Using JBI COnNECT to Implement Using JBI COnNECT to Implement Best Practice across NHSGG&C Best Practice across NHSGG&C (Rehabilitation & Assessment (Rehabilitation & Assessment

Directorate)Directorate)

Elaine Burt and Marie Elaine Burt and Marie McAloon – NHS GG&C McAloon – NHS GG&C (RAD), GCU(RAD), GCU

BackgroundBackgroundNHS GG&C(RAD) in conjunction with NHS GG&C(RAD) in conjunction with GCU secured monies from NHSQIS in GCU secured monies from NHSQIS in April 2009 to roll out JBI COnNECT April 2009 to roll out JBI COnNECT across the Directorate, building on the across the Directorate, building on the RAD Community of Practice project RAD Community of Practice project undertaken in 2008undertaken in 2008

Directorate ProfileDirectorate Profile

• RAD aims to achieve an integrated and RAD aims to achieve an integrated and whole system approach to assessment, whole system approach to assessment, rehabilitation & enablement in the care of rehabilitation & enablement in the care of older people and those with long-term older people and those with long-term conditionsconditions

• Manages Acute services which include frail Manages Acute services which include frail elderly, palliative care, falls, physical elderly, palliative care, falls, physical disability, stroke and AHP services, as well disability, stroke and AHP services, as well as a range of community services including as a range of community services including Care Homes.Care Homes.

Directorate SitesDirectorate Sites

WESTWEST• Blawarthill, Drumchapel, Western and Blawarthill, Drumchapel, Western and

Gartnavel General HospitalGartnavel General HospitalNORTH EASTNORTH EAST• Stobhill, GRI & LightburnStobhill, GRI & LightburnSOUTHSOUTH• Mansionhouse Unit, Mearnskirk House & Mansionhouse Unit, Mearnskirk House &

Southern General (Langlands & PDRU)Southern General (Langlands & PDRU)CLYDECLYDE• RAH, Johnstone, Inverclyde and Vale of LevenRAH, Johnstone, Inverclyde and Vale of Leven

Ageing PopulationAgeing Population

• The number of people aged over 75 years The number of people aged over 75 years is projected to rise by nearly 81% by 2031. is projected to rise by nearly 81% by 2031. Leading to an increasing number of frail Leading to an increasing number of frail older people needing hospitalisation for older people needing hospitalisation for multiple episodes of care (SG 2007).multiple episodes of care (SG 2007).

• Over 15 million people in the UK currently Over 15 million people in the UK currently have a long term condition, and as the have a long term condition, and as the number of older people is projected to number of older people is projected to increase significantly so the number will increase significantly so the number will increase as will the demand for health care. increase as will the demand for health care.

Nursing Practice Nursing Practice DevelopmentDevelopment

• Today the more Today the more dynamicdynamic areas of areas of nursing practice are to be found nursing practice are to be found within care of the elderly and within care of the elderly and disability settings. – Nursing older disability settings. – Nursing older people is people is core business core business and theand the use use of JBI will enable evidence based care of JBI will enable evidence based care to be implemented consistently to be implemented consistently

Why the NHS needs JBI Why the NHS needs JBI NOWNOW!!Early figures on the knowledge and skills of Early figures on the knowledge and skills of

SCN’S indicate (Senior Charge Nurse SCN’S indicate (Senior Charge Nurse Review)Review)

• Out of 3 cohorts (120 SCN’S) across NHS Out of 3 cohorts (120 SCN’S) across NHS GG&C, only GG&C, only 27%27% have a first degree have a first degree

• Coupled with a mature workforce within the Coupled with a mature workforce within the RAD Directorate could assume there has RAD Directorate could assume there has been limited formal research trainingbeen limited formal research training

• Huge Directorate – 1000 trained staff - Huge Directorate – 1000 trained staff - geographically dispersed --- geographically dispersed ---

Subsequently;Subsequently;

• RAD wished to explore effective mechanisms RAD wished to explore effective mechanisms to ensure best practice is currently to ensure best practice is currently implemented and support SCN’s and trained implemented and support SCN’s and trained staff…..rather than wait for 3-5 years for staff…..rather than wait for 3-5 years for some to complete their first degree/research some to complete their first degree/research training.training.

• Build on the earlier project RAD – Community Build on the earlier project RAD – Community of Practice) which offered ’bite-sized’ chunks of Practice) which offered ’bite-sized’ chunks on the notion of evidence-based practice on the notion of evidence-based practice

Also, need a resource that is SMART Also, need a resource that is SMART that can complement and enable the that can complement and enable the implementation of other healthcare implementation of other healthcare policy initiatives – for example, Better policy initiatives – for example, Better Health, Better Care (SG 2007), which is Health, Better Care (SG 2007), which is where JBI comes into playwhere JBI comes into play

•One of the first CQI’s to be implemented across all Health Boards in Scotland is the falls statement.

•Timely, as the statement refers to NHSQIS (BPS) and JBI as resources.

Way Forward for NHSGG&C Way Forward for NHSGG&C (RAD Directorate)(RAD Directorate)As part of the Implementation Group As part of the Implementation Group (JBI) the intention is to use JBI (JBI) the intention is to use JBI resources to enhance the Practice resources to enhance the Practice Development Journey (PD), in this Development Journey (PD), in this instance building on RAD CoP project. instance building on RAD CoP project. Caledonian Development ModelCaledonian Development Model(Tolson et al 2008)(Tolson et al 2008)

To achieve this end and begin the PD To achieve this end and begin the PD journey the project has 2 strands.journey the project has 2 strands.

1. Look at ‘bigger picture’ Benchmark audit 1. Look at ‘bigger picture’ Benchmark audit - (n=1000) trained staff across RAD to - (n=1000) trained staff across RAD to determine degree status and current determine degree status and current knowledge on JBI (NHS has had JBI licence knowledge on JBI (NHS has had JBI licence for almost 2years)for almost 2years)

•

Based on findings from benchmark Based on findings from benchmark audit – develop a 5 point action plan to audit – develop a 5 point action plan to cascade and utilise JBI resources cascade and utilise JBI resources across RAD. across RAD.

Use the knowledge and skills of CoP Use the knowledge and skills of CoP members, facilitators, link nurses and members, facilitators, link nurses and the PEF’s to share info through the PEF’s to share info through mentors- staff- students, face2face mentors- staff- students, face2face and using CoPand using CoP

Re-audit – similarities to PDSA cyclesRe-audit – similarities to PDSA cycles

•

2. To address the perceived lack of first 2. To address the perceived lack of first degree statusdegree statusRe-package work based learning modules Re-package work based learning modules for Nursing the Older Adult (part of BSc. for Nursing the Older Adult (part of BSc. Professional Development programme) Professional Development programme) using JBI resources as one educational using JBI resources as one educational strategystrategy

Values/Dignity based framework underpins Values/Dignity based framework underpins all module content.all module content.

Finally, and…..Finally, and…..

most important of all!

As a Directorate, be able to move

forward with confidence that we are providing ‘best practice’ to patients across RAD.

References

•Scottish Government (2007), Better Health, Better Care Action Plan, Scottish Government Health Directorate.

•Tolson D et al (2008) Achieving evidence-based practice: impact of the Caledonian Development Model, 16:682-692.

For further information and your JBI COnNECT password please contact

elaine.burt@ggc.scot.nhs.ukmarie.mcaloon@ggc.scot.nhs.uk