Scottish Improvement Science Collaborating Centre Strengthening the evidence base for improvement science: lessons learned Dr Nicola Gray, Senior Lecturer, University of Dundee, Scotland SISCC programme nt #SISCC k

Strengthening the evidence base for improving the quality of care sustainably and at scale

Translation and methods platforms  knowledge interaction  training & development  innovation  knowledge into action Behaviour change Spread & sustainability Context Capacity & capability building Methods Related work Work-stream projects  Older people  Maternal and child Engagement, co-creation

Workshops with those involved in large scale improvement initiatives Behaviour change Measurement domains Planning large-scale improvement projects Documentary analysis: change at scale Evidence scans for evidence-based actions Systematic mapping and analysis of related empirical studies of improvement Early work

Unintended consequences are key consideration Developing methodologies to assess how change happens Difficult to draw firm conclusions about causality Economic evaluation essential Experience measures are important in broader measurement framework Timely data collection and analysis challenging Early lessons Evaluation Separate out impact of specific improvement initiatives Inequalities analysis important

Potential to widen existing health disparities Explore ways to include minority, frail or disadvantaged groups Early lessons Inequalities Universal coverage significantly reduces inequalities, improves care Population level data important to establish and monitor population and geographical equality targets Local skilled and supported multidisciplinary teams needed to develop ownership

Early lessons Co-creation Multidisciplinary Engagement & participation Local adaption of intervention and collaborative culture in and between local unit and larger system Acceptability and incremental changes increased by involving key stakeholders and identifying roles and relationships Payment by results can increase access for disadvantaged groups

Incentives to motivate and gain managerial buy-in Account for wider economic/ political context Highly engaged staff Interplay of evidence, context and facilitation Support, education and tailored training Tailored facilitation strategy to meet local needs Early lessons Strategies and facilitators Complex social and cultural behaviour changes needed Widespread policy change Support from service commissioner s

Using early lessons to design a large-scale improvement project: Care for babies in neonatal units and their families Collaboration with government, national agencies, professional groups, advocacy and user groups All neonatal units in Scotland: circa 6,700 babies per annum Evidence-based actions identified - key to addressing inequalities Drawing on lessons learned to design intervention, evaluation, engagement processes Includes clinical, psycho-social, resource use outcomes Potential to follow through to community context

Dr Nicola t #SISCC Thank you! With thanks to all involved in the work of the SISCC Our growing list of partners