1. ‘Kick Start Your Quality Improvement Project’ Learn how to undertake and deliver quality improvement projects QIP Quiz for Registrars
Wednesday 13th April 2016

2. QIP Quiz
What is Quality Care? (Institute of Medicine came up with 6 indicators)
Who can tell us where problems might lie? (Think 360 deg PSA)
What measurement tools can we use to assess quality care?
Draw a process map of your morning so far. (max 10 steps)
Why should processes in medicine be standardised?
Which sport has successfully applied “the philosophy of marginal gains”?
What is a driver diagram?
How did Mazda make the new MX5 lighter?
What does PDSA stand for? (Not People’s Dispensary for Sick Animals)
Why should targets be SMART?
In any study what is best to measure, structure, process or outcome?
Unintended consequences of any change are called B______ M_______
In a QIP, why is data over time better than 2 averages?
Regarding the HEEM QI Resources website…
How would you find it?
What information does it have?

3. innovate AND improve 2012, 13 & 15 – Tour de France winners
Cycling is one of the UK’s great sporting success stories. In 2012 they won 7/10 [check] track golds available plus Bradley Wiggins won the Olympic time trial and the Tour De France.
The cycling success story demonstrates the benefits of both innovation – for example transferring revolutionary training methods from track cycling to the road, and using sports physiologists to plot out exact training plans for stage races such as the Tour de France leading to Bradley Wiggins winning the UK’s first ever yellow jersey, followed up by a second win in two years with Chris Froome leading the team.
At the same time, they employed a ‘Head of Marginal Gains’, Mat Parker, whose job was to find a thousand areas where a 1% improvement was possible and when added up these could make the difference between silver and gold medals.
Examples included battery powered heated shorts to be removed seconds before the race which keep the muscles warm ready for a huge push off and cleaning the tyres with alcohol solution before the race to remove any specks of dust which could increase energy loss due to friction.
You may remember that the French team accused the British of having rounder wheels than everyone else, such was the success of this strategy.
We don’t know whether Mat Parker uses driver diagrams but they certainly would have been a good way to come up with solutions such as these.
2012, 13 & 15 – Tour de France winners
2008 & 12 – 8 Olympic Golds
2004 – 2 Olympic Golds

4. Philosophy of ‘Marginal Gains’
The whole principle came from the idea that if you broke down everything you could think of that goes into riding a bike, and then improved it by 1%, you will get a significant increase when you put them all together“
David Brailsford, 2012
e.g. take your own pillow (change project; secondary driver, sleep better)

6. Unintended consequences?
What to measure?
Is it working?
system fit for use?
INPUTS
EXTERNAL
FACTORS
Is it being done?
Process Measure(s)
HUMAN
FACTORS
OUTPUTS
Outcome Measure(s)
INTERNAL PROCESSES & PROCECEDURES
Structure Measure(s)
The world of quality improvement also shows the value of including balancing measures as well
Very easily overlooked
REFLECT: in work you’ve recently been involved in, what, if any balancing measures were recorded?
Unintended consequences?
Balancing Measure(s)

7. What does this data tell us?7
What does this data tell us?
Patients treated in April
600
550
610
540
560
570
580
590
Congratulations,
Aren’t we doing well
Keep up the good work
2008
2009

8. What does this data tell us?8
What does this data tell us?
Patients treated
650
600
550
500
450
400
350
300
All data needs to be put into context.
April 2008
April 2009

9. Time to plan What small thing niggles you?
What tools could you start using?
Why?
When?
What are you going to change?
Where?
How?
How will you measure it?
Over what time scale?
Who will you need to liaise with?
What resources might you need?

10. HEEM Quality Improvement Forum 2015
What had over 100 posters, 75 abstracts, 2 keynote speakers, 4 workshops, 9 presentations, 6 award winning improvement projects  and 350 delegates?
HEEM Quality Improvement Forum 2015
Happening again in 2016!
Come to present you QI project….
….and see others and get inspired!

11. Health Education East Midlands Quality Improvement Forum 2016
HEEMQIF16
SAVE THE DATE! Health Education East Midlands are pleased to announce that the next Quality Improvement Forum will take place on 29th June the Kube, Leicester Racecourse in Oadby, Leicester. Key HEEMQIF16 activities for your diary:
Forum programme cascaded -  w/c 14th December 2015
Call for Quality Improvement Projects Abstracts – w/c 4th January 2016
Call for bookings & workshop bookings open – w/c 4th January 2016
Abstract submissions close – w/c 28th March 2016
Bookings close – 31st May 2016
HEEMQIF16 – 29th June 2016
Join in the conversation on Twitter using
@EastMidsLETB #HEEMQIF16 #loveourlearners

12. A Final Thought from Don Berwick
“The most important single change in the NHS in response to this report would be for it to become….a system devoted to continual learning and improvement of patient care, top to bottom and end to end.”
Don Berwick. A promise to learn - a commitment to act. August 2013.