Welcome to Q
78
@weahsn @theQCommunity @NHSImprovement @HealthFdn #WelcomeToQWest Welcome to
-
Upload
weahsn -
Category
Healthcare
-
view
68 -
download
1
Transcript of Welcome to Q
@weahsn @theQCommunity
@NHSImprovement @HealthFdn
#WelcomeToQWest
Welcome to
@weahsn @theQCommunity
@NHSImprovement @HealthFdn
#WelcomeToQWest
Penny Pereira Deputy Director of Improvement
The Health Foundation
Programme Director of the Q initiative
Our vision for QPenny Pereira
29 March 2017
Congratulations!29.03.2017 Welcome to Q in the West of England
Your Q community
• A connected community working together to improve health and care quality across the UK
• Supports people in their existing improvement work: making it easier to share ideas, enhance skills and make changes that benefit patients
29.03.2017 Welcome to Q in the West of England
29.03.2017 Welcome to Q in the West of England
Designed by you, for you
• Designed with 231 founding members – diverse cross section of improvers from across the UK
• Members continue to help shape the community
29.03.2017 Welcome to Q in the West of England
Collaborating
Thriving Q
Connecting
Learning
29.03.2017 Welcome to Q in the West of England
Choose how you are involved
29.03.2017 Welcome to Q in the West of England
29.03.2017 Welcome to Q in the West of England
To connect?
5min
30mi
ns +hour
29.03.2017 Welcome to Q in the West of England
To learn?
5min
30mi
ns +hour
QI Connect Webinars
29.03.2017 Welcome to Q in the West of England
To exchange?
5min
30mi
ns
+hour
29.03.2017 Welcome to Q in the West of England
To collaborate?
5min
30mi
nss
+hour
29.03.2017 Welcome to Q in the West of England
What’s next for you?29.03.2017 Welcome to Q in the West of England
Opportunities to help lead
ConvenerApply to help shape how Q develops locally; facilitating local networks and feeding in centrally
ConnectorsVolunteer to help members make connections online and face to face
29.03.2017 Welcome to Q in the West of England
What might the future look like?29.03.2017 Welcome to Q in the West of England
Thank youVisit us online: http://q.health.org.ukEmail us: [email protected] us on Twitter: @theQCommunity #Qcommunity
@weahsn @theQCommunity
@NHSImprovement @HealthFdn
#WelcomeToQWest
Anna BurhouseDirector of Quality
West of England AHSN
Our
• A chance to meet and collaborate with other like-minded improvers
• Share best practices for improving your local healthcare services
• All teach and all learn philosophy• A place to grow and shape to meet our local needs
Your Journey
• A chance to apply for an improvement coaching course that will enable you to, guide, motivate and support colleagues involved in improvement work
• Co-produce 5 specially designed CPD learning events• Access to our online QI toolkit • Apply to join a ‘Commons Stewardship Group’ which will
lead and facilitate initiatives across the West of England
Q National Commons Stewardship groupMade up of 15 national convenors
West of England Commons Stewardship
Group1 convenor with
5 additional members
Gloucestershire STP Chapter
BNSSG STP Chapter
BSW STP Chapter
Expressions of interest to Dave Evans
@weahsn @theQCommunity
@NHSImprovement @HealthFdn
#WelcomeToQWest
Julian SimcoxPatient Leader
Public Contributor West of England AHSNPPG Chair
CCG Patient Rep Why being part of the Q Community to me as a Patient/ Carer
is such a valuable opportunity
Paradigm Shift begats Behaviour Change
PARADIGM
GET
SEE
BELIEVE
BEHAVEBECOME DO
Deming’s “Chain Reaction”
improve Quality
Costs decrease:
less rework, fewer mistakes,fewer delays, snages,
better use of machine-time and materials
"Out of the Crisis" W. Edwards Deming
1982-86
Productivity improves
Capture the market with better Quality and Lower price
Stay in business
Provide jobs and more jobs
Patient’s rights…
but how can we know?
Joint & Equal, and how?Co-production = "professionals supporting change, not delivering it“
“Co-production is an equal relationship between people who use services and the people responsible for services. They work together, from design to delivery, sharing strategic decision-making about policies as well as decisions about the best way to deliver services.” Think Local Act Personal 2016
September 2015
Patient Volunteers have many skills, some of them in short supply for the NHS.
Personally I have for 25 yrs worked in the field of Quality, and how to design systems that deliver it.
3 x Measurement Paradigms
A RIAccountability Improvement Research
Who?
Audience(Customers)
PurchasersPayers
Patients/membersMedical groups
Medical groupQuality Improvement team
Providers and staffAdministrators
Science communityGeneral publicUsers (clinicians)
Why?Purpose Comparison
Basis for choiceReassurance
Spur for change
Understanding of(a) Process
(b) Customers Motivation and focus
BaselineEvaluation of changes
New knowledge without regard for its
applicability
Sunnyside PPG (Patient Participation Group)
The PPG is a Partnership of patients, doctors, healthcare professionals, and surgery staff.
Our mission is to:
1. Help patients to take more responsibility for their health.2. Contribute to the continual improvement of services and quality of care.3. Provide practical support for the practice and help implement change.4. Foster improved communication between the practice and its patients.
Clevedon Sunnyside
Sunnyside GP practice already applies Improvement Science (IS) in a number of ways, for example ..
