The NHS Tayside Experience Linking Knowledge Management with Quality Improvement Carrie Marr Associate Director of Change and Innovation Tayside Centre for Organisational Effectiveness

Findings Factors used by leading QI organisations to come to improved patients results Build Infrastructure & Capacity Quality program organisation Education Leadership development Priorities maintained during crises Stability of general management and program management Choosing tools compatible with strategy and culture Program logistics Measurement systems Information systems Culture: goodwill Measurement Evidence based learning Learning organisation Ref: Staines 2009

The Balance of Quality and Cost

The Healthcare Quality Strategy for Scotland

Person-Centred - Mutually beneficial partnerships between patients, their families, and those delivering healthcare services which respect individual needs and values, and which demonstrate compassion, continuity, clear communication, and shared decision making. Clinically Effective - The most appropriate treatments, interventions, support, and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated. Safe - There will be no avoidable injury or harm to patients from healthcare they receive, and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times.

NHS Scotland Efficiency and Productivity

Assessing the management information requirements to support better patient flow management Assessing the management information requirements to support better patient flow management To consult with stakeholders across the whole system & recommend areas of priority To consult with stakeholders across the whole system & recommend areas of priority Identify areas of existing & potential constraints within the whole system Identify areas of existing & potential constraints within the whole system Assess the performance of the whole health system with respect to local and national targets Assess the performance of the whole health system with respect to local and national targets Whole Systems Analysis – Business Challenge An Integrated Care Challenge Health Social Care ++

TACTICALSTRATEGIC DEALING WITH THE 5% SPENDING THE 95% BETTER PRODUCTIVITY & EFFICIENCY CRES SERVICE OPTIMISATION TRANSFORMATION

TACTICALSTRATEGIC DEALING WITH THE 5%SPENDING THE 95% BETTER Prevention of admission Improved Day care Improved service liaison and discharge Reduced hospital stays and bed days Case management – improved pathways Intermediate care Care home interface Medications reviews Housing/home care support Technologies Maximise health and social care services Cost minimisation Workforce efficiencies Teleheath / telecare Virtual wards Workforce redesign Self care and enablement New models of care in dementia, falls, end of life care Working with communities - coproduction

The Knowledge Portal The Shift to All Learn : All Teach as a Movement Developing local improvement stories Widening our improvement conversations and networks Profound Knowledge & Evidence of Standards Adopt & Adapt Improvement Tools and Technology Harvest and share and enable new ideas Sharing experiences and embedding the improvement culture Measuring the effectiveness of improvement activities Individual Microsystem frontline Mesosystem Middle mgrs MacrosystemPolicy Real time tests of change Improvement Evidence Workplace VLE Communities of Practice Developing a culture of improvement

Our Organisational Effectiveness Plan Building Capacity & Capability in Knowledge Management Improvement Academy eLearning Portal Science and Art of QI Tools and Techniques Knowledge Management Portal Locally Nationally Improvement evidence (eg Dashboards, case studies, clinical pathways) Improvement experiences (Patients, staff, partners) Improvement Network Real time information and measurement systems Sharing evidence of improvement Clinical engagement Data for discussion not judgement Improvement Culture How much by when Rapid cycle testing Evidence based approach Team Vitality Staff engagement Employee Voice Facing the Future Board Effectiveness Programme TCOE as an Innovation Hub Joint Clinical Boards Leadership and Management Development Virtual learning environment Undergraduate support

Our inquiry so far Governance of credible real time knowledge Reliability – the 2 step challenge User friendly for all staff Opportunity to integrate with PDP’s and individual learning priorities Sharing success and achievement is an essential component Linkage of improvement – research – policy – practice Evolving role of Improvement and Development Advisers, Librarians and learning and development staff in support of this approach