Presentation on theme: "Laura Hibbs Service Improvement Manager, NEYNL SHA Diane Rothwell"— Presentation transcript:
1 Clinical Microsystems – an organisational development approach to service improvement Laura HibbsService Improvement Manager, NEYNL SHADiane RothwellProject Manager, NEYNL CHD Collaborative
2 Aims What is a clinical microsystem? What is the microsystems model and how can it support you in your improvement work?What can we learn from the experience of two of the national pilot sites?
3 What is a clinical microsystem? A frontline team of patients, clinicians, managers, admin and information staff working together in an information rich environment to deliver and improve services to a defined population of patients
4 What is a clinical microsystem? Community, Market, Social Policy SystemSelf-care SystemMacro-organization SystemIndividual care-giver & patient SystemClinical Microsystem
5 …Echocardiography in Barnsley. For example……Echocardiography in Barnsley.
6 Secretary and Administrator Nurses Technicians Patients Information system (new)HealthCareAssistantReceptionistInformationsystem (old)Doctors
7 Information system (modern) ReceptionistPatientsNursesInformation system (traditional)Secretary and AdministratorHealth Care AssistantTechnicianDoctor
8 Microsystems are the building blocks that come together to form larger organisations
10 The Microsystems Model Three key componentsThe 4 P’s FrameworkTools and techniquesTeamwork
11 The 4 PsPPPPPatients Who are they? What do we need to know about them?People the employees; How to involve them more? What do staff think?Processes How do we run the things? What are our systems?Patterns How do things vary? What causes variation?…aiming to build a comprehensive understanding of the microsystem and how it works.
12 Clinical value compass PLANDOSTUDYACTPDSA cyclesVariable510152025303540DateOuncesRun charts &control chartsGenerativerelationshipsFlow charts &deployment chartsData & measuresWorkforceDevelopmentFCSClinical value compassGlobal AimTemplateSmall groupsTaskForceTeamCrewFishbonediagramsMeetingskills & disciplines
13 Summit Camp 3: “How can we all grow?” (11, 12) Camp 2: “Do I belong here?” (7,8,9,10)Camp 1: “What do I give? (3,4,5,6)Basecamp: “What do I get” (1,2)
15 (…and in the boardroom) Data walls(…and in the boardroom)
16 Microsystems resource pack Introduction and survey materialsColour coded for the 4 Ps‘Starter pack’ for microsystem workingMaterials developed by UK pilot sitesAdaptation and improvement continues!Materials available as MS Word documents to change and adapt
17 “How to use…” - Four headings: What is it?“How to use…” - Four headings:Why use it?How to use it?Notes and tips
18 Teamwork Team approach Shared vision, mission, information Agreed priorities, improvement plansRegular meetings, learning eventsRegularly review and improve team climateLearn simple improvement toolsKaizen approach, PDSA cyclesImprovement tools/techniquesReview, reflect and plan together How are we doing? Where next?
19 How can it support you in your improvement work? Cardiology DepartmentBarnsley District General HospitalBlackburn Royal InfirmaryClinical Measurement DepartmentSouthern Derbyshire Acute HospitalsIlkeston Community HospitalErewash PCTNeurological Outpatient DepartmentHurstwood Park HospitalFoxhall Day Surgery UnitIpswich HospitalCardiac Monitoring UnitHull Royal InfirmaryRiverside SurgeryNorth Lincolnshire PCTHow can it support you in your improvement work?
21 Evaluating microsystems in the NHS …some early comments from sites: Liked the ability to adapt materials (e.g. tailor questionnaires) to differing settingsHave been selective in which surveys and questionnaires have been usedGone at their own paceHave variably used the 'tools’ - different bits found to be useful at different sitesFocus on staff views and issues has been popular
22 Evaluating microsystems in the NHS …some early comments from sites: Took a while to get to grips with what microsystems working was and how to applyLot of things (too much?) fitted into the sessionsPace of work - monthly sessions - has been ‘challenging’. Prompt or pressure?Have used it to build on previous workHearing about each others’ experiences had been possibly the most useful aspect
23 Microsystem working…Involves everyone (…the whole team, not just a ‘select few’)Comprehensive and flexible (…not ‘problem focussed’ or highly prescribed)Values staff views, experiences and welfare equally (…avoids improvement at staff expense)Draws together different strands of improvement work (e.g. access improvement and workforce development)Builds on any previous improvement projects (…provides somewhere to go after project ends)