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Professional Development Programme for Organ Donation “Driving improved organ donation within your hospital” Making Change Happen 1 Dr Paul Murphy Adam.

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Presentation on theme: "Professional Development Programme for Organ Donation “Driving improved organ donation within your hospital” Making Change Happen 1 Dr Paul Murphy Adam."— Presentation transcript:

1 Professional Development Programme for Organ Donation “Driving improved organ donation within your hospital” Making Change Happen 1 Dr Paul Murphy Adam King Dimple Cosgrove 26 May 2010

2 Professional Development Programme for Organ Donation By the end of this session, participants will: Understand the importance of having a clearly defined vision for Organ Donation and start to articulate their own vision for Organ Donation within their hospital Appreciate the benefits of annual planning and reporting to leading Organ Donation within their hospitals Understand the skills, knowledge and process required to develop Annual Organ Donation Plans and Annual Reports Be provided with practical hints and tips on developing local Annual Organ Donation Plans and Annual Reports Understand the roles and responsibilities of the Clinical Leads, Donation Committee Chairs and Specialist Nurses for Organ Donation in the Business Planning Cycle Have an opportunity to put theory into practice and build a local plan for organ donation Session objectives 2

3 Professional Development Programme for Organ Donation The progression of your learning journey Online Tool: Self-Assessment Tool, Document Sharing, Podcasts, Discussion Forum, PDP Atlas, Programme Progress Tracker National Kick-Off Event (inc Law & Donation after Cardiac Death Master Class) National Kick-Off Event (inc Law & Donation after Cardiac Death Master Class) Change Management & Leadership Fundamentals Master Class 1 (Diagnosis of Brain Stem Death and Regional Peer Consulting Group Launch) Master Class 2 (Donor Management & Physiology and Emergency Medicine) Making Change Happen (Development of action plan to implement changes in Trust) Master Class 3 (Consent / Authorisation) Donor Simulation & Paediatrics (Additional Subject Areas) Regional Peer Consulting Groups (Coaching & networking event) National Review Event (Review of Programme and Ethics and Media Skills Master Class) National Kick-Off Event (inc Law & Donation after Cardiac Death Master Class) National Kick-Off Event (inc Law & Donation after Cardiac Death Master Class) Change Management & Leadership Fundamentals Regional Peer Consulting Group (Introduction and coaching in action learning sets) Regional Peer Consulting Group (Introduction and coaching in action learning sets) Making Change Happen (Development of action plan to implement changes in Trust) Regional Peer Consulting Groups (Coaching & networking event) National Review Event (Review of Programme and Ethics and Media Skills Master Class) Podcasts : Eye & Tissue Donation, Epidemiology of Donation & Transplantation, Audit & Statistics and PDA: interpretation & Action Online Tool Self Assessment Tool, Document Sharing, Podcasts, Discussion Forum, Programme Atlas, Programme Progress Tracker AllClinical LeadsNon Clinical Champions 3

4 Professional Development Programme for Organ Donation Agenda 1Change Management and Leading Fundamentals Refresh09:30-09:55 2Developing your vision for Organ Donation09: Break11:15-11:30 3The Annual Organ Donation Planning Cycle11:30-11:50 4Developing an Annual Organ Donation Plan11:50-12:05 5Developing an Annual Report12:05-12:20 Lunch12:20-13:00 6Managing and Tracking Against Plan13: Building a Local Plan (Part A)13:20-14:30 Break14:30-14:45 8Building a Local Plan (Part B)14: Summary and Close15:

5 Professional Development Programme for Organ Donation During the Fundamentals of Leading Change session we: Identified what can help to make change successful and what are the common reasons for failure Identified the local barriers to promoting change within your hospitals Introduced the change frameworks which you can use to guide change Management for Organ Donation Discussed the importance of understanding who your stakeholders are to any change effort and tools for identifying and analysing your stakeholders Defined the three way leadership between Donation Committee Chair, Clinical Leads and Specialist Nurse for Organ Donation and your respective roles as Change Leaders Discussed techniques for tackling difficult conversations Started to plan actions to identify and implement the changes you can make within your own hospital Fundamentals of Leading Change - Refresh 5

