1. Aberdeen City

2. Format for Workstreams sessions Introductions at your table Improvement Bootcamp overview and other improvement journeys Components of a learning system – how does our work stack up? Workstream presentations – 30 mins each including Q&A Table top reflection on own learning and application of improvement methodology

3. The Bootcamp Experience : from this…..

4. The Bootcamp Experience : to this……

5. Components of a Learning System 1.System level measures 2.Explicit theory or rationale for system changes 3.Segmentation of the population 4.Learn by testing changes sequentially 5.Use informative cases: “Act for the individual learn for the population” 6.Learning during scale-up and spread with a production plan to go to scale 7.Periodic review 8.People to manage and oversee the learning system From Tom Nolan PhD, IHI

6. Workstream Breakout Day 2 Aberdeen 3 rd. largest city in Scotland. Population = 220, 420. 70, 198 are aged 0-25.

7. Aberdeen The economy is dominated by the Oil Industry. Despite the healthy state of Aberdeen’s economy, the gap between the affluent and our most vulnerable citizens is evident.

8. Current project Early intervention: Allocation of Health Plan Indicator by 16 weeks of pregnancy

9. Why… A Pathway of Care for Vulnerable Families (0-3)

10. Initial Snap Shot TOTAL NO. OF CASENOTES HPI - YESHPI - NOCOMPARISON Antenatal - 20 2 (10%)18 (90%)Matched prediction Postnatal - 40 5 (12%)35 (88%)Matched prediction OVERALL TOTAL 7 (12%)53 (88%)Matched prediction

11. Key wins in presented areas of work Improved communication Improved understanding of GIRFEC Improved social risk assessment in pregnancy

12. Earlier engagement with women and families Development of Assessment Tools Improved quality andCONFIDENCE Key wins in presented areas of work

13. Key lessons Leadership Ownership from wider team Workstream Leads capacity

14. Collaboration has to become the ‘norm’. We need to grow our own Improvement Coaches Be brave! Key lessons

15. Developing Measurement - Key Wins The initial snap shot Real Time Data

16. Real time picture Highlights what’s working well Demonstrates whether the change was an improvement Developing Measurement - Lessons Learnt

17. Make data collection easy Involve the frontline staff in design Have a plan and don’t be afraid Keep it simple! Developing Measurement - Lessons Learnt

18. Results do the talking Builds confidence Engages others Encourages ownership and accountability Small scale delivers results Testing – Key Wins

19. Test, Test, Test! Study & Act QUICKLY Be focused & persistent! Invest time to reap rewards Testing – Key Wins

20. Stay focussed and understand where you want to be Start small – don’t try to solve the worries of the world Don’t be distracted by others frustrations Testing – Lessons Learnt

21. Test under different conditions Spread The ‘so what’ factor The Next 3-6 Months…..

22. TABLE DISCUSSION Who are individuals and/or teams currently working on in this area? Are they currently using Quality Improvement methods/PDSA cycles to guide their learning? Reflecting on the emerging knowledge within this area, what are some potential tests of change you could run that might accelerate your work?