Storyboard submission

Transcription

1 Storyboard submission Follow the detailed instructions in this template for writing a description of your storyboard. Type your information in each section below and save this completed storyboard document as a Microsoft Word file. Please spell check your storyboard before submission as it will be published on the NHS Wales Awards website. Please note: The storyboard should be between words maximum (including references but excluding headings, images or graphs) Submit your storyboard using the online submission system at by Friday 25 January Storyboard submission 1. Storyboard Title Tackling distance and professional isolation in Powys through Tele-Learning 2. Brief Outline of Context (Where this improvement work was done; what sort of unit/department; what staff/client groups were involved) A pilot project to establish the effectiveness of video conferencing, or Tele-Presence, for learning and development activities amongst General Practitioners, their teams, and other practitioners, in rural Powys.

2 3. Brief Outline of Problem (Statement of problem; how they set out to tackle it; how it affected patient/client care) Working in Powys can present unique challenges, because of the region s geography, and the nature of healthcare services in the region. Powys is the largest county in Wales at 2000 square miles, but has the lowest population in Wales (132,000). Powys is situated along the Wales-England border and is predominantly rural. There are no district general or acute hospital services. Instead, services are provided by a network of primary, community and social care services : Service Number Community Hospitals 10 GP Practices in Powys 17 main 13 branch Dental Practices 25 Opticians 22 Pharmacies 23 Nursing & Residential 49 Table 1 : Powys Health & Social Care Services Travelling time between communities within, and outside, Powys can be considerable : up to 2.5hours within Powys and between three to five hours outside Powys. Public transport is limited, with no major train links. There are no major dual carriageways or motorways. Weather conditions, particularly during winter, can seriously impact on travelling times. The international evidence demonstrates that rural practitioners, particularly in smaller units, face potential problems with professional isolation and fewer opportunities for professional development. Many learning activities tend to take place in larger centres. This requires rural practitioners to spend more time travelling, along with the increased costs associated with transport and overnight accommodation. Finding cover for a clinician during their absence can be difficult and expensive, and can result in the clinician concerned losing training opportunities if no one can be found to provide cover. Whilst it is sometimes possible to host events locally, recruiting guest speakers from outside the region can be difficult, again due to the location, travelling times and associated costs.

3 Table 2 : Travel Times around Powys 4. Assessment of Problem and Analysis of its Causes (Quantified problem; staff involvement; assessment of the cause of problem; solutions/changes needed to make improvements) All practitioners in Powys have access to local learning activities, but their access to external learning is reduced, through a mixture of limited training budgets and the difficulty of releasing staff. Increasingly, Powys is looking towards technological advances to overcome these issues, to ensure that all practitioners in Powys have access to training that would not otherwise be available to them. In 2012, 112,000 miles of study-related travel was undertaken by by Powys practitioners, both inside and outside Powys. This resulted in travel expenses in excess of 55,000, and a corresponding loss of time away from the workplace. 5. Strategy for Change (How the proposed change was implemented; clear client or staff group described; explain how they disseminated the results of the analysis and plans for change to the groups involved with/affected by the planned change; include a timetable for change) Powys has a long tradition of locally held continuing professional development activities, particularly in the Primary Care setting. Quarterly Protected Learning Time sessions for Primary Care are held in North and South Powys. These are half day sessions, with the topics selected in advance by practitioners, and arranged on

4 their behalf by Powy THB and the Institute of Rural Health. Evaluation of previous sessions have highlighted key concerns with the amount of time staff lose when attending such events, the amount of travel involved and the associated travel costs for individuals and organisations. The staff appraisal process also identifies a variety of learning activities, which would be beneficial. Due to the distance and associated costs (travel, accommodation, and course fees) it is not always possible for practitioners to benefit from attendance at such activities. Funding is sometimes only available to particular staff groups, e.g GPs, even though the learning would benefit other staff also. To overcome these issues, and to increase the range and availability of learning opportunities available, a pilot project was established in 2012 to harness the benefits of the video conferencing facilities in Powys. All community hospitals and GP surgeries have such facilities. They are mostly used for meetings and telehealth care. Limited use has been made of these facilities to support learning and development activities. A programme of video conference learning events was established to provide access to learning for Primary Care practitioners. The sessions were also opened up to a wider audience, of any practitioner in Powys, though the focus of the sessions are specifically targeted to meet the needs of GPs and their teams. An initial tele-learning session was held at lunchtime on 4 th July 2012, on Respiratory Health, delivered by a Nuffield Respiratory Consultant from Hereford Hospital. The session was attended by both GPs and THB staff (ward and community staff). Four sites joined the session : Bronllys Hospital, Crickhowell GP Surgery, Brecon Hospital and Ystradgynlais Hospital. Twenty people attended this initial event. Table 3 : Attendance figures for initial Tele-Learning events Topic Attendance Respiratory Care 20 Minor Injuries 29 Respiratory Care part 2 15

