NHSScotland's Quality Improvement Hub

Context

NHSScotland’s Improvement Journey

Scottish Patient Safety Programme

Long Term Conditions Collaborative

Diagnostics Collaborative

Planned Care Improvement Programme

Unscheduled Care Collaborative

18 Weeks ServiceRedesign and Transformation

Programme

Mental Health Collaborative

Strategic Lean

Primary Care Collaborative

JANE MURKIN

Associate Director of Improvement, Healthcare Improvement Scotland

Background

Develop the Quality Improvement Hub,

reflecting a new partnership for improvement between NHS National Services Scotland (NSS), Healthcare Improvement Scotland, NHS Heath Scotland, NHS National Education for Scotland (NES), and the Scottish Government Health Directorates Quality and Efficiency Support Team (QuEST).

• The Quality Improvement Hub aims to bring improvement science into the everyday work and language of NHS staff and to support demonstrable improvement in patient care through quality improvement activity

• Building national and local Quality Improvement capacity and capability

Our Aim:

Adoption of Innovation

E Rogers – Diffusion of Innovation 1995

We are not alone:

Shaping the Hub

The NHSScotland Quality Improvement Hub shaped and developed by NHS boards.

Providing :1. Implementation support which is flexible and

responsive2. Education and learning about QI which is

accessible and relevant3. Measurement of QI which is meaningful4. Facilitating QI networks for NHS staff

Implementation Support which is flexible and responsive:

Local • Each board has an infrastructure • Emerging local hubsNational • Supporting NHS boards with the design, testing and

implementation • Think Glucose – testing and spread across other boards• Building capacity and capability for improvement in the

senior charge nurse team• Mortality reduction improvement plan

• Brokering improvement and topic expertise support between boards for the benefit of NHSScotland

• Brokering of design students

Creative Space

• A creative and innovative space that enables users to work in an environment conducive to quality improvement

• The space is flexible, adaptable, accessible and supportive to make it easy for people to think differently to identify creative and innovative solutions

The Improvement Journey

Questions

In your role:• what opportunities do you have to improve

services locally?• what challenges do you face in using quality

improvement methodologies and tools?• what do you need to support you to use

continuous quality improvement and creativity and innovation?

SHONA COWAN

Education Programme Manager, NHS Education for Scotland

EDUCATION AND LEARNING: QUALITY IMPROVEMENT EDUCATION FRAMEWORK

• Focus on four key staff groups – Foundation, Practitioner, Lead and Board Members

• Identifies knowledge and skills required to be able to undertake improvement work and links to KSF

• Designed for use by individuals, organisations and education providers• Quality Improvement Learner Journey will be key - targeted learning

resources will be mapped, where available, and new learning developed to meet gaps

• Opportunity to integrate improvement learning with existing activity• Spread expertise on improvement developing into new service areas

eg public health

EDUCATION AND LEARNING: CAPACITY BUILDING IN MEASUREMENT FOR IMPROVEMENT

• Development of skills framework for measurement

• Identified learning requirement for four groups

• Commissioning learning resources to meet identified needs

• Pilots in quality improvement for organisational development leads and information managers in quality improvement

ROGER BLACK

Head of Improvement Programmes, Information Services Division, NSS

MEASUREMENT: INTEGRATING MEASUREMENT INTO IMPROVEMENT

• NHS Orkney–How to interpret and use the Hospital Standardised

Mortality Rate (HSMR)–Mortality reduction improvement plan

• Blood Transfusion Service–League table approach–From measurement for judgement to measurement

for improvement

MEASUREMENT:BUILDING CAPACITY AND INFRASTRUCTURE

• Building capacity in measurement for improvement in information staff (NES, ISD, HIS)

• Leadership in statistical methodology (ISD)

• Quality improvement data repository to support national improvement programmes (ISD)

An NHS Boards Perspective

CARRIE MARR

Associate Director of Change and Innovation, Centre for Organisational Effectiveness, NHS Tayside

2006 2007 2008 2009 2010 2011 Beyond

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

Full Scale•Public Sector Infrastructure to support improvement •Working with Communities

A History of Quality as a Business Strategy in Tayside

Engaging with the National Quality Hub as part of our QI Strategy

Building capacity and capability locally, nationally and internationally – TCOE, National Quality Hub, IHI

Knowledge transfer and shared learning

Joint mobilisation of national and local expertise to support improvement priorities e.g. population health measurement

National network for Improvement Advisers to learn and stretch

Access to the Patient Safety Fellows and Improvement Advisers to influence and inform our improvement work locally

Hub access to commission the expertise of NHST Improvement Advisers to support Hub improvement work

Access to educational resources in support of our local Improvement Academy

Engaging with the National Quality Hub as part of our QI Strategy

Embedding a Culture of Continuous Quality Improvement

• Winning the hearts and minds of the staff• Develop testing and innovation

– what to test…..how to test

• Leadership and culture• Integration – making it daily work• Creating the infrastructure• Creating capacity and capability • Measurement that has meaning

Upcoming Events

8th September 2011

Quality Improvement and Organisational Development Summit

27th October 2011

Embedding a Culture of Continuous Quality Improvement – Next Steps

Question and Answer Session