6 Professional Development Programme for Organ Donation Understanding the bigger picture 6 PDP Strategic Big Wins

7 Developing a vision for Organ Donation 7

8 Professional Development Programme for Organ Donation What success looks like for the PDP The PDP for Organ Donation will contribute to the Organ Donation Taskforce objective to increase Organ donation rates by a minimum of 50% within 5 years – Making organ donation “Usual” To achieve this vision the Programme will focus on 6 big win areas: 8

9 Professional Development Programme for Organ Donation What does success look like under each of the 6 big wins? We would like you now to split into six groups, one group per strategic big win For your strategic big win we would like you to describe the future state of what a gold standard hospital would be doing under this objective i.e.  What would people in the hospital be doing around organ donation from a clinical perspective?  What would the Organ Donation Committee be doing?  What behaviours would you see?  What outcomes might have been achieved / what success stories are there? Put your ideas on post-it notes and stick these on a flip chart Group discussions for 30 minutes and then 30 minutes feedback 9

10 Professional Development Programme for Organ Donation What can happen without an effective strategic direction? Lack of general direction and lack of a clearly defined ‘future state’ Failure to appreciate the longer-term interests and too much emphasis on short-term success Actions are un-coordinated and without shared purpose or meaning Ineffective decision-making and poor prioritisation What is needed is a compelling view of what the future of Organ Donation looks like in your hospital Why do you need a strategic direction for improving Organ Donation? 10

11 Professional Development Programme for Organ Donation Your strategic direction for Organ Donation must be developed in the context of the wider vision for Organ Donation and the local visions of your individual hospitals Ensuring alignment of your Organ Donation Strategic Direction NHSBT will identify the common organ donation themes and support Donating Hospitals to shape their local strategic direction for organ donation in alignment with the Taskforce vision Organ Donation Taskforce Objective To increase organ donation rates by 50% within 5 years Local Hospital Organ Donation Strategic Direction Overall Hospital Vision Annual Plan Local Organ Donation strategies will be based on local needs, the overall hospital vision and the ODTF objectives 11

12 Professional Development Programme for Organ Donation Ensuring your strategic direction for Organ Donation is effective Build a believable image of how Organ Donation will be in the future in your hospital Is it realistic? Ensure that this image is inspiring, realistic and achievable so that people are motivated to act as the vision intends them to Is it achievable? Align the vision to the interests of key stakeholders, the wider organisation and those of the national agenda for Organ Donation Is it meaningful to a wide audience? Focus the vision on clear priorities and ensure that it is easily understood Does it eliminate confusion and support decision making? Create a vision that is easily communicated to the rest of the hospital Is it concise and does it appeal to people’s emotions? Avoid visions which are too prescriptive or constrain individual initiative Is it flexible? 12

13 Professional Development Programme for Organ Donation Examples of Organ Donation Visions Transplant Australia exists to enrich and celebrate life. Our vision is for Australia to lead the world in organ and tissue donation and transplantation - saving lives, improving quality of life and providing much needed care and support. The vision of Donate Life America is to ensure that every person in the U.S. understands the need for organ and tissue donation and accepts donation as a fundamental human responsibility. We wish to see organ donation become a usual rather than unusual event as part of end-of-life care across the NHS Each individual should be given the choice and opportunity to offer their organs for the purposes of transplantation after their death. This choice should not be denied by the assumptions of NHS staff or a lack of facilities and infrastructure We wish to see organ donation become a usual rather than unusual event as part of end-of-life care across the NHS Each individual should be given the choice and opportunity to offer their organs for the purposes of transplantation after their death. This choice should not be denied by the assumptions of NHS staff or a lack of facilities and infrastructure 13

