Bradford teaching Hospitals,

Associate Clinical Director, Improvement Academy

Usha Appalsawmy, Renal Registrar & Leadership Fellow, AHSN Improve-

ment Academy

Breakout Session B

Day 1, Monday 21st November, 15.45-17.00


“The UK’s first national conference about

evidence- based Improvement in Healthcare”

Day 2—Tuesday 22nd November 2016

Harrogate International Conference Centre,

Yorkshire, UK

08.30 Registration & poster set up

Chair : Richard Taunt, Director of the UK Improvement Alliance

09.00

-

09.30

Swatting Mosquitoes: The end of an era for safety in healthcare.

Rebecca Lawton, Director of Yorkshire Quality and Safety Research Group & Professor of Health Psychology

09.30

-

10.00

Take Care Son…the story of my Dads dementia

Tony Husband, Award-Winning cartoonist for The Times, The Spectator & Private Eye

10.00 Poster viewing

11.00

-

12.15


C1. Being positively deviant: how do organisations and teams deliver patient safety?

C2. Innovative approaches to improvement

C3. Human Factors workshop

C4. Achieving Behaviour Change for Patient Safety

C5. Improving Patient Flow: learning from across the UK

C6. Patient Engagement in Improvement and Patient Safety

C7. Learning from Hospital Mortality: The Yorkshire & Humber Experience.

12.15 Lunch

13.00

-

14.00


D1. ‘The patient will see you now’

D2. Innovative approaches to improvement

D3. How can we support the workforce to improve pa-tient safety?

D4. Safer Surgery workshop

D5. Improving Patient Flow: combining improvement science and coaching skills to transform care pathways

D6. Improvement in the time of austerity: necessity or nice to have?

14.00 Comfort break

14.15 – 14.45

Are hospitals less safe at weekends?

Mohammed Mohammed, Professor of Healthcare Quality and Effectiveness, University of Bradford

14.45

–

15.15

Improving Improvement

Nick Barber, Consultant at The Health Foundation

15.15 - Questions and close

“The UK’s first national conference about

evidence- based Improvement in Healthcare”

Day 2—Tuesday 22nd November 2016

Harrogate International Conference Centre,

Yorkshire, UK

Breakout Session C

Day 2, Tuesday 22nd November, 11.00 – 12.15

C1. Being positively deviant: how do organisa-

tions and teams deliver patient safety?

C2. Innovative approaches to improvement

C3. Applying Human Factors to practice

What is positive deviance and how can you identify

it?

Hip and knee services in Yorkshire and Humber: What

does positive deviance look like

Identifying and understanding positive deviance in

elderly medical wards

Spreading the learning: a discussion (all)

Rebecca Lawton, Director of Yorkshire Quality and Safety

Research Group

Lesley Dewhurst, Senior Research Fellow Yorkshire Quality

and Safety Research Group

Ruth Baxter, PhD Student Yorkshire Quality and Safety Re-

search Group

Improving implementation progress using Normalization

Process Theory: Development and validation of the No-

MAD survey tool

T.L. Finch, Institute of Health and Society, Newcastle University, Newcas-

tle upon Tyne, United Kingdom et al.

Practice nurse led frailty assessment in primary care

Dr Halina Clare1,1Doctors Lane Surgery, Hambleton Richmondshire &

Whitby CCG, Sarah De Biase, Y&H AHSN Improvement Academy

To determine if it would be safe and practical to transfer

routine prescribing tasks from ward doctors to pharma-

cists and technicians

William Chellam, Stan Dobrzanski, Bradford Royal Infirmary, UK

Seamless Surgery – Spreading and Sustaining Best Practice

Luke Wheldon, Mr, Sheffield Teaching Hospital NHS Foundation Trust, UK

Tim Sands, Mr, Sheffield Teaching Hospital NHS Foundation Trust, UK et

al.

Join us in this interactive workshop where we will

explore how human factors affect the care we deliv-

er to patients.

Using a case study we will analyse the impact of

non technical skills on a well known scenario and

collectively develop solutions to reduce the impact

of these issues in future practice.

Debbie Clark, Senior Lecturer in Nursing Sheffield Hallam

University


Breakout Session C


C4. Achieving Behaviour Change for Patient Safety

C5. Improving Patient Flow: learning from across the UK

C6. Patient Engagement in Improvement and

Patient Safety

Improving Patient Flow – Learning from Experience

Dr Jacqueline Smithson, Medical Director for Medicine, Hull and East

Yorkshire Hospitals NHS Trust, Liz Watson, Project Manager, AHSN

Improvement Academy et al.

Improving the Delivery model for a Chemotherapy

Service.

Dr. Delia Pudney. Consultant Clinical Oncologist, ABM University

Health Board, Wales.

Healthcare professional’s attitudes towards involving

patients and their relatives in detecting clinical deterio-

ration in hospital

Abigail Albutt*; University of Leeds et al

What do patients see that staff don’t? Exploring the

experience of patients as observers within an experi-

ence based co-design project

Ms Liz Thorp (MSc, RGN), University of Leeds, Bradford Institute for

Health Research, Funded by the Health Foundation , England

Transformational Learning – enhancing practice in Pa-

tient-led patient safety teaching

Naomi Quinton, Dr, Leeds Institute of Medical Education, University of

Leeds, Leeds, UK, et al.

