The Scottish Early Years Collaborative. 1941, William A. Foster "Quality is never an accident; it is always the result of high intention, sincere.

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Presentation transcript:

The Scottish Early Years Collaborative

1941, William A. Foster "Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives.”

Quality planning Quality assurance Quality improvement Juran’s trilogy

Quality Improvement “Quality Improvement is a broad range of activities of varying degrees of complexity and methodological and statistical rigor through which … providers develop, implement and assess small-scale interventions and identify those that work well and implement them more broadly in order to improve clinical practice.” Mary Ann Bailey, The Hastings Center

Implementing at scale…. can it be done? Will Ideas Execution

Evidence based discovery  Evidence based delivery 17 years to get 14% of evidence into practice

25.1 harms per 100 admissions

Our change theory A clear and stretch goal A method Predictive, iterative testing

“By what method?” W.Edwards Deming A Breakthrough Series Collaborative underpinned by the Model for Improvement A clear aim Over 40 measures Five change packages Site visits, a listserve, learning sessions

IHI Breakthrough Series Collaborative Select Topic (develop mission) Planning Group Develop Framework & Changes Participants ( teams) Prework LS 1 P S AD P S AD LS 3 LS 2 Supports (listserv) Phone Conferences Visits Assessments Monthly Team Reports AD P S Expert Meetings AP1AP2 AP3 LS – Learning Session AP – Action Period Holding the Gains

IHI Breakthrough Series Collaborative Select Topic (develop mission) Planning Group Develop Framework & Changes Participants ( teams) Prework LS 1 P S AD P S AD LS 3 LS 2 Supports (listserv) Phone Conferences Visits Assessments Monthly Team Reports AD P S Expert Meetings AP1AP2 AP3 LS – Learning Session AP – Action Period Holding the Gains

What did the teams achieve?

HSMR – Jan. – Mar Deaths and discharges = 221,674 Observed deaths = 6401 Expected deaths = 7167 HSMR = 6401/7176 = fewer than expected deaths since January in this quarter alone

Compiled from reported data by Jason Leitch – September 2012 HSMR: Scotland Jan. ’08  Mar. ‘ % reduction

Surgical Mortality 35% 0.51% 0.78%

Prepared 1 st March 2012 General ward C.Difficile rate (per thousand patient days) % reduction

~6500 people

Act your way into culture change

Communities

The Improvement Guide, API Aim Measures Changes Execution

New measurement skills Run charts Transparency All-or none measurement

You can only learn as quickly as you test.

Having the best professionals in the world is no longer enough

@jasonleitch