1. Peer Reviewer Training for MTC’s Improving health outcomes across England by providing improvement and health expertise

2. Welcome and Introductions Improving health outcomes across England by providing improvement and health expertise

3. Aims of Peer Reviewer Training To promote understanding of the purpose and implementation of the National Peer Review Programme To provide peer reviewers with the skills and information to enable them to fully contribute and participate as equal team members in the National Peer Review Programme Improving health outcomes across England by providing improvement and health expertise

4. Learning Outcomes By the end of the session you will: Understand the principles of the National Peer Review Programme and your responsibilities as a reviewer Understand your role and relationship with other team members and the peer review team Understand what you need to do for the self assessment Have practiced reviewing evidence required for self assessment Be familiar with and recognise the importance of the TQuINS electronic communications system Be familiar with the VIMS electronic communications system Improving health outcomes across England by providing improvement and health expertise

5. Session 1 The National Peer Review Programme Improving health outcomes across England by providing improvement and health expertise

6. Our Key Principles Clinically Led Focus on Coordination within and across organisations - networking Consistency in delivery of programme Driver for service development and quality improvement Quality assurance process for clinical services Peer on Peer Lay person Involvement Improving health outcomes across England by providing improvement and health expertise

7. Aims of Peer Review To ensure services are as safe as possibleTo improve the quality and effectiveness of careTo improve the patient and carer experienceTo undertake independent, fair reviews of services To provide development and learning for all involved To encourage the dissemination of good practice Improving health outcomes across England by providing improvement and health expertise

8. Organisation of the Programme Ruth Bridgeman National Director Richard McMahon North Region Quality Director Local Review Units (LRU) x 3 QM & AQM Sally Edwards South Region Quality Director Local Review Units (LRU) x 4 QM & AQM Clinical Leads Julia Hill Deputy Director NVMU Marie Cummins Programme Development Manager Improving health outcomes across England by providing improvement and health expertise

9. Using TQuINS Available via the web site at: www.tquins.nhs.uk Secure web based database supporting each stage of the MTC’s peer review process Records self assessments and reports Provides information for national analysis and reporting Improving health outcomes across England by providing improvement and health expertise

10. TQuiNs Front end website Resources for teams Self Assessment Form Published Reports Public information about MTC’s Login access to the database Will not be publicly accessible Improving health outcomes across England by providing improvement and health expertise

11. TQuINS Homepage Improving health outcomes across England by providing improvement and health expertise Navigate to CQUINS homepage www.tquins.nhs.uk www.tquins.nhs.uk Enter your Registration details

12. Locating the Trauma Centre Improving health outcomes across England by providing improvement and health expertise Click on Regional Major Trauma to show all Trauma Centres Click on Dummy Regional Major Trauma to practice using the system

13. Selecting the trauma service Improving health outcomes across England by providing improvement and health expertise Click on Regional Major Trauma team you want to view

14. Viewing the Key Evidence Improving health outcomes across England by providing improvement and health expertise Self- Assessment Report and Peer Review Reports here Dates for Visit and Completion of Self Assessment Evidence Document will appear here

15. Uploading Evidence Document Improving health outcomes across England by providing improvement and health expertise Self- Assessment Report and Peer Review Reports here Dates for Visit and Completion of Self Assessment Evidence Document will appear here

16. Completing the Self Assessment Improving health outcomes across England by providing improvement and health expertise Complete the commentary against each section Enter the Name of the Lead Clinician Enter the compliance with the measures Always Save !!!

17. Completing the Peer Review Assessment Improving health outcomes across England by providing improvement and health expertise Enter the Name of the Lead Clinician Enter the names of the reviewers Always Save !!!

18. Completing the Peer Review Assessment Improving health outcomes across England by providing improvement and health expertise

19. Completing the Peer Review Assessment Improving health outcomes across England by providing improvement and health expertise Click on the drop down assessment and enter yes or No Complete the commentary

20. The Peer Review Programme for MTC’s Evaluation Education & Training Day (Date TBC) Round Two (start 03/12/13) All teams/services Round One (completed 28/11/13) All teams/services Improving health outcomes across England by providing improvement and health expertise

21. What is the benefit of a Peer Review ? Provide an opportunity to meet with members of a service to determine recommendations against the Self Assessment form Identify any broader issues relating to the delivery of a quality and safe service including a review of clinical indicators The provision of learning and exchanging best practice across networks To enable clinicians a greater engagement to improve and deliver a high quality service for all Improving health outcomes across England by providing improvement and health expertise

22. Developing Measures using the Self Assessment Form Divided into five sections: Network Organisation Pre Hospital Reception/Resus Definitive Care Rehabilitation Improving health outcomes across England by providing improvement and health expertise

23. Network Organisation Measures Improving health outcomes across England by providing improvement and health expertise

24. Pre-Hospital Care Measures Improving health outcomes across England by providing improvement and health expertise

25. Reception and Resuscitation Measures Improving health outcomes across England by providing improvement and health expertise

26. Reception and Resuscitation Measures Cont. Improving health outcomes across England by providing improvement and health expertise

27. Definitive Treatment Measures Improving health outcomes across England by providing improvement and health expertise

28. Rehabilitation Measures Improving health outcomes across England by providing improvement and health expertise

29. Rehabilitation Measures Improving health outcomes across England by providing improvement and health expertise

30. Notification to teams to be peer reviewed Deadline for submission of evidence for all teams to be visited Self Assessment evidence and compliance matrix sent to reviewers and copied to teams Visit day Report published 8 weeks after last review day Notification - 2 Weeks 0 - 4 Weeks The Peer Review Visit Plan Preparation for review + 8 Weeks Improving health outcomes across England by providing improvement and health expertise