1. Reducing DNA Rates over time – an initiative that now impacts 1/3 of practices in North Somerset.
2. Working with patients who want to learn to Self-Manage using their own data, as well as the data collected (over time) on their behalf by clinicians
3. FFT over time patient-by-patient/ signal-from-noise4. Establishing a “systems approach” to our STP – specifically via Sign Posting
& Social Prescribing 5. Establishing a “systems approach” to Involuntary Loneliness e.g. Leg Club
But some HCPs don’t get the paradigm that Quality ≡ IS ≡ over time Systemics
Viewing Variation – Over Time
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Financial Year
-200
-150
-100
-50
0
50
100
150
200
250
300
350
400
excess mortality observed minus expected deaths
BaseLine 1.00.017
26/04/2011
06/05/2011
16/05/2011
26/05/2011
29/05/2011
10/06/2011
20/06/2011
02/07/2011
12/07/2011
22/07/2011
01/08/2011
15/08/2011
19/09/2011
17/10/2011
10/11/2011
02/12/2011
24/12/2011
20/01/2012
18/02/2012
15/03/2012
09/04/2012
07/05/2012
08/06/2012
10/07/2012
16/08/2012
13/09/2012
12/10/2012
24/11/2012
30/12/2012
15/03/2013
20/04/2013
26/05/2013
29/06/2013
02/08/2013
06/09/2013
2 o3 times per week
0
25
50
75
100
125
150
175
200
BP SYSTOLIC
BaseLine 1.00.017
PARADIGM
GET
SEE
BELIEVE
BEHAVEBECOME DO
Paradigm Shift begats Behaviour Change
@weahsn @theQCommunity
@NHSImprovement @HealthFdn
#WelcomeToQWest
Mark Juniper Consultant in Respiratory
and Intensive Care Medicine
Quality Lead GWH Swindon
Taking my place in the Q…
What is Q?
“A connected community working together to improve health and care quality across the UK”
My QI journey…
Habits of an improver
Q ResourcesHealth foundation
– Publications– Website
-Patient safety links-QI methodology-Person-centred care
Network of colleagues – directory
3 universities
1 ambulance
trust
5 community
health service providers
2 mental
health trusts
Connecting through Q
Effective networks for improvement:‘The 5C wheel’
Shaping our approach: what can we do?
100 people
1000 ideas?
……where is there variation?
……what can we improve together?
Shaping our approach: what can we do?We have a history of delivery!
NHS South West Quality and Patient Safety Improvement Programme 2009WEAHSN
– NEWS and sepsis– ED safety checklist– mortality reviews
GWH approach:
- Structured sustainable projects:– SU2S– ELC– PQUIP– Point of Care (cardiology)– HIPQIP Scaling Up– ‘Saving Babies Lives’ care bundle
• Delirium (Scotland)• Sepsis (Wales)
Shaping our approach: what can we do?
“A connected community working together to improve health and care quality across the UK”
@weahsn @theQCommunity
@NHSImprovement @HealthFdn
#WelcomeToQWest
Suzie Bailey
Director of Leadership and Quality Improvement at NHS Improvement
…..Mission Possible?
51
Culture and leadership are fundamental to safe, effective and patient-centred care
Cultures are… “the way we do things around
here”
“There needs to be a more consistent approach across the NHS, and a coordinated drive to create the right culture”Freedom to Speak Up Report, February 2015
52
53
Clear evidence base
“Every interaction by every leader at every level shapes the emerging culture of an organisation”(West et al, 2014)
54
– Specification and planning– Infrastructure design– Measurement and oversight– Self-study
55
Lessons from high performers?– Leverage operational excellence– Swarm problems in real time– Discipline of knowledge share – Create opportunities for learning – But…the hard part is the leadership model
Leaders should:– Find ignorance – Convert to knowledge – Teach others to do the same
56
What is the typical approach to change in the NHS?
Deficit based• what is wrong?• solve problems• identify what we
need to improve• fill gaps and
deficiencies
Strength based• what is strong?• work with our
existing assets and resources
• amplify what works• “positive deviants”
57
Importance of co-production and ownership across the system
58
59
An adaptive framework – local, regional and national
Create and sustain the necessary conditions
for continuous
improvement
13 initial
actions
Develop capabili
ty
60
10 Leadership Behaviours
61
62
63
A framework for action
Our commitment to change – 3 pledges
16
• We will model in all our dealings with people and in our own organisations the inclusive, compassionate leadership and attention to people development that establish continuous improvement cultures.
• We will support local decision-makers through collectively reshaping the regulatory and oversight environment. In particular, we owe local organisations and systems time and space to establish continuous improvement cultures
• We will use the framework as a guide when we do anything at a national level concerning leadership, improvement and talent management so we engage across the sector with one voice.
It’s all about the people…
65
66
67
68
15 years……?
How do we avoid the echo chamber?
22
Enthusiasts Visionaries Pragmatists Conservatives Laggards
The typical effect sizes of spread activities are perhaps 10-20% at best (Grimshaw)
Source: Geoffrey Moore, building on the work of Everett Rodgers
71
Let’s go together…
@weahsn @theQCommunity
@NHSImprovement @HealthFdn
#WelcomeToQWest
Next steps…
‘Shaping our approach’• Healthcare Q’mmunity connects and activates
improvement
• Q network helps to save lives
• Q network welcomes 1000th member
• In control of my health through Q
• Q fever hots up healthcare
• Using Q to end the queues
‘Shaping our approach’
‘Shaping our approach’
‘Shaping our approach’
‘Shaping our approach’
‘Shaping our approach’
![n g ~ a ~~~? - Welcome to the United Nations...... r] ~Q.~~Q6o i Q.~Q=-'"O'" "t -- = a - 6 (1 n ~ _.o '" CG -. 0 ~ c CG'Q CG~- S-~t4t4g~ ~ OQ 8' = ~ a 5-0 -0< Q Q.='OQ ~g--'Q"'OQr»](https://static.fdocuments.in/doc/165x107/5aabf1257f8b9a8d678c6e50/n-g-a-welcome-to-the-united-r-qq6o-i-qq-o-t-a-6.jpg)
