1. Introducing 1000 Lives Plus
27th October 2011
Introducing 1000 Lives Plus
Sue Lister
Insert name of presentation on Master Slide

2. CoventryUniversity Systems Thinking Sue Lister s.lister@coventry.ac.uk
Service & Quality Improvement in Healthcare,
Coventry University

3. The Model for Providing Care
Access System
Assess
Diagnose
Treat
Follow-up
Clinical Outcomes
Functional Health Status
Total Costs
Patient with needs
Balanced measure of care
Satisfaction against need
Nelson et al (1996)

4. It is the system …
Every system is perfectly designed to produce the outcome it achieves!
paraphrased from Berwick (1996)

5. Process mapping … Select a process e.g. baking a cake

6. Process mapping … Select a process Map the process

7. Map the process

8. Analyse the current situation
Process mapping …
Select a process
Analyse the current situation
Map the process

9. Analyse current situation
Reworked loops
bottlenecks
Lots of steps
delays
Reworked loops

10. Identify opportunities to improve
Process mapping …
Select a process
Map the process
Analyse the current situation
Identify opportunities to improve

12. Identify opportunities to improve
With as few steps as possible
Each step must add value to the process.

13. The real heroes are those who change the system to remove the flaws!
The health service has many heroes. The staff who work harder, predict problems and compensate for short comings.
Heroic thoroughness may make patients lives a little safer - but - a real improvement in the quality of care provided to patients is not created by heroes who compensate for the flawed processes.
The real heroes are those who change the system to remove the flaws!

14. A Model for Improvement
What are you trying to accomplish?
How will you know that a change is an improvement?
What changes can you make that will
result in the improvements you seek ?
Aims
Measurement
Ideas, hunches, other people etc.
Three fundamental questions for improvement
Act
Plan
Study Do
How to make change happen
Langley et al (1996) – cited in NHS III (2007)

15. 3 fundamental questions
What are you trying to accomplish?
Aims
How will you know that a change is an improvement?
Measurement
Three fundamental questions for improvement
What changes can you make that will result in the improvements you seek ?
Ideas, hunches, etc.

16. The PDSA Cycle Act Plan Study Do www.1000livesplus.wales.nhs.uk
How to make change happen …
Act
Plan
Study Do
Walton (1989)
Objective
What do we want to do?
Plan to carry out the cycle
(who, what, where, when)
Plan for data collection
What changes
are to be made?
Next cycle?
Analyse the data
What did or didn’t
work?
Summarise what
was learnt
Just do it!
Carry out the plan
Document problems
and unexpected
observations

17. A Model for Improvement
What are you trying to accomplish?
How will you know that a change is an improvement?
What changes can you make that will
result in the improvements you seek ?
Aims
Measurement
Ideas, hunches, other people etc.
Three fundamental questions for improvement
Act
Plan
Study Do
How to make change happen
Langley et al (1996) – cited in NHS III (2007)

18. Examples of Student Improvement Projects, using systems thinking…
Meal times in a care home
Stethoscopes and infection control
Dehydration of stroke patients
Hand washing in theatre
Patient dignity in A & E
1000 Lives Plus - Making patient safety a priority

19. Any questions?