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………..