SHAREHD Roadmap & Toolkit For use alongside Collaborative Learning Events Or As individual Trust initiative V.6 draft

Shared Care Driver diagram The following generic diagram has been produced as a result of the input form multiple events, workshops and courses. It is a living tool and will continue to evolve Many of the components are generic and can support trust in looking to identify where they are good at aspects of where change can be made. Remember you CANNOT and do NOT have to do everything, chose the areas you want to focus first then when that has been improved start to take on other areas. So onto the Roadmap. Gosh I hear you sigh… why are we bothing with that as well … Recognised that everyone is at different stages But there are common themes and common steps - the roadmap tries to put this together for others to see and use Even if you are well established this can still be relevant as it can help when you need to encourage a new unit in your trust to get started ?

Example Linkage of Shared Care Global Aim to Sustained Change Primary Drivers Secondary Drivers Change Ideas Measures PDSAs Environment /Operation efficacy PDSA 1 Sustain  SHARED CARE All levels of Patient Engagement PDSA 3 Increase numbers Provide facilities for Patients to monitor Blood Pressure in Waiting Room Commissioning & Commercial Facilitate for Patients to be Active in their Care PDSA 2 Identify barriers Weekly monitor On the left is our overall aim – we want to increase Shared Care Primary drivers are the things that have a direct impact on the overall improvement goal They are the FACTORS that Cause the outcome To the right of the primary drivers – are the secondary drivers Secondary Drivers and the factors the influence the Primary drivers – 1 secondary driver can influence multiple Primary drivers PDSA 1 How to measure Improvement Ramp All levels of Staff Engagement

Generic Shared Care Driver Diagram Primary Drivers Outcome Secondary Drivers Data Compliance Commissioning & Commercial ICHD Capacity Maximisation of Efficiencies Effective Workforce Planning & Comms Environment / Operation Efficacy ie “TIME” Correct Cultural Environment Correct Physical Environment Increased Shared Care Equipment Availability Increased Health Literacy Facilitation of Patient Centred Flexibility “what matters to me” All Levels of Patient Engagement Increased Renal pathway and choices awareness Increased confidence & Trust Control of disease / treatment Staff Education / Awareness / Skills Increased Renal pathway and choices awareness Directorate KPIs and uPDATES All Levels of Staff Engagement Policies and Procedures

Generic Shared Care Driver Diagram

Tools & Change Ideas Data Compliance ICHD Capacity / Funding available Secondary Driver Tools & Change Ideas Primary Driver CQUIN Data Compliance Renal registry Tasks data Audit Trails Exxpand HHD ICHD Slot flexibility ICHD Capacity / Funding available Our of Hours Dialysis (Sunderland) Commissioning & Commercial Self Care Units (York) SC embedded into routine through culture change Maximisation of Efficiencies Peer Support Dedicated machines

Tools & Change Ideas Effective Workforce Planning & Comms Secondary Driver Tools & Change Ideas Primary Driver Shared Care Lead allocated and manages comms Effective Workforce Planning & Comms Shared Care Huddle Consistent of approach between staff so patients do not get confused. Environment / Operation Efficacy Patient Status Communication Log Correct Cultural Environment SHC Visibility – Lanyards / Badges / Armbands Awareness posters Training Space Correct Physical Environment Create Area for hand Washing X Equipment Available X

Tools & Change Ideas Increased Health Literacy Secondary Driver Tools & Change Ideas Primary Driver Increased Health Literacy PREMS PROMS Achievement Notification's (eg certificates) Facilitation of Patient Centred Flexibility “what matters to me” Flexibly Dialysis Times Early Starts for Self Care patients Patient Engagement Increase Patients monitoring Blood pressure in waiting room (Nottingham) Facilitate Patients Involvement to be active in their care X Increase Patients documenting post HD weights (Sunderland) Self care Bays, HHD Increased Renal pathway and choices awareness Patient Information days Pre Dialysis Introductions Increased confidence & Trust 121 links patient to staff Control of disease / treatment X

Tools & Change Ideas Staff Education / Awareness / Skills Secondary Driver Tools & Change Ideas Primary Driver Staff & Patient Induction Management SHC Course Staff Education / Awareness / Skills Nurse SHC Course Media & Advertising Display results Regular Directorate review update (Powerpoint slide) Directorate KPIs and uPDATES Define Standard KPIS All Levels of Staff Engagement Included in job descriptions Policies and Procedures Consistent Patient documentation Regular Staff and Patient audits