Using Lean for Continuous Improvement

Transcription

1 Using Lean for Continuous Improvement Special points of interest: Improvement News BICS Academy Sharing the Learning Celebrating Success Forthcoming events Inside this issue: Theatre wins safety award 1 Urgent care VSA 2 Clinical correspondence Maternity: induction of labour Outpatient productivity AQUA news 4 Exemplar update 4 Exemplar update 4 Lean leadership article 5 Bronze training dates 5 Handy Hints 5 Shared learning and Market Place We are moving and Bolton runners 6 6 BICS Newsletter Issue:3/11 March 2011 THEATRES WIN PATIENT SAFETY AWARD! With over 550 guests present, the best in patient safety were rewarded at the Patient Safety Awards, held in London. The event was supported by the Nursing Times and the Health Services Journal. They awarded areas in which patient safety was central to daily work. With almost 400 entries the judges were impressed by the quality and commitment to patient safety evident in many health service providers. The award represents all the hard work that has been done not only in theatres but also in Pre-assessment. Many improvement events have been carried out in both areas, the outcomes of which have become part and parcel of daily work for all staff. Examples of events are available on our intranet homepage BICS. Please see our intranet link to all case studies applications/articles/articlelist.asp?typeid=242&catid=936 As the Senior Facilitator Debora Tinsley is extremely happy with the award and hopes to continue to build upon past improvements. It was for this very Continuous Improvement that the trust was recognised amongst its peers! The award and certificate can be viewed in the main entrance glass corridor at Royal Bolton Hospital. The winning presentation is available on the Bolton Improving Care System intranet homepage. The event was attended by Rae Wheatcroft (Associate Divisional General Manager for Anaesthetics and Surgery), Jackie Furlong (Theatre Manager), Stephanie Leonard (Outpatients Sister), Nora Manalastas (Theatre Practitioner) and Debora Tinsley (Senior BICS Facilitator: Theatre Safety & Productivity).

2 Improvement News Page 2 URGENT CARE VSA: 1 WEEK EVENT = MASSIVE CHANGE FOREVER! Big Thank You to all who participated in the event!! The week of March 14, 2011 provided Leaders and staff from all sectors of Health and Social care in Bolton, including the Chair from Bolton Local Involvement Network (LINk) representing the patient s voice to come together and jointly agree a strategic vision for Urgent Care that will benefit all of our patients. Prior to this week, patient feedback was gathered, from patients in hospital, through GPs, Walk-in Centre, Key Messages from Urgent Care Event: - Strategic Model for Urgent Care was agreed - Detailed Action Plan Developed, with input from the specialty strategic reviews - Series of Events and Rapid experiments planned over the next months Principles of the strategic model include simplify access and information of service, equity of service, patient driven, pull from appropriate service / specialty. Strong integrated collaborative working is essential, from all sectors, Primary Care, GPs have a major role in shaping health care delivery and meeting needs of their patients, the new integrated organisation will have opportunities to deliver services in least waste way, with improved patient flow helping to deliver better care together. During the week the team had many highs and lows, addressing the complexity of Urgent Care. The Team realises that it is not all cut and dry, and this is only the beginning and there will be more hard work, and challenging times ahead. But the team is fully committed and signed up to deliver a quality service for patients of Bolton and neighbouring areas. What will happen next? Governance Arrangements will be put into place and lead staff will be assigned to take actions forward. Implementation of the detailed Action plan will commence, this will include a series of Rapid Improvement Events, Rapid Experiments, Projects and Just do it. Work will be taking place all across the health economy, some in parallel and others sequentially. The hard work starts now so. Get involved! We need your help! Help to make it a reality! For more information please contact Cindy (cindy.walton@rbh.nhs.uk). CLINICAL CORRESPONDENCE: ASCRIBE eds Ascribe is the medicines management system currently in use within pharmacy and this system will be enhanced to produce an electronic discharge summary (eds) which will replace the current ICM discharge summary and discharge flimsy (for take home medications) that is currently being used across the Trust as this information will be provided as part of the eds. This will significantly reduce concerns that GP s have raised with the Trust regarding the poor quality and safety issues caused by the current system When will eds be introduced? A business case has been developed and approved and work has commenced to adapt the system to meet our needs. It is anticipated that early implementers (D!,D2,D3, D4 & F3) will go live on the system in May 2011 with a view to full roll out of the system being completed by the end of July The pharmacy team with support from the BICS team are raising awareness regarding the new system with clinical teams. However, it is essential that ward teams including medical staff participate in work planned to take place in April to agree the new process to enable eds to be produced in real time. For further Information please contact Carol (carol.bernstein@rbh.nhs.uk).