31. Review Schedule Agenda: Improving health outcomes across England by providing improvement and health expertise Working lunch (30 mins) Tour of the MTC (90 mins) Reviewers to split and walk around the different sections MTC Presentation (30 mins) Q&A should be after the presentation not during, in order to save time Pre-Meeting Evidence Review (60 mins) Reviewers only – Review the evidence and prepare questions and lines of enquiry for the peer review visit

32. Improving health outcomes across England by providing improvement and health expertise Review Schedule Agenda Continued: Complete Report (60 mins) Feedback to the Network (20 mins) Preparation of Feedback (20 mins) Review of Services Meeting (100 mins) Pre-Hospital Care (20 mins) Reception and Resuscitation (20 mins) Definitive Care (20 mins) Rehabilitation (20 mins) Network Governance (20 mins) Reviewer should not leave until the first draft report is complete

33. Session 2 Review of Evidence Improving health outcomes across England by providing improvement and health expertise

34. Evidence Documents Protocols Staff work rotas Work logs Audits Improving health outcomes across England by providing improvement and health expertise

35. Key Themes Network OrganisationPre-HospitalReception/ResusDefinitive CareRehabilitation Improving health outcomes across England by providing improvement and health expertise

36. Relationship of Self Assessment Form to Key Documents When reviewing the evidence you will need to refer to the self assessment form Decisions against the self assessment form are made in discussion as a team Yes / No / N/A – at the time of the visit –All aspects of the measure have to be met Comments –No and … –No but … –Yes and … –Yes but … Improving health outcomes across England by providing improvement and health expertise

37. VIMS Improving health outcomes across England by providing improvement and health expertise

38. VIMS (Visit Information Management System) This system is used for online storage of key evidence peer review measures for reference visit schedule logistical arrangements contextual information travel expense and honorarium forms Improving health outcomes across England by providing improvement and health expertise

39. VIMS Prior to review you will be sent an email containing: a web link a user ID a user password These have to be typed in User reviewers can request hard copies of the documents. Improving health outcomes across England by providing improvement and health expertise

40. VIMS – Work page view

41. Session 3 Meeting with the Team Improving health outcomes across England by providing improvement and health expertise

42. Question Types OpenEncourage people to talk What, where, when, why, how? ClosedChecking factsHow many? do you? HypotheticalTest contingenciesWhat if? ProbingGreater depthIn what way? Tell me more.. LeadingPacifying Use with care You do, don’t you? MultipleAvoidWho sends it, what do you do and how? Improving health outcomes across England by providing improvement and health expertise

43. Listening Listen before deciding response –Their story not yours! –Be active summarise regularly ask confirmatory questions –Encourage contributions from everyone –What if they won’t stop talking? Improving health outcomes across England by providing improvement and health expertise

44. Body Language Look for reaction and adjust style to suit Watch for defensive behaviour sudden arm-crossing agitation face touching avoidance of eye-contact Use empathy wisely Improving health outcomes across England by providing improvement and health expertise

45. Approach Open, fair, consistent and comparable Encourage development and learning All members of the team have a valuable contribution to make Try to understand and follow the patient’s journey Seek clarity where required Improving health outcomes across England by providing improvement and health expertise

46. Meeting the Team Start on time and keep to time Make sure everyone is introduced Put at ease – and get comfortable Develop rapport Explain purpose and structure Note-taking Open questions to start Improving health outcomes across England by providing improvement and health expertise

47. Closing the Meeting Give the opportunity for further comment: –“Is there anything we’ve missed?” –“Is there anything else you’d like to tell us about?” –“Which aspect of the service are you most proud of?” Thanks Improving health outcomes across England by providing improvement and health expertise

48. Session 4 Report Writing & Recommendations Improving health outcomes across England by providing improvement and health expertise

49. Categorising Review Findings An issue that is likely to result in harm and requires immediate action which will be included in the recommendations Immediate Risk An issue that could compromise the quality or outcome of patient care to be included in the recommendations Serious Concern An issue that affects the delivery or quality of the service Concern Relates to the service and can be either innovative or common practice undertaken very well Good Practice Improving health outcomes across England by providing improvement and health expertise

50. Reviewer Responsibilities Working on behalf of the health community Preparation before the visit – information pack and VIMS Reviewing the evidence and ascertaining compliance Identifying issues relating to the self assessment form and to the quality of service for patients Allocating questions for each reviewer Keeping to timetable Confidentiality...sensitivity Obtaining consensus re compliance/report content Writing & checking the report at several stages Clarification on any issues following review Responsibilities include: Improving health outcomes across England by providing improvement and health expertise

51. Reviewer responsibilities 2 Notifying the peer review team as early as possible of the need to cancel participation in a review Completing travel expense forms and returning them as soon as possible Further responsibilities include: Improving health outcomes across England by providing improvement and health expertise

52. What Happens Next? Round One (completed 28/11/13) Round Two (start 03/12/13) Training and Education Event for MTC’s (date TBC) Evaluation of Round One & Two Proposals for next Round Improving health outcomes across England by providing improvement and health expertise

53. Resources Available www.tquins.nhs.uk www.tquins.nhs.uk NPR Handbook Slides and from today VIMS Improving health outcomes across England by providing improvement and health expertise

54. Any Questions? Thank you Improving health outcomes across England by providing improvement and health expertise