14 Professional Development Programme for Organ Donation The process involves the combination of both creative and logical approaches Development of the vision may involve several iterations as you test your ‘hypotheses’ and validate with your colleagues and stakeholders The type of data which you can use to input into the development of your strategic direction include:  Review of the Organ Donation Taskforce Report and the Programme’s 6 Strategic Big Wins  Assessment of the national legal and policy frameworks for organ donation  Assessment of your hospital’s overall vision  Analysis of current Organ Donation practices within your hospital  Benchmarking against Organ Donation best practice within other hospitals  PDA data How do you develop a strategic direction? Draft strategic direction and collect data to test it Refine the direction and validate with others Communicate and embed the strategic direction 14

15 Professional Development Programme for Organ Donation Communicating your strategic direction to your colleagues and the wider hospital and receiving their buy-in is essential to the vision’s success Ways of communicating your vision include: Written and verbal communication e.g. the Annual Organ Donation Report, the Annual Organ Donation Plan, training materials and other communications Encouraging discussion of the Organ Donation strategic direction within your hospitals and amongst colleagues Reinforcing key messages by linking it to the day-to-day activities of the hospital You know your vision has been embedded when: Stakeholders are able to articulate the strategic direction and it’s impact in their own words The strategic direction is discussed outside of situations in which it is required Elements of the strategic direction become part of the organisational culture and ‘the way things are done around here’ Communicating your vision for Organ Donation? 15

16 The Annual Organ Donation Planning Cycle 16

17 Professional Development Programme for Organ Donation What is the Annual Organ Donation Planning Cycle? 17 The annual organ donation planning cycle provides a structure of analysis, planning and reporting around which you can make the right changes to improve organ donation Purpose of planning cycle: Ensure content of plan reflects realistic ‘path’ from current state to objectives Ensure delivery of plan is on-track and responds to changes in circumstances Ensure oversight by Executive Board

18 Professional Development Programme for Organ Donation What does the Organ Donation Planning Cycle look like? Benchmarking Data Mid Year Review - ODC Meeting Annual Organ Donation Plan July October January May June December NovemberSeptember March February April (Financial Year begins) August Annual Report Key Organ Donation Planning Cycle Annual Report Annual Organ Donation Plan Benchmarking data Mid Year Review Present to Executive Board CLOD, SNOD & DCC* PDA 18

19 Professional Development Programme for Organ Donation How can you plan effectively in line with the Organ Donation plan? 1.Assess:  Conduct analysis of internal and external environment to identify issues and potential opportunities 2.Plan:  Consider objectives to overcome issues / make the most of opportunities and establish activities and when these would happen to achieve objectives 3.Implement:  Deliver & track against plan, as well as reporting against progress Planning is not a one off activity – it requires regular assessment of progress and interventions. Remember 3 simple steps: Assess; Plan; and Implement 19

20 Professional Development Programme for Organ Donation Key Assessment Activities Assess Fishbone Analysis Potential Donor Audit (PDA) SWOT Analysis Unit ProfileStakeholder AnalysisBenchmarking To what extent is this person/ group affected by the Change? High Low Influence Impact 20

21 Professional Development Programme for Organ Donation Potential Donor Audit - Introduction What is it? The Potential Donor Audit (PDA) is an audit of all deaths occurring in Intensive Care Units for patients under the age of 75. A recent initiative is extending the audit to Emergency Medicine departments, however, this is still in progress. Aims of the PDA? Determine the potential for solid organ donation Understand why solid organs were not retrieved where potential recognised Identify all patients for whom death was diagnosed following brain stem tests Raise the profile of solid organ donation Heighten awareness of donation issues with clinical staff 21

22 Developing an Annual Organ Donation Plan and Report 22

23 Professional Development Programme for Organ Donation What is it? An Annual Organ Donation Plan is a formal statement of a set of ‘Organ Donation goals’ for the hospital, the reasons why they are believed attainable, and the planned interventions (or activities) for reaching those goals What are the benefits? Clarity of vision Objectives and actions Describe the metrics Define the seriousness of the venture What is an Annual Organ Donation Plan? 23

