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Welcome to the zoo

Innovation & Improvement in the NHS & learning from you

Orlando HamptonInnovation Development ManagerHealth Education East Midlands orlando_hampton orlando.hampton@nhs.net

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Aims• Brush up on service improvement in the NHS• Share our experiences in small groups• Feedback to the room• Learn at least one new thing• Squeeze that all into 35 minutes

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Definitions:• Innovation: The process by which an idea or invention is

implemented in practice, resulting in a change or improvement.

• Quality: Refers to the inherent or distinctive characteristics of properties of an object, process or other thing which may set apart a person or thing from other persons or things, or may denote some degree of achievement or excellence. In terms of quality improvement in healthcare, quality is about learning what you are doing and doing it better.

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Definitions cont.• Lean: A management philosophy centred on

preserving value with less work, by reducing waste to improve overall customer satisfaction.

• Plan-Do-Study-Act (PDSA) Cycle: Another name for a cycle designed to test a change. The PDSA cycle includes four phases: Plan, Do, Study and Act. PDSA Cycles are small scale, reflective tests used to try out ideas for improvement.

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Basics of Lean

The term Lean is used to describe a set of principles and tools used to support organisations to pursue continuous improvement of their systems and processes. Lean focuses on adding value and eliminating waste and, importantly, always striving to improve.

This focus can be on a process or a system.

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• Originates from research in the late 1980s in Toyota • High quality products at a lower cost by focussing

on some key principles.• How the workplace was organised and managed. • Based on management thinkers of 20th century ie

Edward Deming “Plan-do-study-act”.

The origins of Lean

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• improve services for the customer• supporting a positive work environment for staff • running an effective, high performing organisation

• adopted and adapted by healthcare organisations to support continuous improvement

The origins of Lean cont.

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What do we mean by “add value”Value:Noun – The regard that something is held to deserve, the importance or preciousness of something: “your support is of great value”.

Verb – Estimate the monetry worth of (something): “her house is worth £100,000”.

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The Productive Ward: Releasing time to careThe Productive Series

Innovation in the NHS

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NHS Change model

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Balancing Lean in the NHS: 2013

NHS Scotland QI Hub, 2013, 2011

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2011

1. Reduce variation2. Better metrics and information3. Systematic delivery mechanisms4. Incentives and investments5. Procurement for quality & value6. Develop our people7. Leadership in innovation8. Mandate the adoption

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How will this happen?

IHW, 2011

Derby Hospitals

Prototype, testing and

manufacture with

commercial provider

DH FlyerBBC article

Expo (London)The

Improvement Network

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Barriers to innovation in the NHS

IHW, 2011

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What makes “diffusion” happen?

IHW, 2011

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Models as a timeline

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Models as a timeline

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Models as a timeline

LEAN: Add value and eliminate waste

IMPACT: Any outcome to service or participants

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Table exercise 11. Nominate a scribe

2. Nominate a time keeper

3. In one minute describe one service improvement cycle you have done/been part of / witnessed

4. Scribe notes it in one sentence

5. Choose one, answer questions on next slide

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Table exercise 2: Choosing one example, answer:

1. Did it add value?

2. Did it eliminate waste?

3. Identify barriers encountered and if/ how they were overcome.

4. How was it shared?

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Table exercise 3

• Group share back with the room

• All examples will be written up and shared with permission

• Would you like to put your email to your one liner?

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Feedback

• Name• Animal Type• Improvement project in a sentence • Add value?• Eliminate waste?• Barriers?• Shared?

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Zoo Review

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Resources and references•NHS Scotland Quality Improvement Hub: www.qihub.scot.nhs.uk

•The Lean Enterprise Academy: www.leanuk.org/health

•The (former) Institute: http://www.institute.nhs.uk/innovation/innovation/introduction.html

•“It’s a zoo around here” Nigel Risner, 2005

•The Improvement Network (for now): http://www.tin.nhs.uk/innovation-nhs-east-midlands

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‘Heavier than air flying machines are impossible’

Lord Kelvin, president, Royal Society, 1895

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The Zoo – Workshop Resources

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LionSingle-minded

VisionaryStraight forward

PurposefulPersevering

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ElephantCautious

MeticulousDeliberateScepticalFormal

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MonkeyPlayful

EnergeticExtrovert

LivelyPersuasive

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Dolphin Caring

NurturingSupportive

PatientRelaxed