3 Improvement News Page 3 MATERNITY: INDUCTION OF LABOUR EVENT Approximately 20% of women have labour induced on a high volume pathway where there are frequent delays. This leads to increased length of stay and impacts on safety and the woman s experience. As a result of Making it Better it is anticipated that the number of inductions will increase from 900 to 1500 so the process needs to flow in preparation. A multi-disciplinary team reviewed the current induction pathway alongside guidelines and data collected on inductions and outcomes Potential Deliveries Mon Tues Wed Thurs Fri Sat Sun Mapping highlighted variations in practice and identified areas for improvement. It was also noted that out of area women were required to attend an antenatal appointment just to be given a date for induction: this results in 200 clinic appointments. There was no information for women about induction of labour and the current guidelines needed revision therefore standard work was written and an information leaflet developed for women which is now being trialled. The induction diary was redesigned to level the demand on capacity and visual management techniques were used to design an induction communication board for Delivery Suite to ensure efficient workforce planning. Watch out for our 90 day update! For more information please contact Debbie (Debbie.tinsley@rbh.nhs.uk). OUTPATIENTS PRODUCTIVITY: PREPPING OF CASE NOTES EVENT The improvement of outpatient services is one of the Trust s key priorities for 2010/11. Management of outpatient services is spread across all divisions, with no single reporting structure there is a lack of consistency in governance, quality, training and support for staff. With reference costs at 127 for all outpatient services and savings of 400K required, improvements were essential to ensure the continuity of a viable outpatient service within the Trust. Although the majority of case-notes are stored in Health Records, some notes were stored and prepped for clinics in devolved reception areas. Thus providing the opportunity to reduce waste by centralising the storage and preparation of notes for clinics using standardised procedures in one designated area whilst improving the reception function in these devolved areas. Several improvement events have been held to assess if centralisation plan was feasible, with robust process timings and rapid experiments to Plan Do Check Adjust proposed changes prior to full implementation. In March 2011, ENT, Oral Surgery and Orthodontics were the first areas to be successfully incorporated into the centralised prepping process. There is a rolling programme of integration to bring all remaining devolved areas into the centralised prepping team by Autumn BENEFITS OF CHANGES IMPLEMENTED SO FAR: Purpose built space for prepping notes, whilst reception have more space and are more patient focused. 6S score raised in ENT from 25% to 50% in preparation for the reception move and Health Records prepping stations from 23% to 96%. Multi-skilling of team, improving cross cover and continuation of service Increased standard and quality of work produced, whilst eliminating duplication, reduction in extras and possible reduction in number of missing case-notes. For further information please contact Debbie Carr (Debbie.carr@rbh.nhs.uk)

4 Improvement News Page 4 AQUA WebEx (Virtual meeting/learning space) combines real-time desktop sharing with phone conferencing so everyone can see and hear the same thing at the same time, and eliminates the need for people to travel and meet onsite. Joining is easy with just a phone line and internet connection required other than the cost of the phone call, there are no additional charges. For the month of April there are two sessions scheduled and the spotlight is on Stroke 90:10 which is an improvement collaborative supported by the Health Foundation as part of its portfolio of improvement programmes. It was designed and delivered by NHS North West. 26 hospitals worked together in multidisciplinary teams to improve the regional Sentinel Audit Score. In less than two years they increased compliance by 30%. 12 April Falls Series, exercise/strength and balance research all sectors, all staff. 14 April Falls Series, empowering and engaging staff in falls improvement, all sectors (although more relevant to Acute), all staff. EXEMPLAR PROGRAMME The Exemplar journey so far CONGRATULATIONS TO THE EXEMPLAR DEPARTMENT ON REACHING THE FINALS AT THE PATIENT SAFETY AWARDS! Congratulations to the following teams who have been awarded Exemplar status in February and March 2011 Wards - Departments - Revalidations C1, CCU, D3 and E3 Oral Maxillo Facial Surgery For further details please contact Dympner (dympner.partington@rbh.nhs.uk).