24 Professional Development Programme for Organ Donation What is it? An Annual Report is a comprehensive report on an Organ Donation team’s activities throughout the previous year. It is intended to provide their stakeholders including NHSBT with information regarding the team’s activities and performance against their goals. What is the purpose? The Annual Report is intended to provide their stakeholders including NHSBT with information regarding the team’s activities and performance against their goals in an easy to digest format Development of the report helps the Organ Donation team to reflect on their performance from the previous year and aid their future strategy development The Annual Report is a celebration and communication of past and recent successes Communicating the Annual Report within and outside of the local hospital will help to share lessons and develop learning What is the Annual Report for Organ Donation? 24

25 Professional Development Programme for Organ Donation Annual Organ Donation Plans are a decision making and communication tool and should be determined by the specific goals and stakeholders of the Organ Donation team. Typical high level structure includes: What does an Annual Organ Donation Plan look like? ContentDescription 1. Introduction What are their main priorities for the year, what is the purpose of the Annual Organ Donation Plan? 2. Background Who is in the team, what are the primary roles of the Organ Donation Team. What’s happening in the hospital that would impact Organ Donation activities? 3. Policy Framework What national and legal polices have changed over the last year, how will this affect the key targets for the following year? 4. Strategic Direction What are the high level strategic plans for the Organ Donation Team and their hospital? 6. Action Plans Detail actions against the objectives and indicate timelines for completion as well as owners, risks and issues 7. Risks/ Issues What are the likely key risks and challenges inhibiting delivery against the action plan and what mitigation strategies can be put into place to minimise the impact? 8. Performance Indicators and Monitoring Arrangements How will the Organ Donation team measure success against each of the key targets for the following year? 25

26 Professional Development Programme for Organ Donation Annual reports consist of but are not limited to the following contents: \ What does an Annual Report look like? ContentDescription IntroductionIntroduction to the report including messages from the Donation Committee Chair and Clinical Lead Overview and BackgroundFeedback from the Donation Committee and the Strategy and Vision for Organ Donation Summary of the YearSummary of performance for the year based on objectives set in the Annual Organ Donation Plan Performance Variances and Action Plans Detailed review of variances against the action plans and set objectives PDA BenchmarkingBenchmarking of Donation rates across hospitals and regions Local InitiativesTopics to include may include local activities to increase Organ Donation rated, promote awareness or responses to change in law or policy Future DevelopmentVision and desired actions for the following year – Where does the Organ Donation Team want to be in a year’s time? Possible risks/pressuresHighlight risks and issues identified through the year, what are the challenges, how are the Organ Donation Team going to overcome these? 26

27 Professional Development Programme for Organ Donation SMART Objectives SMART SpecificMeasureableAccurateRealisticTimely Is there a description of a precise or specific behaviour / outcome which is linked to a rate, number, percentage or frequency? Is there a reliable system in place to measure progress towards the achievement of the objective? With a reasonable amount of effort and application can the objective be achieved? Can the person with whom the objective is set make an impact on the situation? Do they have the necessary knowledge, authority and skill and is it relevant to the organizational goals and aims? Is there a finish and/or a start date clearly stated or defined? The Annual Organ Donation Plan should be focussed upon SMART objectives 27

28 Professional Development Programme for Organ Donation Example SMART Objectives Objectives for the next year Actions required to deliver objective Measurable outcome/KPIs Person responsible for leading action To have 100% referral of all potential non-heart beating donors and brain stem dead donors – with 80% conversion rate by 2010 Resident Specialist Nurse for Organ Donation to feedback PDA Utilise Clinical Lead and Donation Committee PDA reflects 100% referralSpecialist Nurse for Organ Donation lead Clinical Lead for Donation To achieve an 80% conversion rate by 2010 Resident Specialist Nurse for Organ Donation to feedback PDA Utilise Clinical Lead and Donation Committee PDA reflects 80% conversionSpecialist Nurse for Organ Donation lead Clinical Lead for Donation The minimum notification criteria is used in 100% of all cases to ensure timely referral Communicate/ reaffirm minimum notification criteria to all relevant staff PDA reflects use of notification criteria in 100% of cases Clinical Lead To scope the implementation of a new Organ Donation programme within the Emergency Medicine department within 6 months Understand the process within emergency medicine Agree roles and responsibilities for scoping exercise A comprehensive report that progresses an Organ Donation programme within Emergency Medicine to be made Specialist Nurse for Organ Donation lead Clinical Lead for Donation The Annual Organ Donation Plan should be focussed upon SMART objectives 28