5 Linking five sites 6. Measurement of Improvement (Details of how the effects of the planned changes were measured) Participants were asked to evaluate the first session : What worked well Greater access to training (75%) Travelling time either reduced or cut out altogether (63%) What needs to be improved More training and support in use of the video conferencing kit (50%) Guidance on how to run a learning event via video conferencing e.g to ensure all participate in the event (50%) Travel expenses either reduced to within Powys or cut out altogether (63%) Learning to use new technology (63%) Opportunity to interact with colleagues from across Powys, and external to Powys (13%) Table 4 : 1 st Tele-Learning event feedback Evaluation of subsequent sessions reflected the initial findings that video conferencing is an effective means of accessing learning activities for practitioners in Powys. Based on this initial feedback, five further tele-learning sessions were held between September 2012 and December Further sessions are now scheduled for Primary Care in 2013.

6 7. Effects of Changes (Statement of the effects of the change; how far these changes resolve the problem that triggered the work; how this improved patient/client care; the problems encountered with the process of changes or with the changes) For Powys, Tele-Learning provides an increased range of learning opportunities. It is a cost-effective way of delivering such activities, as the amount of time spent travelling (and associated travel expenses) is reduced. The amount of patient-contact time is also increased, as staff are able to return to their duties more quickly. Sessions can be opened up to a wider range of staff, benefitting team-working and multidisciplinary communication across multiple sites. Sessions can be tailored to the specific needs of Powys patients and their care teams. Powys is now in the process of establishing a range of clinical and learning activities delivered via Tele-Learning : Speciality Linking Category Palliative Care Ystradgynlais Hospital, Brecon Palliative Care Team & Ty Olwen Palliative Care Teams (Morriston) including CPD activities and study days in development Palliative Care Motor Neuron Disease Neurological Rehabilitation Neurological Rehabilitation Llanidloes Palliative Care Team and Bronglais Palliative Care Team Llanidloes Hospital, Welshpool Hospital and Severn Hospice (Shrewsbury) Newtown, Llandrindod and Brecon Hospitals with consultant therapist (based in Newtown) Hwyel Dda and Powys THB community and outreach teams with Rockwood Hospital including CPD activities and study days in development including CPD activities ongoing (every fourth Thursday in the month) including CPD activities including CPD activities in development Stroke Rehabilitation Stroke teams in Powys Clinical meetings, including CPD activities monthly meetings investigating feasibility of educational sessions for patients and carers Minor Injuries Llandrindod Wells Hospital MIU and Hereford Hospital MIU. Table 5 : future developments Informal drop-in training sessions to ensure skills maintained, eg. Suturing in development. Patient advice and triage.

7 8. Lessons Learnt (Statement of lessons learnt from the work; what would be done differently next time) Ensure that those delivering the session understand how the facility functions, including the use of additional functions such as datasharing. That the person delivering the session has received some guidance on how to run events via video-conferencing, e.g the etiquette of such sessions; and how to ensure all sites and individuals have the opportunity to ask questions or contribute to the session. Ensure that each site has a local contact to act as trouble-shooter on the day, and that the video-conferencing facilities are set up in advance at least 20 minutes to allow for any problems. Have a backup plan in case the video-conferencing network fails, e.g handouts, audio kit to allow discussion to continue. 9. Message for Others (Statement of the main message they would like to convey to others, based on the experience described) The use of video-conferencing is a cost-effective means of delivering learning and development activities, particularly in a rural or community setting where distance, or time factors, place pressure on the availability of staff to attend such events. It can help to reduce professional isolation, by making available learning and development activities to a wider range of staff, which would previously have only been accessible by one or two individuals.