What works? National and regional initiatives to build health worker improvement competencies Lesley Anne Quality Improvement Programme Director, NHS Education for Scotland Tana Senior Improvement Advisor, US Agency for International Development Applying Science to Strengthen and Improve Systems Project, University Research Co., LLC (URC), Australia #I9, #Quality2014 Friday 11 th April International Forum for Quality and Safety in Healthcare, Paris We have no conflicts of interests to declare

What works? National and regional initiatives to build health worker improvement competencies Challenges How? Challenges How?

What works? Challenges How? 1.Health systems needs 2.Utilizing competencies 3.Health worker education systems 4.Stakeholder engagement

Quality Education for a Healthier Scotland Building Capacity and Capability for Quality Improvement A National Approach Lesley Anne Smith Quality Improvement Programme Director NHS Education for Scotland

Quality Education for a Healthier Scotland Our vision is that by 2020 everyone is able to live longer healthier lives at home, or in a homely setting. NHS Scotland 20:20 Vision

Quality Education for a Healthier Scotland “All staff need to be appropriately trained and have access to learning and development to support the Quality Ambitions and 2020 Vision for Health and Social Care Workforce Vision

Quality Education for a Healthier Scotland NHSScotland Quality Improvement Capacity and Capability Building Plan Improve the confidence, capacity and capability of those leading and practicing quality improvement across NHS Scotland by 2015 Quality Improvement Education Framework (What) Identify Target Audience (Who) Quality Improvement Learning Resources Delivery Model (How) Infrastructure

Quality Education for a Healthier Scotland NHSScotland Quality Improvement Education Framework

Quality Education for a Healthier Scotland NHSScotland Improvement Skills Model

Quality Education for a Healthier Scotland Quality Improvement Educational Resources  E-learning modules  Formal national programmes oSPSP Fellowship oImprovement Advisor (IHI) oImprovement Science in Action (IHI)/ Scottish Improvement Skills oSkills for Improvement - Measurement for Improvement  Collaboratives oScottish Patient Safety Programme (SPSP) oPerson Centred Health & Care oEarly Years  NHS Board courses oInternal and external

Quality Education for a Healthier Scotland

NHSScotland e-Learning Modules Introduction to our Purpose and Values Introduction to Quality and Quality Improvement Introduction to Healthcare Systems Introduction to Quality Improvement Methods Introduction to Measurement for Improvement Lean in Healthcare Knowledge into Practice in Healthcare Building a Quality Culture Leading Quality Improvement Creativity and Innovation in Healthcare Introduction to Data Analysis Measurement for Improvement – Presenting Data Evaluating Quality Improvement Introduction to Statistical Process Control Skills for Improvement: Measurement Module A – Planning Skills for Improvement: Measurement Module B – Analysing Data

Quality Education for a Healthier Scotland Purpose: Develop and strengthen clinical leadership capability to support the SPSP Contribute to the development of a long term quality improvement and patient safety culture Establish a learning support network for transformational leadership Strengthen existing collaborations within NHS Scotland Scottish Patient Safety Fellowship

Quality Education for a Healthier Scotland To provide participants with: An in-depth understanding of core Improvement Science Concepts Ability to apply Improvement Science tools, techniques and methods to improvement projects The skills required to lead or support improvement projects The ability to teach and coach individuals and teams in improvement science NHSScotland/IHI Improvement Advisor Programme

Quality Education for a Healthier Scotland NHSScotland Future Lead Level Programmes

Quality Education for a Healthier Scotland NHSScotland Approach to Practitioner Level Development ???

Quality Education for a Healthier Scotland Lesley Anne NHSScotland QI Hub

What works? Challenges How? 1.Health systems needs 2.Utilizing competencies 3.Health worker education systems 4.Stakeholder engagement

USAID Applying Science to Strengthen and Improve Systems Maximize healthcare quality with the health workforce (change agents) we have The world redrawn according to its share of nurses

USAID Applying Science to Strengthen and Improve Systems Service delivery Health workforce Information Medical products, vaccines and technology Financing Leadership/governance Weak/dysfunctional health system Health worker education Does the education we have set up health workers to succeed in the reality of current health systems? Every system is perfectly designed to achieve exactly the results it achieves

USAID Applying Science to Strengthen and Improve Systems + improvement competencies Change agents Service delivery Health workforce Information Medical products, vaccines and technology Financing Leadership/governance Integrating improvement competencies into pre-service education + life long learning: Lifelong change agents #WHWWeek

USAID Applying Science to Strengthen and Improve Systems Integrating improvement across the continuum of learning: Key issues and examples from low and middle income countries 22 Pre-service education Life-long learning USAID ASSIST/HCI eg: East Africa (partnership with RCQHC), Swaziland (2), Nicaragua (8) WHO Patient Safety Curriculum Guide: Difficult to change educational culture to be patient centered, faculty capacity to teach improvement, sustainability of teaching resources East Africa: In-service training is commonplace but doesn’t reach all, training is not competency-based, resources are donor dependent Push for transformative learning & social accountability = opportunity

USAID Applying Science to Strengthen and Improve Systems Integrating improvement across the continuum of learning: What stakeholders do we need to engage? 23 Education & training Profession + Services Policy + regulators Funders Evaluate impact? Determine value? Inclusion as core competency? Leverage investment?

USAID Applying Science to Strengthen and Improve Systems Scaling efforts to build a workforce of change agents – we’ll need to work with others

USAID Applying Science to Strengthen and Improve Systems 77% 52% 33% 10% 25 L Miller Franco & L Marquez, BMJ Qual Saf, projects, 12 LMIC countries Rapid: 6-13 mo to 80% performance Real + substantial potential health gains in LMIC

What works? Challenges How? 1.Health systems needs 2.Utilizing competencies 3.Health worker education systems 4.Stakeholder engagement Panel: Carly Strang, IHI Open School, USA Marie Kehoe O’Sullivan, Health Information and Quality Authority, Ireland Tricia Woodhead, Safer Care South West our Quality Improvement Collaborative, UK Diana Frymus, US Agency for International Development, Washington DC, USA