1. Service Improvement an interprofessional learning activity

2. The Session will introduce What is service improvement and why do it? The 3 step approach Introduce Process Mapping Introduce a model for improvement

3. The Case for Service Improvement Quality & safety Service user experience Productivity Job satisfaction

4. 3 step approach 1. Where are we now? 1. Where are we now? 2.Where do we want to be? 2.Where do we want to be? 3. How do we get there? 3. How do we get there?

5. Do we have the right mix? You can have the right ingredients but not get the result you want! It is what you do with the ingredients and the processes: Resource management. Small changes can have a big impact on the outcome. Systems – every system gets the result it deserves!

6. PROCESS MAPPING Where are we now, the first step in process mapping

7. Seeing the bigger picture - interprofessional

8. It is important we consider different perspectives to get the whole picture Need to know how different parts of the system connect Need to know the relationship between different parts of the system Need to communicate effectively to get the best understanding

9. Where is there need for improvement? Consider the different processes you are involved in. Highlight where within these processes you think there is potential for improvement. Looking at the bigger picture – decide where as an interprofessional team to focus your improvement efforts.

10. Definition - a process is a series of connected steps or actions to achieve an outcome Inputs Process steps Output What do we mean by a process?

11. How do we map the process? Decide which process to map Clarify what “product” you are mapping Decide where you start and finish List each step in order using post-it notes Add timings for each step

12. A process map we did earlier

13. Example: and usually we manage to get to our destination. “ABQ RIDE system map," © 2009 busboy4, Found at: http://www.flickr.com/photos/busboy4/5575611790/. Used under a Creative Commons Attribution-Non-commercial-ShareAlike 2.0 Generic license: http://creativecommons.org/licenses/by- nc-sa/2.0/deed.en_GBhttp://www.flickr.com/photos/busboy4/5575611790/

14. Exercise Where does it start ? Where does it end ? Write each step on a post-it and put them in order Develop a Process Map: Making tea/coffee

15. Analysing the process map How many steps in your process? How many ‘hand offs’ in your process How long does each step take? Where is there “waste” or delays? Where are the bottlenecks? “S7005036," © 2007 vovchychko, Found at: http://www.flickr.com/photos/schneelocke/392216042/. Used under a Creative Commons Attribution-Non-commercial-ShareAlike 2.0 Generic license: http://creativecommons.org/licenses/by-nc-sa/2.0/deed.en_GB http://www.flickr.com/photos/schneelocke/392216042/

16. Step 2: Where do we want to be? Redesigning the process map: Focus on improvements for the user Try to reduce the number contacts Think about what might make for greater convenience and speed the process Reduce or eliminate batching Try to reduce the number of “hand offs” Is the most appropriate person doing the job? Could processes be aligned or moved to improve flow? Any other possible solutions?

17. INTRODUCING A MODEL FOR IMPROVEMENT Step 3: how do we get there?

18. Act What should you do next? Plan How will you test the ideas? How will you know if it is an improvement? Who, what, when etc. Study Analyse the data Was it an improvement? Do Carry out the plan, Observe the process Capture the data as you go Boaden, R., G., Harvey, C., Moxham & N., Proudlove., [n.d]. Quality Improvement: Theory and Practice in Healthcare. NHS Institutie for Innovation and Improvement. Model for Improvement

19. Repeated use of PDSA cycle Hunches theories ideas Changes that result in improvement Measurement Need to start small!!

20. ActPlan StudyDo 1What are we trying to accomplish? 2Map the process - where are the problems 4 What changes can we make that will result in the improvement that we seek? 5 How do we know a change will be an improvement? 6 PDSA cycles at appropriate stages Fitting this with process mapping

21. Your Practice In your groups share some potential areas where you can see opportunity for improvement from your previous experiences? Experiences can include, personal life, student life or may be experience of health and social care. At the end of this activity as a group decide on one of these processes to map.

22. Group Process Map As a group work together to map the process that you have decided on. Agree your start, end and then agree the process (this can take some time as often processes are more complicated than anticipated). Look for potential areas for improving this process. Agree which improvement to work on first. Develop an improvement plan You have six hours to complete this work.

23. Things to remember You must respect current practice. Value everyone’s contribution Listen Teamwork Small steps Don’t always get it right first time This project is about the process not the outcome

24. Improvement Presentation You have 30 minutes to present your work to three other groups. This presentation needs to demonstrate that everyone has worked on this activity. You must show that you considered and listened to different perspectives. Demonstrate how you managed to come to group consensus.

25. Group Reflection 30 minute discussion on the interprofessional challenges and opportunities of this work. How did you overcome the challenges? What can you take forward into your future practice? Any key contacts you have made?

26. Final Thoughts In our workplaces we all face leaner times and maybe if we do not learn how to improve our practice and services then others may tell us what we must do. By working interprofessionally we see the bigger picture which should help us better improve our services and systems.

27. Support materials http://www.institute.nhs.uk/