Introducing 1000 Lives Plus 27th October 2011 Introducing 1000 Lives Plus Sue Lister Insert name of presentation on Master Slide

CoventryUniversity Systems Thinking Sue Lister s.lister@coventry.ac.uk Service & Quality Improvement in Healthcare, Coventry University www.1000livesplus.wales.nhs.uk

The Model for Providing Care Access System Assess Diagnose Treat Follow-up Clinical Outcomes Functional Health Status Total Costs Patient with needs Balanced measure of care Satisfaction against need Nelson et al (1996)

It is the system … Every system is perfectly designed to produce the outcome it achieves! paraphrased from Berwick (1996) www.1000livesplus.wales.nhs.uk

Process mapping … Select a process e.g. baking a cake www.1000livesplus.wales.nhs.uk

Process mapping … Select a process Map the process www.1000livesplus.wales.nhs.uk

Map the process www.1000livesplus.wales.nhs.uk

Analyse the current situation Process mapping … Select a process Analyse the current situation Map the process www.1000livesplus.wales.nhs.uk

Analyse current situation Reworked loops bottlenecks Lots of steps delays Reworked loops www.1000livesplus.wales.nhs.uk

Identify opportunities to improve Process mapping … Select a process Map the process Analyse the current situation Identify opportunities to improve www.1000livesplus.wales.nhs.uk

Identify opportunities to improve With as few steps as possible Each step must add value to the process. www.1000livesplus.wales.nhs.uk

The real heroes are those who change the system to remove the flaws! The health service has many heroes. The staff who work harder, predict problems and compensate for short comings. Heroic thoroughness may make patients lives a little safer - but - a real improvement in the quality of care provided to patients is not created by heroes who compensate for the flawed processes. The real heroes are those who change the system to remove the flaws! www.1000livesplus.wales.nhs.uk

A Model for Improvement What are you trying to accomplish? How will you know that a change is an improvement? What changes can you make that will result in the improvements you seek ? Aims Measurement Ideas, hunches, other people etc. Three fundamental questions for improvement Act Plan Study Do How to make change happen Langley et al (1996) – cited in NHS III (2007) www.1000livesplus.wales.nhs.uk

3 fundamental questions What are you trying to accomplish? Aims How will you know that a change is an improvement? Measurement Three fundamental questions for improvement What changes can you make that will result in the improvements you seek ? Ideas, hunches, etc. www.1000livesplus.wales.nhs.uk

The PDSA Cycle Act Plan Study Do www.1000livesplus.wales.nhs.uk How to make change happen … Act Plan Study Do Walton (1989) Objective What do we want to do? Plan to carry out the cycle (who, what, where, when) Plan for data collection What changes are to be made? Next cycle? Analyse the data What did or didn’t work? Summarise what was learnt Just do it! Carry out the plan Document problems and unexpected observations www.1000livesplus.wales.nhs.uk

A Model for Improvement What are you trying to accomplish? How will you know that a change is an improvement? What changes can you make that will result in the improvements you seek ? Aims Measurement Ideas, hunches, other people etc. Three fundamental questions for improvement Act Plan Study Do How to make change happen Langley et al (1996) – cited in NHS III (2007) www.1000livesplus.wales.nhs.uk

Examples of Student Improvement Projects, using systems thinking… Meal times in a care home Stethoscopes and infection control Dehydration of stroke patients Hand washing in theatre Patient dignity in A & E 1000 Lives Plus - Making patient safety a priority

Any questions? www.1000livesplus.wales.nhs.uk