Implementing InS:PIRE in University Hospital Crosshouse Geraldine Ovens: Improvement Advisor Laura Haggarty: Physiotherapist Pauline Murray: Deputy Charge Nurse David Kimmett: Senior Charge Nurse

Team InS:PIRE UHC

Physiotherapy My background Must see it in action! Challenges ICU, rehab programmes Must see it in action! Challenges Only 5 weeks Wide range of abilities and needs Idea – pre InS:PIRE clinic

Physiotherapy - Clinic Preparation for clinic assessment paperwork, suitable venue, equipment, appointments Set up 2 afternoons in the 2 weeks prior to InS:PIRE Psychologist → Nurse → Physiotherapist Outcome Patients were risk assessed, engaged & committed to programme Identified issues to be addressed Questionnaires completed Physio – identified appropriate starting level & those who required further 1:1 and/or specific programmes

Physiotherapy - Class Format of class What makes it different? Warm up, circuits, cool down, breathing control, education session What makes it different? Range of abilities Relatives joining in It worked! Gelled during education

Physiotherapy – 1:1 sessions Benefits Thorough assessment addressing issues important to them Plan in place, supporting them to move forward Challenges MSK assessment skills! (shoulder tests etc) Signposting/referral knowledge & information Generated work (home programmes, referrals etc)

Physiotherapy – 1:1 sessions Benefits Thorough assessment addressing issues important to them Plan in place, supporting them to move forward Challenges MSK assessment skills! (shoulder tests etc) Signposting/referral knowledge & information Generated work (home programmes, referrals etc)

Physiotherapy – moving forward Create a patient 'pack' Work alongside ICU physio Great experience Really rewarding programme Patients came back!

Planning Plan, plan , plan! And more planning Timeline Venue Team Meetings, meetings and more meetings! Emails, emails and more emails! HAVING OCD tendencies helps  (I can identify 3 team members at least)

Communication Emails galore Meetings Forward planning (due to venue constraints) 2017 is looming close

Support Utilise Tara and Jo ( & rest of GRI team ) Don’t be afraid to ask… Visit GRI or us to understand the structure and format of the programme (can’t emphasise this enough) Paperwork

Enjoy! Worth all the hard work despite some stress It’s a fabulous experience / opportunity to be involved in and will be rewarding in more ways than you can imagine

Integrating Improvement Methodology into Stephanie Frearson Geraldine Ovens Improvement Advisors

Patient feedback each week Measurement Plan Patient feedback each week Debrief each week What went well? What would make it even better Week 6 shared learning session Project Charter

What was good about this week? What was not so good about this week? Is there anything we could have done better? Any suggestions for future weeks? Process of completing questionnaires needs to be refined Ensure patient knows who to see next Staff were all really helpful More organised this week Documentation of goal setting not clear! Appointments list in every room 1 patients left without seeing the pharmacist Great to get positive feedback from patients/relatives Coordinator role Better biscuits would be good Card with contact numbers Appeared less busy Peters feedback in bigger font

Key Learning from cohort 1 Patients who require a 1:1 (shadowing) are identified prior to week 1. A different member of staff if possible to shadow each of these patients. Being mindful that there will not be as many staff in cohort 2. Staff to discuss how patients were progressing with their goals at the debrief each week Some communication required to each patients GP on their InS:PIRE journey. Lots of issues raised from patients when they are transferred out of ICU (Possibly devise a driver diagram to highlight these issues for a future improvement project?)

What’s Your Investment? Each Cohort 6 weeks with Learning Week + 3 & 12 month follow-up Add time for recruitment, administration and co-ordination UHC aims for 3 Cohorts annually, next Cohort-September Ensure Senior Management buy-in to create sustainability Be on 1st name terms with your Financial Accountant to ensure good financial governance.

What’s Your Investment?(2) Set up costs (UHC) All team members visited GRI Focus Groups Pre Assessment Clinics x2 All team members participated (Cohort 1 only)

Building a Team (2) Our team Medical, Nursing, Physiotherapy, Pharmacy, Clinical Psychology, Social Work, Secretarial, Volunteer, Clinical Improvement Need to be ‘InS:PIRING’ people Ideally 2 in each position

InSPIRE is an evolving project. No 2 cohorts will be the same Hugely rewarding and worthwhile Thanks to Tara and Jo The Health Foundation The InS:PIRE team at UHC

We will however try to answer any!! Thank you We will however try to answer any!!

Peter. O'Brien@aapct. scot. nhs. uk Pauline. Murray@aapct. scot. nhs Peter.O'Brien@aapct.scot.nhs.uk Pauline.Murray@aapct.scot.nhs.uk Geraldine.Ovens@aapct.scot.nhs.uk Laura.Haggarty@aapct.scot.nhs.uk Lesley.Barker@aapct.scot.nhs.uk David.Kimmett@aapct.scot.nhs.uk