1. 1000 Lives Improvement

2. work based improvement – Improving Quality Together Emma Thomas Improving Quality Together Lead for Higher Education, 1000 Lives Improvement Service (E) emma.thomas13@wales.nhs.ukemma.thomas13@wales.nhs.uk (M) 07790 843411

3. Learning Objectives By the end of this session you should be able to; Examine a ward situation identifying good and practice through ‘fresh eyes’ Propose simple changes to routine that focus on patient centred care Consider issues in patient centred care from different perspectives

4. What can you see? It’s your first day on this ward....... Watch the following video and consider any issues that you see Base your views from the objective of the person identified in your group scenario

5. Ward Round Video This video was recorded for training purposes as part of a quality improvement process mapping session on a real ward. Please respect the confidentiality of the patients and staff included in this video.

6. Reflection – What did you see? You have just seen the video of the breakfast round on the ward...... Consider any issues that you saw in the video from the point of view you have been given – what would you tell your friends about what you’ve seen? In your groups make a list of issues you have seen on post-it notes and what you would change

7. Feedback Each group should feed back: What were the key issues from their perspective What was the focus of their perspective? How would you solve some of the issues? How do you like to have your breakfast?

8. Person-centred approach 1, 2, 5 Does this ring true from your experience? Do we practice this every day in all we do?

9. Circle of influence So thinking about your service from your customer’s perspective; problems that you hear about from staff in your service: Where do the various possible problems sit on your team’s circle of influence?

10. Circle of influence Your first improvement wants to focus here

11. Choosing where to start Decide in your groups one or two areas where you might start to make improvements. You could vote or use another improvement tool to make the decision. What changes might make the most difference? What changes might be really easy to do? Which of the things on the list would be within your control?

12. What are we trying to accomplish? Your quality improvement Aim A worthwhile topic Outcome focused Measurable Specific population Clear timelines Succinct but clear A worthwhile topic Outcome focused Measurable Specific population Clear timelines Succinct but clear Adapted from Tom Nolan in The Improvement Guide Features of a good aims statement What would be your aim for the ward round scenario?

13. Recap Learning Objectives By now you should be able to; Examine a ward situation identifying good and practice through ‘fresh eyes’ Propose simple changes to routine that focus on patient centred care Consider issues in patient centred care from different perspectives

14. Scenario 1 - Patient Watch the video as if you are one of the patients receiving their breakfast. Consider the issues through their eyes. How did the scene look from your position in the bed? How did you feel? What did you hear / see? How would you improve what you saw?

15. Scenario 2 – Kitchen Staff Watch the video as if you are one of the staff members distributing breakfast. Consider the issues through their eyes. How well did you distribute the food? What issues did you find? How did you feel? What did you hear / see? How would you improve what you saw?

16. Scenario 3 – Family Member Watch the video as if you are a family member of one of the patients receiving their breakfast. Consider the issues through their eyes. How did the scene look from your position sat next to the bed? How did you feel about what was happening? What did you hear / see? How would you improve what you saw?

17. Scenario 4 – Clinical Staff Watch the video as if you are one of the clinical staff required to treat the patients. Consider the issues through their eyes. How easy was it to focus on what you were doing? What issues did you find? How did you feel? What did you hear / see? How would you improve what you saw?