29 Managing and Tracking Against Plan 29

30 Professional Development Programme for Organ Donation Balanced scorecard and Key Performance Indicators (KPIs) Purpose: The balanced scorecard is a strategic planning and management system that is used to:  Align business activities to the vision and strategy of the organisation  Improve internal and external communications  Monitor organisation performance against strategic goals Key performance indicators are quantifiable measurements, agreed to beforehand, that reflect the critical success factors of an organisation. KPIs help an organisation:  Define and measure progress toward strategic and operational goals Benefits: Increase focus on strategy and results Improve organisational performance by measuring what matters Align organisation strategy with the work people do on a day- to-day basis Focus on the drivers of future performance Improve communication of the organisation’s vision and strategy Prioritise projects / initiatives Adapted from Robert S. Kaplan and David P. Norton, “Using the Balanced Scorecard as a Strategic Management System,” Harvard Business Review (January-February 1996):

31 Professional Development Programme for Organ Donation Organ Donation KPIs Resources, learning and growth (What we need to enhance to succeed) Outcomes (What we want to achieve) Internal Processes (What we need to do well to reach our goals) Customers / Partners (What we need to do for and with others) SNODs achieve and maintain competencies Right proportion time spent in NHS organisations Implement policies and best practice Embedded SNODs Increase submission data on time Increase donor family consent Complaints and Clinical Governance incidents Increased approaches by trained person CLODs are in place Increase referral rates Increase DBD conversion rates Increase BSD testing Chairs of Donation Committees are in place Improve adherence to MNC Increase DCD conversion rates Increase DBD organ donors Increase transplantable organs DCD Effective partnership working Increase transplantable organs DBD Increase DCD organ donors Increase proportion solid organ donors donating eye tissue 31

32 Professional Development Programme for Organ Donation Roles and Responsibilities ResponsibleAccountableConsultedInformed Annual Organ Donation Plan Specialist Nurse for Organ Donation, CLOD & Committee Chair Donation Committee Executive Board EM / ICU Departments Senior Nurses, other Clinicians & Healthcare Professionals NHSBT Medical Director & Director of Nursing Chief Executive Governance Committee Annual Report for Organ Donation Specialist Nurse for Organ Donation, CLOD & Committee Chair Donation Committee Executive Board Senior Nurses, other Clinicians & Healthcare Professionals NHSBT Medical Director & Director of Nursing Chief Executive Governance Committee Hospital Policy Specialist Nurse for Organ Donation & CLOD Donation Committee Portering/ Lab Staff Senior Nurses, other Clinicians & Healthcare Professionals Other hospital staff Medical Director & Director of Nursing Chief Executive Governance Committee Unit Profile Specialist Nurse for Organ Donation Clinical Lead Other clinicians Unit clinicians PDA Specialist Nurse for Organ Donation & CLOD NHSBT Other cliniciansDonation committee Other clinicians Chief Executive Medical Director & Director of Nursing 32

