1. Phase Two Learning Session 0 6 May 2013 Diana Dowdle - Campaign Manager David Grayson – Campaign Clinical Leader

2. Background The increasing demand on resources across Counties Manukau is driving the need for continuing improvements in the way that we keep our community healthy. To meet the predicted 5.5% increase in bed days, we need to save 20,000 days.

3. The Campaign aims to give back to our community 20,000 healthy & well days, so reducing hospital bed days by 20,000. 20,000 Days Campaign

4. Campaign Driver Diagram

6. 5 essential Collaborative components 1.A specified topic 2.Clinical, Management & Quality Improvement experts 3.Multi-professional teams from multiple sites /sectors 4.Model for improvement with clear & measurable targets 5.Series of structured activities - Schouten et al. BMJ 2008

7. Collaborative Structure Select Topic Expert Meetings Identify Change Concepts Pre work LS 1 25-26 June S P A D LS 2 31 Oct -1 Nov Collaborative Teams Phase Two Supports : emails/ visits/ reports/ sponsors / meetings/ assessments / conference calls P A D S The Breakthrough Series: IHIs Collaborative Model for Achieving Breakthrough Improvement LS – Learning Session LS 0 6 May 2013 LS 3 April 2014 Spread in Localities Divisions Wards Sectors

8. The Steps to Change

9. Campaign Milestones Dragons’ Den session25 March 2013 Interventions selected5 -19 April 2013 Collaborative Teams establishedApril/ May 2013 Learning Session 06 May 2013 (4 hours) Learning Session 125-26 June 2013 Learning Session 231 October – 1 November 2013 Learning Session 3April 2014 Celebration of AchievementsJune 2014 Savings Achieved1 July 2014

10. Phase Two Collaboratives Medical Admission Pair (MAP) Improved Management of Complex Pain Early supported discharge of Stroke Enhanced Primary Mental Healthcare Inpatient care for people with diabetes Reducing disparities for people with gout Acute Geriatric Care Unit Medical Assessment Unit Franklin Co-ordination Service Mental Health EC Adult Observation Unit Dementia Care Locality Prevention of Skin Infections in Community Environmental Cleaning

11. Phase One Collaboratives Implementing changes permanently: Very High Intensity Users (VHIU) SMOOTH – Safer Medicines Outcomes on Transfer to Home Better Breathing- Pulmonary Rehabilitation ERAS – Enhanced Recovery after Surgery Delirium Care Hip Fracture Management Transitions of Care - Goal Discharge Date (GDD) Transition to Phase Two: Healthy Hearts – Community Rehabilitation for people with heart failure Helping High Risk People - At Risk Individuals Localities Pilot

12. Support for Collaboratives Campaign Team Learning Sessions Coaching & Mentoring Monthly reporting Measurement analysis Methodology expertise Master classes IHI Open School

13. Campaign Team Roles Collaborative Project Manager : Responsible for BTS Collaborative methodology Manages overall Collaborative progress Coaches teams at Learning Sessions and action periods Improvement Advisor (IA): Expert in model of improvement & methods. Responsible for driving the outcomes Co-ordinates development of theory for the topic Change package development Designs measurement system & data analysis