This workshop is a taster version of the Yorkshire and

Humber Improvement Academy popular “ABC for

Patient Safety”

Providing an opportunity to learn from leading re-

searchers in behaviour change. Interactive learning

and discussion will lead to improved understanding

and enhanced practice in improving patient safety

through behaviour change.

Dr Judith Dyson, Senior Lecturer Mental Health, Acting Head of

Department Psychological Health and Wellbeing, University of

Hull

C7. Learning from Hospital Mortality: The York-shire & Humber Experience.

Using Structured Judgment Case Note Review in CQC Mortality alert analysis

Mr Paul Curley, Deputy Medical Director, Mrs Kirstie McEnhill SRN, Lead Nurse for Quality, Medical Director’s Office, Mid Yorkshire Hos-pitals NHS Trust

Learning from mortality review in LTHT; a large teach-ing hospital's experience

Dr Anna Winfield, PSQM Leeds Teaching Hospital Trust

Format: Workshop Format: Presentation sessions Format: Presentation sessions

D1. ‘The patient will see you now’ D2. Innovative approaches to improvement

D3. How can we support the workforce to im-prove patient safety?

To provide an opportunity for researchers, improve-

ment specialists, clinical staff, managers and members

of the public to ask a panel of patient representatives

questions about Patient and Public Involvement (PPI)

within the context of patient safety research and quali-

ty improvement in the NHS.

Members of the Yorkshire Quality & Safety Patient Panel Bradford

Institute for Health Research

Dr Claire Marsh (PhD) Senior Research Fellow (Quality & Safety)

Directorate, Bradford Institute for Health Research,

Ms Liz Thorp (MSc, RGN) PhD Research Student/Research nurse

University of Leeds, Bradford Institute for Health Research, Funded

by the Health Foundation, England,

Reframing research rigour in quality improvement using

Developmental Evaluation: Learning from four complex

intervention projects in multiple, acute hospital settings in

England

Dr. Eileen McDonach, Honorary Research Fellow et al

The Design, Development and Implementation of the Medi-

cation Safety Thermometer

Paryaneh Rostami, Ms., Manchester Pharmacy School, University of

Manchester, Manchester Academic Health Sciences Centre

(MAHSC), Oxford Road, Manchester, UK

Improving Intravenous Fluid Prescribing and Fluid Manage-

ment in adult inpatients

Dr Melanie Cockroft, ST3 Anaesthetics and Intensive Care Medicine,

Gloucestershire Hospitals NHS Trust, UK

Exploring multi-disciplinary staff experiences and the effect

of implementing patient safety huddles on medical wards

Miss Sofia Arkhipkina, University of Leeds

To consider and discuss workforce wellbeing in

healthcare

To understand how and why staff wellbeing is linked to

patient outcomes

To generate solutions: How can we support the work-

force to improve patient safety?

Miss Kathryn Melling & Dr Judith Johnson (co-chairing), Bradford

Institute for Health Research, UK

Breakout Session D



D4. 8 years of the WHO safer surgery checklist: are

theatres safer?

D5. Improving Patient Flow: combining improve-ment science and coaching skills to transform care pathways

D6. How do we keep Improvement relevant in

times of austerity

This workshop is informed by the results from a study

using behaviour change theory to explore the biggest

barriers to theatre teams embracing the checklist.

Participants will have the opportunity to;

Explore the original evidence base for the check-

list,

Understand why never events still happen,

Review the biggest barriers to effective imple-

mentation .

Alison Lovatt, Clinical Improvement Network Director, Im-

provement Academy

Susan Douglas, Consultant, Rotherham NHS Foundation

Trust

Exploring the complexities surrounding collaborative

pathway improvement work.

Introducing participants to the emergent Improving

Flow programme

Sarah Davies, Flow Project Support Officer, Sheffield Teaching Hos-

pitals NHS Foundation Trust, UK

Nick Miller, Flow Programme Manager, Sheffield Teaching Hospitals

NHS Foundation Trust, UK

Tom Downes, Clinical Lead for Quality Improvement and Consultant

Geriatrician, Sheffield Teaching Hospitals NHS Foundation Trust, UK

The NHS is in the middle of a financial crisis. 85% of

acute trusts are in deficit, and even the Department of

Health is struggling to stay within its budget. Against

this backdrop, what role can improvement play? This

workshop, led by the UK Improvement Alliance, will

focus on the importance of improvement in a time of

austerity. This is an exciting opportunity for participants

to co-create a new programme of work for the Alliance

on improvement and efficiency, agreeing priority areas

for how improvement can best support productivity

across the NHS.

Richard Taunt, Director of UK Improvement Alliance and colleagues

Breakout Session D


Format: Workshop Format: Workshop Format: Workshop

harrogate international onference entre, yorkshire, uk

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