Service Redesign

A Team Effort !

CPPC Study Day September 2009 Irene Pullar

The Team ?

or

The Continence Team(In no particular order!)

• Continence Nurses/advisors• Continence Physiotherapists• GP’s• Urologists• Urogynaecologists• District Nurses• Midwives• Colorectal Surgeons• Physiologists• Carers• Any appropriately trained health care professional• Managers/Budget holders• And last but not least ››››››

The patient !

Service Redesign

• Service Design is the activity of planning and organizing people, infrastructure, communication and material components of a service , in order to improve its quality, the interaction between the NHS as service provider and patients and the patient's experience

Service Redesign

• How do we know our service need changed?

• Think and ask anyone in the ‘Team’

and remember to include Yourself!

Why does it need changed?

• New guidelines -Local or National

• Departmental changes

• Patient choices

• You

Why does it need changed?

• Waiting lists

• DNA rates

• National Government ‘Drives’ -18 weeks pathway

What needs changed?

• Clinic times ?• Patient information ?• Waiting times?• DNA rates?• Staffing ?• Training ?• Attitudes ?

Have the same changes been done elsewhere?

• Ask other areas

• Google it

• iCSP

• Clinical Governance Dept

• Modernisation team

• Don’t reinvent the wheel

How do we change it?

• Ask the ‘Team’• Get evidence – Local /National Guidelines• Get help – Colleagues ,Clinical Interest

groups• Modernisation Team • Audit department• Clinical Governance (local or national)

Clinical Governancehttp://www.clinicalgovernance.scot.nhs.uk

PDSA Cycle

• Plan• Do• Study• Act• Small pilot• Review • Any further changes• Then implement • Review ……

PDSA Improvement Model

Cycle 1 Cycle 3Cycle 2

What are we trying to accomplish?

How will we know that a change is an improvement?

What changes can we make that will result in an improvement?

Does it need funding?

• Small changes may not need funding

• Local NHS Intranet – source local or national initiatives. Fit your project to their project

• Modernisation Teams

Funding?

• Drug companies.

• Local University/Medical school-lists of bursaries/awards.

• ACPWH/CSP- Lists of bursaries/awards

• Local charities

How do we know that our change is an

improvement?

• Audit it but Get Help and use your trust’s audit/clinical governance department.

Simple patient/Staff questionnaire QOL scores Validated outcome tools. Touch screen waiting room Questionnaires

Go for it!

• Think positive

• Jot down ideas

• Go for small projects first

• Try to fit your ideas to any ‘directives’

Go for it

• If you don’t ask you don’t get!

• Don’t give up at the first hurdle.

• Persevere , if you don’t succeed try again or somewhere else

• Use the NHS Clinical governance/audit departments

Useful websites

• http://member.goodpractice.net/ContinuousImprovementToolkit/resources/core-improvement-tools/overview-to-core-improvement-tools.gp

• www.scottishcf.org/grantsforwomen

• http://www.show.scot.nhs.uk/CSO/index.htm)

• Your NHS Intranet

• http://www.nice.org.uk/usingguidance/commissioningguides/uiwomen/UrinaryContinenceService.jsp

• http://www.institute.nhs.uk/index.php?option=com_quality_and_service_improvement_tools&Itemid=551.html

Useful websites

• http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Tools/Plan-Do-Study-Act+(PDSA)+Worksheet.htm

• http://www.csp.org.uk/director/members/research.cfm

• http://www.18weeks.nhs.uk

• http://www.clinicalgovernance.scot.nhs.uk/section2/pdsa.asp

• http://www.healthdesign.org/

• http://www.google.com

Any Questions? Or Have I confused you enough!