Collaboration for Leadership in Applied Health Research and Care Next steps for Day of Care Survey: stakeholder mapping and starting a PDSA cycle Professor Derek Bell Stuart Green 7 th December 2017 The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) is hosted by Chelsea and Westminster Hospital NHS Foundation Trust and academically led by Imperial College London, in partnership with
Objectives Review DOCS data to identify local priorities for improvement Develop a stakeholder map for an improvement initiatives Initiate a Plan-Do-Study-Act cycle?
What area should your team prioritise?
Quality improvement at CLAHRC NWL Use data to recognise problems and prioritise action Identify and engage stakeholders Build success from small trials of change
Our principles Manage stakeholders Use Plan-Do-Study- Act cycles Understand variation
Stakeholder mapping Important to recognise The different people involved in delivering care relating to area of change How different parts of the healthcare system work and identify where improvements are needed That it is necessary to reconcile different perspectives about how to make improvements
Who is a stakeholder? Anyone who has influence over or interest in the success of your improvement
Influence Collaboration for Leadership in Applied Health Research and Care Stakeholder Map Matrix HIGH LOW LOW Interest HIGH The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) is hosted by Chelsea and Westminster Hospital NHS Foundation Trust and academically led by Imperial College London, in partnership with
Activity: Map your stakeholders Stakeholder Matrix How to get started: Write the names or job titles of your project s stakeholders on your matrix Consider: Their levels of interest Their influence over the success of your project.
Influence NIHR CLAHRC Project Stakeholder Map v.2 HIGH Foundation trusts Trust executives University pharmacy schools Medical school -> curriculum for meds op pharma Local area team directors Foundation programme providers London chief pharmacist Frontline staff Health and wellbeing boards Acute medical doctors NICE prescribing guidelines Frontline staff NHE pharmacy lead CCG prescribing / meds mgmt. team Quality surveillance groups London office CCGs pharmacist Payer CCG trust Elderly care MDT GP/ CCG Elderly care Drs Ethnic reps Dept of health England CNWL/ WLMH clinicians prescribers pharmacists NICE Acute trust meds op boards Finance director GP CCG pharmacists Patient/ carer Community matron YELLOW- acute GREEN- broader impact commissioners/policy Pink - community/intermediate LOW LETBs academics Police Public Services Supermarkets Social workers Faith and religious leaders Social services local caretaking Local policy patients Service line directors Drs nurses (local budget pharmacists holders) families OT Minister of Health Educational bodies (deaneries) Direct caregivers e.g. healthcare assistants and frontline nurses AHP prescribers Carers Drug companies researchers Patient groups board Health watch Researchers Community nurses/midwives/ psych workers Unheard people Communitypharmacist Repeat prescription generators Specialist voluntary groups Care home management/ Staff LOW Interest HIGH
Collaboration for Leadership in Applied Health Research and Care Communications plan The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) is hosted by Chelsea and Westminster Hospital NHS Foundation Trust and academically led by Imperial College London, in partnership with
Collaboration for Leadership in Applied Health Research and Care Stakeholder management Who /role What do we want them to do, when? What are their motivations? What will we do, who, when? Next step The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) is hosted by Chelsea and Westminster Hospital NHS Foundation Trust and academically led by Imperial College London, in partnership with
Plan-Do-Study-Act cycles
Why use PDSA cycles? Source: NHSIQ
Why use PDSA cycles? Source: NHSIQ
Benefits of PDSA cycles Able to try ideas out sooner than later Test lots of ideas in a short time frame Try things out under different conditions Increase degree of belief that an idea works before scaling up Fail fast and learn as you go Reduce any risks associated with change because testing on a small scale Lower time commitment makes it an easier sell to stakeholders
Activity: Initiate PDSA cycle PLAN: What exactly will we do? Who will do it: Where: When (duration): What: Prep needed? What data will we need to measure? How will this data be collected (how often?): Who will collect it? What criterion will we use to decide on success? How many patients will we test this on? PREDICTION: We predict that