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Clinical Microsystems – an organisational development approach to service improvement Laura Hibbs Service Improvement Manager, NEYNL SHA Diane Rothwell.

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Presentation on theme: "Clinical Microsystems – an organisational development approach to service improvement Laura Hibbs Service Improvement Manager, NEYNL SHA Diane Rothwell."— Presentation transcript:

1 Clinical Microsystems – an organisational development approach to service improvement Laura Hibbs Service Improvement Manager, NEYNL SHA Diane Rothwell Project 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 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 What is a clinical microsystem?

4 Community, Market, Social Policy System Macro- organization System Clinical Microsystem Individual care-giver & patient System Self- care System

5 For example… …Echocardiography in Barnsley.

6 Patients Nurses Doctors Information system (old) Information system (new) Receptionist Secretary and Administrator Technicians Health Care Assistant

7 Doctor Receptionist Technician Information system (modern) Health Care Assistant Information system (traditional) Nurses Secretary and Administrator Patients

8 Microsystems are the building blocks that come together to form larger organisations

9 What is the Microsystems Model?

10 The Microsystems Model Three key components The Microsystems Model Three key components The 4 Ps Framework Tools and techniques Teamwork The 4 Ps Framework Tools and techniques Teamwork

11 Patients Who are they? What do we need to know about them? Processes How do we run the things? What are our systems? Patterns How do things vary? What causes variation? People the employees; How to involve them more? What do staff think? P …aiming to build a comprehensive understanding of the microsystem and how it works. PPP The 4 Ps

12 Workforce Development Small groups Task Force Team Crew PLAN DO STUDY ACT PDSA cycles Flow charts & deployment charts Fishbone diagrams Meeting skills & disciplines Variable Date Ounces Run charts & control charts Global Aim Template Data & measures Generative relationships F £ CS Clinical value compass

13 Basecamp: What do I get (1,2) Camp 1: What do I give? (3,4,5,6) Camp 2: Do I belong here? (7,8,9,10) Camp 3: How can we all grow? (11, 12) Summit

14 Data walls (Swedish style)

15 Data walls (…and in the boardroom)

16 Introduction and survey materialsIntroduction and survey materials Colour coded for the 4 PsColour coded for the 4 Ps Starter pack for microsystem workingStarter pack for microsystem working Materials developed by UK pilot sitesMaterials developed by UK pilot sites Adaptation and improvement continues!Adaptation and improvement continues! Materials available as MS Word documents to change and adaptMaterials available as MS Word documents to change and adapt Microsystems resource pack

17 How to use… - Four headings: What is it? Why use it? How to use it? Notes and tips

18 Team approachTeam approach Shared vision, mission, information Agreed priorities, improvement plans Regular meetings, learning events Regularly review and improve team climate Learn simple improvement toolsLearn simple improvement tools Kaizen approach, PDSA cycles Improvement tools/techniques Review, reflect and plan together How are we doing? Where next?Review, reflect and plan together How are we doing? Where next? Teamwork

19 Cardiology Department Barnsley District General Hospital Cardiology Department Blackburn Royal Infirmary Clinical Measurement Department Southern Derbyshire Acute Hospitals Ilkeston Community Hospital Erewash PCT Neurological Outpatient Department Hurstwood Park Hospital Foxhall Day Surgery Unit Ipswich Hospital Cardiac Monitoring Unit Hull Royal Infirmary Riverside Surgery North Lincolnshire PCT How can it support you in your improvement work?

20 Wasting time in Ipswich

21 Evaluating microsystems in the NHS …some early comments from sites: Liked the ability to adapt materials (e.g. tailor questionnaires) to differing settings Have been selective in which surveys and questionnaires have been used Gone at their own pace Have variably used the 'tools - different bits found to be useful at different sites Focus on staff views and issues has been popular Liked the ability to adapt materials (e.g. tailor questionnaires) to differing settings Have been selective in which surveys and questionnaires have been used Gone at their own pace Have variably used the 'tools - different bits found to be useful at different sites Focus on staff views and issues has been popular

22 Took a while to get to grips with what microsystems working was and how to apply Lot of things (too much?) fitted into the sessions Pace of work - monthly sessions - has been challenging. Prompt or pressure? Have used it to build on previous work Hearing about each others experiences had been possibly the most useful aspect Took a while to get to grips with what microsystems working was and how to apply Lot of things (too much?) fitted into the sessions Pace of work - monthly sessions - has been challenging. Prompt or pressure? Have used it to build on previous work Hearing about each others experiences had been possibly the most useful aspect Evaluating microsystems in the NHS …some early comments from sites:

23 Involves everyone (…the whole team, not just a select few)Involves everyone (…the whole team, not just a select few) Comprehensive and flexible (…not problem focussed or highly prescribed)Comprehensive and flexible (…not problem focussed or highly prescribed) Values staff views, experiences and welfare equally (…avoids improvement at staff expense)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)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)Builds on any previous improvement projects (…provides somewhere to go after project ends) Microsystem working…

24 Any Questions?

25 Key Contacts Ian Golton, Modernisation Agency Peter Wilcock, NHSU Laura Hibbs, NEYNL SHA Diane Rothwell, NEYNL CHD Collaborative


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