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U Using Care Bundles Steve Kingsbury and Ann York.

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Presentation on theme: "U Using Care Bundles Steve Kingsbury and Ann York."— Presentation transcript:

1 U Using Care Bundles Steve Kingsbury and Ann York

2 Habit Handle Demand Extend capacity. Let go of families. Process map and redesign. Flow management. Use Care Bundles. Look after staff. Average 43% 40% 30% 38% 8% 68% Data from 100 teams in 2005 Average total score 38% (42/111)

3 Remember…artificial variation  Natural variation Users are different We are different  Artificial variation How we do things Research shows that artificial variation has greatest impact on services!

4 Use Care Bundles Links to High Impact Changes number 6: ‘increase reliability of interventions by designing care based on: what is known to work and that service users and carers inform and influence’

5 Care Bundles  Manage complex problems  Reduce variation in practice  Aim to ensure everyone receives the best care  Defines what you do  Draws on evidence, expert view and user views  Easy to monitor compliance

6 Table discussion A  What problems could you develop care bundles for?

7 Developing a Care Bundle 1. Know current best practice  Decide what you are going to develop a Bundle on!  Something where a combination of approaches are needed  Find evidence e.g. NICE, Drawing on the Evidence

8 Developing a Care Bundle 2. Local best practice  Evidence from research may not be available!  Discuss and reach consensus  Ask users what works

9 Developing a Care Bundle 3: Implement and monitor  Quick checklist in file  Monitor frequently

10 e.g.Surgical site infection Bundle Appropriate antibiotic prophylaxis Control of blood glucose Use of ‘clipping' not shaving Maintain core temperature above 36.6 C

11 Developing a Care Bundle for Anorexia Nervosa in Richmond CAMHS  Eating Disorders team gathered evidence  Asked users what helped  Agreed together what needed to be done at assessment and by whom  Agreed package of interventions  Agreed monitoring  Wrote up  Have a bundle implementation plan

12 Richmond Anorexia nervosa bundle (1) Assessment Choice appointment unless BMI under 15  Multi-disciplinary assessment within 2 weeks Systemic Dietetic Psychiatric Physical EDE

13 Richmond Anorexia nervosa bundle (2) Intervention with 3 monthly reviews Physical care Family therapy Psychiatric Multifamily groups Individual Dietetic

14 School refusal bundle development in E Herts.  Process Did a team role play to explore various experiences Formed a working group Met and written a draft pathway and bundle Planning initial meeting with EWO management to understand their process After that will have multi-agency workshop to consider plan Forgotten user input!

15 Table discussion B  Go back to your suggestions  Pick one and devise a Bundle for one of them…  Who, what, where, when…

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