1. Implementing InS:PIRE in University Hospital Crosshouse
Geraldine Ovens: Improvement Advisor
Laura Haggarty: Physiotherapist
Pauline Murray: Deputy Charge Nurse
David Kimmett: Senior Charge Nurse

2. Team InS:PIRE UHC

3. Physiotherapy My background Must see it in action! Challenges
ICU, rehab programmes
Must see it in action!
Challenges
Only 5 weeks
Wide range of abilities and needs
Idea – pre InS:PIRE clinic

4. Physiotherapy - Clinic
Preparation for clinic
assessment paperwork, suitable venue, equipment, appointments
Set up
2 afternoons in the 2 weeks prior to InS:PIRE
Psychologist → Nurse → Physiotherapist
Outcome
Patients were risk assessed, engaged & committed to programme
Identified issues to be addressed
Questionnaires completed
Physio – identified appropriate starting level & those who required further 1:1 and/or specific programmes

5. Physiotherapy - Class Format of class What makes it different?
Warm up, circuits, cool down, breathing control, education session
What makes it different?
Range of abilities
Relatives joining in
It worked!
Gelled during education

6. Physiotherapy – 1:1 sessions
Benefits
Thorough assessment addressing issues important to them
Plan in place, supporting them to move forward
Challenges
MSK assessment skills! (shoulder tests etc)
Signposting/referral knowledge & information
Generated work (home programmes, referrals etc)

7. Physiotherapy – 1:1 sessions
Benefits
Thorough assessment addressing issues important to them
Plan in place, supporting them to move forward
Challenges
MSK assessment skills! (shoulder tests etc)
Signposting/referral knowledge & information
Generated work (home programmes, referrals etc)

8. Physiotherapy – moving forward
Create a patient 'pack'
Work alongside ICU physio
Great experience
Really rewarding programme
Patients came back!

9. Planning Plan, plan , plan! And more planning Timeline Venue Team
Meetings, meetings and more meetings!
s, s and more s!
HAVING OCD tendencies helps  (I can identify 3 team members at least)

10. Communication Emails galore Meetings
Forward planning (due to venue constraints)
2017 is looming close

11. Support Utilise Tara and Jo ( & rest of GRI team )
Don’t be afraid to ask…
Visit GRI or us to understand the structure and format of the programme (can’t emphasise this enough)
Paperwork

12. Enjoy! Worth all the hard work despite some stress
It’s a fabulous experience / opportunity to be involved in and will be rewarding in more ways than you can imagine

13. Integrating Improvement Methodology into
Stephanie Frearson
Geraldine Ovens Improvement Advisors

14. Patient feedback each week
Measurement Plan
Patient feedback each week
Debrief each week
What went well? What would make it even better
Week 6 shared learning session
Project Charter

15. What was good about this week? What was not so good about this week?
Is there anything we could have done better?
Any suggestions for future weeks?
Process of completing questionnaires needs to be refined
Ensure patient knows who to see next
Staff were all really helpful
More organised this week
Documentation of goal setting not clear!
Appointments list in every room
1 patients left without seeing the pharmacist
Great to get positive feedback from patients/relatives
Coordinator role
Better biscuits would be good
Card with contact numbers
Appeared less busy
Peters feedback in bigger font

16. Key Learning from cohort 1
Patients who require a 1:1 (shadowing) are identified prior to week 1. A different member of staff if possible to shadow each of these patients. Being mindful that there will not be as many staff in cohort 2.
Staff to discuss how patients were progressing with their goals at the debrief each week
Some communication required to each patients GP on their InS:PIRE journey.
Lots of issues raised from patients when they are transferred out of ICU (Possibly devise a driver diagram to highlight these issues for a future improvement project?)

17. What’s Your Investment?
Each Cohort 6 weeks with Learning Week +
3 & 12 month follow-up
Add time for recruitment, administration and co-ordination
UHC aims for 3 Cohorts annually, next Cohort-September
Ensure Senior Management buy-in to create sustainability
Be on 1st name terms with your Financial Accountant to ensure good financial governance.

18. What’s Your Investment?(2)
Set up costs (UHC)
All team members visited GRI
Focus Groups
Pre Assessment Clinics x2
All team members participated (Cohort 1 only)

19. Building a Team (2) Our team
Medical, Nursing, Physiotherapy, Pharmacy, Clinical Psychology, Social Work, Secretarial, Volunteer, Clinical Improvement
Need to be ‘InS:PIRING’ people
Ideally 2 in each position

20. InSPIRE is an evolving project. No 2 cohorts will be the same
Hugely rewarding and worthwhile
Thanks to
Tara and Jo
The Health Foundation
The InS:PIRE team at UHC

21. We will however try to answer any!!
Thank you
We will however try to answer any!!

22. Peter. O'Brien@aapct. scot. nhs. uk Pauline. Murray@aapct. scot. nhs