Faculty for Quality Improvement Cardiff & Vale UHB and Cardiff University. Maureen Fallon

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1 Faculty for Quality Improvement Cardiff & Vale UHB and Cardiff University Maureen Fallon

2 Background: A joint venture between Cardiff University and the Cardiff and Vale UHB Critical mass of clinical and academic staff working together the most research active site in Wales Bedside to Bench and Bench to Bedside (education, training and CPD) Currently virtual and working to a physical site in 2014/15

3 Why set up the Faculty? Share good practice Support Signpost Success

4 Faculty For Quality Improvementwhat is it? Established in 2011 the ambition for the Faculty is: to play a major role in fostering a quality improvement and innovation culture by creating a dynamic environment where excellence comes as standard Key to the Faculty s success is harnessing the tremendous potential and energy of our staff; particularly by engaging, encouraging and empowering them. As a result, the Faculty embraces everyone, whatever their role, on the basis that every member s contribution is essential to care quality.

5 Collaborative and partnership relationships, to advance and promote innovation Increase quality reliability and effectiveness of care Faculty aims: Eliminate harm, variation and waste Best health Best value Best for Patients & Citizens Best care Best place to work Develop a culture of continuous improvement and capacity building Adapted from AQuA Alliance Increase the quality, reliability and effectiveness of care (Best Care) 2. Develop a culture of 'continuous improvement' through developing a programme to support capacity and capability in healthcare improvement methodology and delivery at the coal face and in the educational settings (Best Place to Work) 3. Build and maximise collaborative relationships with partnership organisations that seek to advance and promote innovations in promoting and delivering health care (Best Health) 4. Add value and improve efficiency by focussing efforts that tackle Harm, Waste and Variation (Best Value)

6 Aim & Measures Primary Drivers Secondary Drivers Aim To establish a framework to motivate and build with, enthusiasm and drive for delivering high quality care across the UHB Measures By March 2016 Be recognised as an International centre of excellence Delivery of 1000 Lives+, AQF and intelligent targets Develop and support 100 Improvement Advisers (IQT Silver Practitioners) Develop and support 1000 Improvement Practitioners (OD Programme; LQI; Yellow Belt; RCN leadership programme Implement real-time business intelligence to capture quality outcomes, efficiencies and financial savings Best Health Collaborative and partnership relationships, to advance and promote innovation Best Care Increase quality reliability and effectiveness of care Best Place Culture of quality improvement: Can Do Best Value Eliminate harm, variation and waste Establish strategic alliances and partnerships with Cardiff University Health Care Related Schools and other external influential organisations Work with the Welsh Public Health UKCRC to tackle the underlying determinants of poor physical and mental health Build on the work of Magic & Expert Patient initiatives to incorporate shared decision making as part of the UHB s Strategy Establish clinical and governance dashboards Build on the work of the Pt Experience Team to incorporate signposting of services & capture outcomes of Exec Walkrounds & HCS Promotion of a culture of improvement that has the patient/citizen at its centre e.g. Transforming Theatres, ERAS and the Patient flow collaborative Establish faculty expertise across the key themes of improvement, education & management Delivery of core curriculum to support quality improvement via OD/ IQT training & Breakfast club and web-ex methods Develop positive staff engagement activities: Chairman s Award; competitions & ATP Establish a business intelligence for real time information and measurement systems Working with the SPN collaborative develop a quality cost matrix to pinpoint savings Improved performance against productivity benchmarks: CHKS, WAMI & Intelligent Targets

7 Creating the Conditions Formal programmes of QI education Embed QI into all development work e.g. leadership and management development Shaping the Culture: Will and commitment Quality reinforced at every level by behaviour, action and communication Patient/Family/Carer centredness at all times Build Infrastructure & Capacity Data is our vision - we must learn from it Real time measurement and Information systems Enabling people to lead improvement in their daily work processes Tools, techniques, support

8 Creating the conditions: Culture - 2 jobs Celebration Recognition Dissemination Training/education Bench to Bedside Growth Capacity Capability Expertise Partnerships Networks Academic Clinical Research

9 Our Journey So Far.. Scaling Up Public Health Working with Communities Clinical innovation centre Movement Task force System Infrastructure - IQT and LIPS Creating Breakthrough and Leverage Redesign Improvement as a Systems Property Triple Aim Excellence at a lower cost per capita CSI Co-production / Prudent Healthcare Lean and Rapid Improvement work Real time data and measurement for improvement Education Learning from 1000 Lives+, Qulturum, Tayside and the IHI Links to Harmonisation; C21 and HEI programmes Improvement experts and practitioners training LQI/IQT Board Effectiveness Development Programme Awareness Safer Patient Initiative Change & Innovation Plan Faculty for Quality Improvement and Beyond

10 Faculty outputs improvement and innovation in action

11 Faculty outputs in action (clinical training)

12 Will NCEPOD Report Caring to the End (2009) highlighted that poor communication between teams at handover contributed towards 13.5% of adverse outcomes in Acute Hospitals.

13 Innovation Rob Tan Ollie

14 Delivery ~ what we Did 13 th Aug 15 th Sept e-learning package 17 th Sept 4 th Nov e-handover training Support- HANDS ON).PDSA. Feedback from Junior Doctors 5 th Nov.Software updated

15 Engagement.Enduring SpRs/Jnrs SNPs Post Graduate Dept E Medical Director Directorate Mgt Team IM&T Clinical & MGT Lead

16 e- Handover screen shot

17 Sustainability UHL Mean: 88/week; 70 at w/ends number of requests requests on w/e& BH UHW Mean: 94/week; 68 at w/ends number of requests requests on w/e& BH

18 Spread I am moving to Surgery next month...i can t believe that they don t use e- handover what can we do? F2 - Catherine - Emergency Unit - Paediatrics - Surgery Emma F1 Medical Assessment Unit Why can t we use e-handover..it would be much safer and easier to keep a track on patients Visit by Cwm Taf..

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20 Standard map. Service nodes in blue, demand nodes in yellow.

21 Heat map showing demand density. Service nodes in blue. Demand nodes on gradated red (high) green (low) scale.

22 In closing 1928: Pencillum discovered by Fleming 1939: Chain and Florey took an interest..penicillin 1940 s: Heatley got involved : Nobel Prize for Medicine Without Fleming, no innovation; without Chain and Florey, no testing, without Heatley, no wide scale use of penicillin

23 And finally.if you always do.. but really, we all know it takes more than tools to make real change happen!