Presentation on theme: "Sustainability & Spread"— Presentation transcript:
1 Sustainability & Spread Maureen FallonAssistant Director Innovation & Improvement,Cardiff and Vale University Health Board
2 SustainabilityMeans…….Holding the improvements and evolving as required ALTHOUGH…….. history tells us that 1/3 of all major improvement initiatives in healthcare fail to achieve the sustainable changes needed to meet their planned objective. Take 2 minutes to discuss possible reasons WHY with your neighbour?
3 Session objectives 1 2 3 Introduce the Sustainability Tool Factors influencing SDM uptake2Top Tips for embedding, sustaining and spreading SDM3Life beyond MAGIC in Cardiff and Newcastle – ‘walking the talk’
5 Sustainability Tool Process Staff Organisation Or, put another way, Credibility ofthe evidenceAdaptabilityBenefit beyondhelping patientsMonitoringprogressBehavioursTraining andinvolvementSenior leadersClinical leadersFits with thegoals andculture (internaland external)InfrastructureOr, put another way,the Micro (local team level);the Meso (the department/practice level)the Macro (the organisation level)
6 Team level ingredients Does your team agree thatSDM is important?Do you have support fromthe key members in theteam?Have you got an interestedpatient advocate?Are you able to access SDMskills training?
7 Dept/Practice level ingredients Credibility of the evidence – be able to demonstrate a positive impact on staff and an improved patient experience e.g. what are the benefits beyond helping patients?In South Tyneside CCG, shared decision making was a key component of the referral management scheme (project focused on improving the quality of referrals). Focus on General Surgery, Orthopaedics and Gynaecology. The results included:reduced referralsimproved patient satisfaction and engagement with secondary care£500k savings in one year.
8 Patients’ knowledge post diagnostic consultation Measuring impact of change in clinical practice (Option Grid)Patients’ knowledge post diagnostic consultationHere you can see the difference in knowledge at the end of diagnostic consultation between the first and second sets of data.Massive improvement between two sets of data.A few possible explanations:Small numbersParticularly intelligent group of patients ;-)Team galvanised by seeing first set of dataOption GridThe only two questions that the majority of patients are still not getting right – effect of radiotherapy on breast size and length of time for radiotherapy – are NOT included in the Option Grid.8
9 Dept/Practice level ingredients SUREScoreMonitoring progress –be able to demonstratethat patients areinvolved in their careand that their views arelistened to e.g. simpletools such asSUREScore or moredetailed tools such asDQM’s (Cardiff) andSDMQ’s (Newcastle)Did you discuss the different treatment options for you?Did you discuss the risks and benefits of the different options?Did you discuss what is important to you in your treatment?Yes No Unsure
10 Organisation level ingredients EXTERNALINTERNALFits with the organisation’sculture: ‘Caring for people,keeping people well’.QI agenda – patientcentrednessCQUIN‘A promise to learn – a commitment to act’‘…patients and their carers should be PRESENT, POWERFUL and INVOLVED at all levels of healthcare organisations’
11 Summary & Top Tips Ensure the ‘conditions are right: Identify your aim – does it fitwith the direction of travel?Going it alone rarely works….remember Renal…Adopt ateam approach.Access to training/ AGILEEngage your PatientExperience/PALS teams at theoutsetEvaluation – how will you knowa change is an improvement?Organisation levers
12 Life beyond MAGICBoth Newcastle and Cardiff are engaged in an Evaluation study, sponsored by the Health Foundation;The teams continue to collaborate to ensure Sustainability and Spread;Newcastle has well established links with Health Education North East in the undergraduate curriculum. Opportunity to expand across all levels of inter-professional education as part of a regional strategy;Cardiff is engaged in discussions with Public Health Wales with a focus on SDM as a pillar of the Welsh Co-Production agendaThe Health Foundation continue to play an important role in enabling ‘Walking the Walk’