33 Professional Development Programme for Organ Donation Suggested schedule for Donation Committee Meetings Core Donation Committee MeetingsMonthly Update Meetings FrequencyQuarterly (minimum)Monthly Attendees*Clinical Lead Donation Committee Chair Specialist Nurse for Organ Donation Medical Director Clinical Lead or Senior Nurse for: ICU Emergency Medicine Neuro ICU (if appropriate) PICU (if appropriate) Consultant surgeon Consultant Palliative Care or lead nurse End of Life Care Pathway Lead Operating theatre representative – Senior nurse Practice Development Nurse Service Improvement Clinical Lead Specialist Nurse for Organ Donation Donation Committee Chair Key InputsPDA and comparative data Data collected from other sources (interviews, conversations, general observations etc) Annual Organ Donation Plan Individual updates Minutes from previous Donation Committee Meetings Suggested Agenda Items to include Quarter 1 1.Review PDA and comparative data 2.High level assessment of progress and achievements 3.Draft key headlines for Annual Report and Annual Organ Donation Plan 4.Agree contributions and timelines for content development Discuss key updates Discuss progress against action plan Review PDA data provided by Specialist Nurse for Organ Donation Discuss next steps and priorities Discuss risks and issues Discuss individual cases, outcomes and implications for future Organ Donation activity Quarter 2 1.Discuss feedback on Annual Report and Annual Organ Donation Plan from Executive Board 2.Revise Annual Organ Donation Plan if necessary 3.Review progress and identify remedial actions Quarter 3 1.Review PDA and comparative data 2.Conduct mini-assessment of progress and achievements 3.Identify remedial actions 4.Confirm requirement for a mid-year review and key areas of focus Quarter 4 1.Discuss insights from mid-year review 2.Identify remedial actions 3.Agree preparatory activities for Annual Report (meetings, data collection etc.) 4.Consider key priorities for following year *Other potential representatives include: Ethics Committee; Chaplaincy (multi-faith); Patient groups/ Foundation Trust Council (where applicable); Local donor family; communications department ; A representative from dialysis or transplant services 33

34 Action Planning 34

35 Professional Development Programme for Organ Donation Building a Local Action Plan We would now like you to work with your strategic big win team from this morning and consider the key actions you would need to carry out to achieve the vision set for your big win To do this you will need to consider:  SMART objectives against your vision  Supporting actions  Prioritisation of actions i.e. immediate, short, medium and long-term We would like you to use the SMART template below to support your thinking and jot all your actions on post-it notes We will then ask you to come and plot your activity along the T-map as we did during the case study activity Objectives for the next year Actions required to deliver objective Measureable outcomes / KPIs Person responsible for leading action Completion date Resources required 35

36 Professional Development Programme for Organ Donation Transformation Map Increased referral according to minimum notification criteria Increased diagnosis of brainstem death Increased consent / authorisation rates Increased rates of donation in Emergency Medicine Quick WinsVisionMedium TermLong TermShort Term Increased organ donation rates by 50% in 5 years Increased donation after cardiac death Increased quality and quantity of organs from improved donor management 36

37 Professional Development Programme for Organ Donation Summary 37 Make sure you have a realistic and strategic vision that will support you to hit and achieve targets for organ donation in your hospital Use the organ donation planning cycle to help you support your planning, reporting and meeting together as a team and organ donation committee Take time to complete annual organ donation planning and reporting documentation to support you lead Organ Donation within your hospital Understand how you can best share workload for making changes in your hospital between the Clinical Lead, Donation Committee Chair and Specialist Nurse for Organ Donation Focus on those activities which are really going to make a difference in your hospital around the six big wins for organ donation Remember that this programme is an evolution not revolution - change will take time!

38 What’s Next? 38

39 Professional Development Programme for Organ Donation BristolLondon 1London 2*EdinburghBirminghamManchesterLeeds Kick-off Event 01/02/10 – 02/02/10 (London – Britannia International Hotel) Change & Leadership Fundamentals 24/02/10 10/03/1015/03/10 19/03/1014/04/1015/04/1021/04/10 Diagnosis of Death & RPCG Kick- off 31/03/10 28/04/10 11/05/1029/04/1009/06/10 Donor Mgt & Emergency Medicine 22/04/10 15/06/10 08/09/1006/10/1012/05/10 Paediatrics 19/05/10 (London) Making ChangeHappen 13/05/10 26/05/1023/06/10 10/06/1027/05/1030/06/1016/06/10 Consent / Authorisation 09/09/10 13/10/10 03/11/1021/09/1014/10/10 RPCG Follow-up 21/10/10 16/09/1007/09/10 18/10/1018/11/1016/11/1024/11/10 National Review Event 18/01/11 (London) PDP for Organ Donation: Regional Event Calendar


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