5 BICS Academy Page 5 Lean leadership Article Bolton s Perspective The Journal of The Health Management Institute of Ireland features and article on how senior leaders, partners, GPs, the local authority and patient representative organisations in Bolton worked together to design a new integrated healthcare organisation focusing much more on transformational activity along the whole end-to-end pathway with a much bigger focus on population health. Featuring interviews with Lesley Doherty, Chief Executive, Joy Furnival, Head of Lean Transformation and Carol Bernstein Improvement Lead, Anaesthetics and Surgery Division. The article is available on our intranet site or via the link below: Bronze Level Training Places still available. Applications are now being taken for the BICS Academy Bronze Level Accreditation for June Bronze Level Accreditation is the second level of the BICS Learning and Development Academy. The course focuses on enhancing your leadership and BICS skills either to lead improvements or to be a more confident team member. It covers using tools such as A3 thinking, mapping and problem solving. It will help you to see waste and prepare for how your staff may react to change. The course provides theory, supported by practical application and examples, reflection, group discussion and sharing experiences. Should you wish to apply, please ensure you fulfil the pre-course criteria of attending Green Level Awareness and participating in at least 1 BICS event Dates available: 20th - 22nd June (limited places still available) More dates to be announced soon. To apply or for further information see our Academy page on our intranet site, contact BICS@rbh.nhs.uk or phone ext Handy Hint: New books available in the Main Library The Northwest Leadership Academy & BICS has supported the funding of 15 new books that may be of interest to you in relation to Lean, approaches to improvement, leading change and continuous improvement. Titles include: W. Bridges, Managing Transitions: making the most of change. E. Goldratt, The Goal. D. Whitney, The power of appreciative inquiry: a practical guide to positive change. J. Bicheno, The LEAN toolbox. J. Womack, Lean Thinking: banish waste and create wealth in your corporation. P. Senge, The fifth discipline: the art and practice of the learning organization. J. Seddon, Systems thinking in the public sector R. Heifetz, Leadership on the line P. Bate, Organizing for quality: the improvement journeys of leading hospitals in Europe and the United States

6 Take a look at our case study page on our intranet site for more information on these events. Sharing the Learning: Page 6 COMING SOON... THE SHARED LEARNING WEBSITE In this Trust 100 s of good ideas are being implemented everyday to overcome problems. Many of these are never shared with other wards and departments. The aim of the SHARED LEARNING website is to provide a place to be able to share this good practice and to offer inspiration when you are looking for ideas to address an issue. The site will allow you to search through hundreds of ideas already being used. It also gives you contact names so that you can find out more details and visit areas to see it for yourself. The site is supported by The Exemplar Programme and the BICS Team. To find out more information the BICS Team at BICS@rbh.nhs.uk MARKET PLACE 14-15TH OF APRIL 2011 Forthcoming Events In April 2011 Prepping of case notes TPOT implementation in Theatres Admission flow Next event week begins on the 11th of April 2011 Next BICS Outbrief 15th April 2011 Lecture Theatre Education Centre 11.30am Everyone welcome! Visitors will include: Lithuanian Health Organisation North Cumbria Acute Hospital Clydesdale Bank Unipart For more information about any of our events or about BICS in general, please refer to our intranet site Bolton Improving Care System Contact details: BICS@rbh.nhs.uk ext: 5482 Website: Bolton Improving Care System Over 20 clinically led specialty reviews have been taking place across the Royal Bolton Hospital NHS Foundation Trust over recent months. Opportunities have been taken to assess individual specialties in terms of safety, sustainability and affordability with the support of managerial and nursing colleagues. Based on the evaluation each specialty has developed strategic options to address the key challenges that have emerged. These options form a starting point for further development and pathway work across the health economy. Each specialty presents their challenges and option to the Executive Board. Currently specialties in wave four are preparing for their feedbacks. The Market Place will be held on the 14th of April in the Education Centre at Royal Bolton Hospital, pm. This event is to share the review process and corporate learning for Trust Board, Governors, internal staff and community colleagues. All specialties have been asked to develop a poster presenting the main conclusions from their review. The market place will be a n informal way of sharing their work with colleagues from all disciplines and also hear Lesley Doherty our Chief Executive present her reflections and next steps. Please contact either Jo Bolger (Joanne.bolger@rbh.nhs.uk) or Hifza (hifza.quraishi@rbh.nhs.uk) to book yourself a place, alternatively ring the BICS office on Ext The posters will remain in the education centre on the 15th of April for all day viewing during BICS event Outbrief day, all members of staff welcome. WE ARE ON THE MOVE... As from the 7 th April the Bolton Improving Care System (BICS) Team will bid farewell to L Block tower and moving into Ground Floor, East Wing of Musgrave House. Contact Details:- All individual contact numbers will remain the same. BICS Academy:- As from the 27 th April all Green training will take place within one of our new BICS training rooms, which are situated on the Ground Floor of Musgrave House, as will our Silver and Bronze training. We look forward to welcoming you into our new home! DON T FORGET TO SUPPORT OUR RUNNERS! Jo Bolger and Debbie Carr are running the Manchester 10K in order to raise funds to buy additional equipment for the new integrated unit, which is due to open in Autumn 2011 and will replace G5 and B1.They will be joining 13 other members of the trust on the 15th of May...Please show your support at: