June 6, 2016

 Improvement is a journey  It is life-long  It should be a state of mind

 The desire to want to improve  To make things better for service- users (  quality)  To make things easier for staff  To save money (  efficiency) June 6, 2016

 This does not require great knowledge or experience  Some basic theory  The chance to practice in a clinical setting  Simple tools June 6, 2016

 Practice  Confidence in your ideas  Being taken seriously by the team  Seeing some positive results  Courage to try again in the future June 6, 2016

 To improve the user-experience of healthcare –  safety,  quality & improve efficiency   Employability of students  Aim = Every single person is capable, enabled and encouraged to work with others to improve their part of the service [Penny 2003] June 6, 2016

Making things better for patients, their carers and staff in terms of their experience, safety, access, outcomes etc All improvements need changebut not all changes are improvements

4 Steps Identify opportunities to improve Select a process Map the process Analyse current situation

June 6, 2016 Langley G.L. Nolan K.M. Nolan T.W. Norman C.L. Provost L.P (2009) The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd Edition). Jossey Bass, San Francisco.

The PDSA Cycle How to make change happen … Act Study Do Deming & Walton (1992) Carry out the plan Document problems and unexpected observations Begin analysis of the data Complete the analysis of the data Compare data to predictions Summarise what was learned What changes are to be made? Next cycle? Plan Objective Questions/predictions Plan to carry out the cycle (who, what, where, when) Plan for data collection

 Process mapping is a simple exercise  It helps a team to know where to start making improvements that will have the biggest impact for patients and staff  A process map is a picture  Just as a road map is a picture of how you get from A to B, a process map is a picture of the patient's journey through your process  It can also be a picture of how a transaction travels through your process, for instance the journey that a purchase order takes, from first contact with the supplier to payment of invoice  The map shows all of the steps in a process June 6, 2016

In consultation with the educator the student will:  Identify a situation where an improvement may be desirable  Complete a process map in order to identify each step  Consider what changes could be made to improve the process The project should:  be small & manageable  involve any staff or service-user experiences  take no more than 4 hours of clinical time (unless the educator feels it warrants more). June 6, 2016

 Background – including your aim  Actions – what steps did you take?  Impact – how will you know if an improvement is made  What went well?  Who did you involve?  Did your project link with any other projects?  Were there any issues/constraints?  Did the team agree to take your idea forward?  Have you appended your process map? June 6, 2016

 Students are not expected to implement the change, merely to analyse the situation and make suggestions, however if the educator agrees with the suggestions and there is time, a student may expand their project as desired  The student will leave a copy of the process map with the educator who may consider implementing changes if appropriate June 6, 2016

 Your educator should be aware of the task  It is your responsibility to explain it and ensure that they understand what is required  Ask them for their opinion: Traffic Light Score  Your visiting tutor can always advise if required  The resource pack will be made available to your educator and visiting tutor June 6, 2016

The placement educator did not think that this was a suitable idea to consider for improvement. The placement educator thought that this was a good idea but it requires more work or discussion with the wider team prior to implementation. The placement educator thought that this was a good idea and the team are going to adopt it.

 This task will enhance your CV!  All NHS professionals are expected to engage with Service Improvement  You may get the opportunity to put a similar task into practice once you are qualified  You will certainly have the skills to engage with Service Improvement as the opportunity arises June 6, 2016

Available on Blackboard: Practice Education  Placement Resource Pack – BSc Programme  Reflective template  Visiting tutors  After placement submit copies of your reflection form plus Educator feedback to your Personal Advisor  All task paperwork should be kept in your CPD portfolio for future reference June 6, 2016

Batalden PB & Stoltz PK (1993) A Framework for the Continual Improvement of Healthcare: Building and Applying Professional and Improvement Knowledge to Test Changes in Daily Work. Journal on Quality Improvement, October. 19 (10) Berwick DM (1996) A primer on leading the improvement of systems. British Medical Journal Cox S, Wilcock P & Young J (1999) Improving the Repeat Prescribing Process in a Busy General Practice - A study using continuous quality improvement methodology, Quality in Health Care, Nelson G, Batalden P, Plume S, Mohr J (1996) Improving Health Care Part 2 - A Clinical Improvement Worksheet and Users’ Manual. The Joint Commission Journal on Quality Improvement. 22 (8) NHS III (2007) The Improvement Leaders’ Guide to Process Mapping, Analysis and Redesign. NHS Institute for Innovation and Improvement, NHS III and University of Warwick (2007) Going lean in the NHS: How lean thinking will enable the NHS to get more out of the same resources. Scholtes PR Joiner BL Streibel BJ (2003) The Team Handbook (3rd ed) Joiner Assoc. Inc. Madison. Warwick Centre for Service Improvement NHS Institute for Innovation and Improvement Trent Improvement Network Institute for Health Care Improvement (USA) Healthcare Improvement Skills Center References