1. Version 1.5 – 07/11/08 5S Housekeeping April 13 th 2010 Cohort 1 - Day 4 April 13 th 2010 Cohort 1 - Day 4 NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL

2. Version 1.5 – 07/11/08 5S Housekeeping Checks:  Fire Tests  Mobiles/Bleeps  Breaks  The Loo’s NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL © Heart of England NHS Foundation Trust. All rights reserved 2

3. Version 1.5 – 07/11/08 5S Housekeeping NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 3 © Heart of England NHS Foundation Trust. All rights reserved DAY 4 – CHECK AND ADJUST REVIEW IMPACT AND HANDOVER o Project Management Exercise o Communications Strategy o Case Study development o Sustainability o Next Steps o Project Management Exercise o Communications Strategy o Case Study development o Sustainability o Next Steps

4. Version 1.5 – 07/11/08 5S Housekeeping NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 4 © Heart of England NHS Foundation Trust. All rights reserved Reflections & Review of Actions from Day 3 Team development of A3’s

5. Restructur e A last minute presentation Traffic Lets Take a Break – 15 Minutes NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 5 © Heart of England NHS Foundation Trust. All rights reserved

6. NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 6 © Heart of England NHS Foundation Trust. All rights reserved NHS Milton Keynes Project Management

7. Version 1.5 – 07/11/08 Circle of Conce rn Restructur e A last minute presentation 4 hour reaches Traffic NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 7 © Heart of England NHS Foundation Trust. All rights reserved Patient value Problem solving Remove waste Smooth flow Keep getting better

8. Version 1.5 – 07/11/08 Circle of Conce rn Restructur e A last minute presentation Traffic NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 8 © Heart of England NHS Foundation Trust. All rights reserved Plan, Do, Check, Act - PDCA

9. Version 1.5 – 07/11/08 Circle of Conce rn Restructur e A last minute presentation Traffic NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 9 © Heart of England NHS Foundation Trust. All rights reserved Plan Do Check Adjust Plan Do Check Adjust Gra sp the Situ at- ion Plan = deeply understand the problem and its root causes. Define the key measures that will tell you if you are making an improvement. Do = actually carry out the experiment. Check = observe and assess the results. Use the data to understand the effects of the experiment. Adjust = reflect on what has been done, learn from it and begin a new PDCA over again.

10. Version 1.5 – 07/11/08 Improvement Future PresentPast Plan DoCheck Adjust NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL

11. Let’s Have Lunch – 30 minutes NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 11 © Heart of England NHS Foundation Trust. All rights reserved

12. NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 12 © Heart of England NHS Foundation Trust. All rights reserved NHS Milton Keynes Communications

13. Restructur e A last minute presentation Traffic Lets take a break – 15 minutes 15 minutes NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 13 © Heart of England NHS Foundation Trust. All rights reserved

14. Version 1.5 – 07/11/08 Restructur e Paedophiles Traffic Sustainability NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 14 © Heart of England NHS Foundation Trust. All rights reserved

15. Version 1.5 – 07/11/08 Paedophiles Sustainability NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 15 © Heart of England NHS Foundation Trust. All rights reserved How would you define Sustainability?

16. Version 1.5 – 07/11/08 Paedophiles Sustainability NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 16 © Heart of England NHS Foundation Trust. All rights reserved How would you define Sustainability? o Holding the gains o Evolving as required o Definitely not going back to the old way

17. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 17 © Heart of England NHS Foundation Trust. All rights reserved Sustainability is a problem outside of the NHS as well. Price Waterhouse Coopers research: 2.5% of change programs delivered the desired business results 70% not sustaining Fortune 100 companies: 20%-50% success of change initiatives

18. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 18 © Heart of England NHS Foundation Trust. All rights reserved Every cloud has a silver lining!

19. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 19 © Heart of England NHS Foundation Trust. All rights reserved So what can we do to improve our chances? Put as much effort into planning for sustainability as you do for planning the change itself. What might this mean?

20. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 20 © Heart of England NHS Foundation Trust. All rights reserved So what can we do to improve our chances? Consider engagement: What’s In It For Me – WIIFM Need relevant clinicians Powerful winners help sustainability Powerful losers inhibit sustainability Indirect influence can be effective Peer-to-peer

21. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 21 © Heart of England NHS Foundation Trust. All rights reserved So what can we do to improve our chances? Strong Project Leadership: experience in project management influencing & communication skills Clinician CEO or Snr Leader Project Lead

22. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 22 © Heart of England NHS Foundation Trust. All rights reserved So what can we do to improve our chances? Innovators & early adopters vs. early majority and laggards: Innovators and early adopters can appear ‘flaky’ from the point of view of the majority. Laggards may only be so because of a lack of understanding.

23. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 23 © Heart of England NHS Foundation Trust. All rights reserved So what can we do to improve our chances? Do 4N’s with the ‘laggards’ to explore their scepticism and ‘WIIFM’. Go for a bold new approach. Do things differently.

24. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 24 © Heart of England NHS Foundation Trust. All rights reserved So what can we do to improve our chances? Give high priority to Organisational Development. Equip people with the tools and techniques of change. Communicate, communicate, communicate why the change is necessary.

25. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 25 © Heart of England NHS Foundation Trust. All rights reserved Self-assess against a number of key criterion for sustaining change Recognise and understand key barriers for sustainability, relating to their specific local context Identify strengths in sustaining improvement Plan for sustainability of improvement efforts Monitor progress over time.

26. Circle of Conce rn Restructur e A last minute presentation Paedophiles 4 hour breaches Traffic Case Study Development NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 26 © Heart of England NHS Foundation Trust. All rights reserved

27. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 27 © Heart of England NHS Foundation Trust. All rights reserved Case Study Development at HEFT Develop the format - Front cover - Introduction - Initial areas for improvement - Outline of what was done - Results - Where next - What is Lean - Contacts for further information

28. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 28 © Heart of England NHS Foundation Trust. All rights reserved Case Study Development at HEFT Before starting - Interview the people who were involved - Get qualitative results before & after - Collect quantitative data before & after - Before and After pictures!

29. Version 1.5 – 07/11/08 Paedophiles NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 29 © Heart of England NHS Foundation Trust. All rights reserved Case Study Development at HEFT When writing - Remember the audience - Easy to read - Remember the purpose - Congratulate those who made the improvements - Get someone else to proof read

30. Circle of Conce rn Restructur e A last minute presentation Paedophiles 4 hour breaches Traffic 4N’s of today's session NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 30 © Heart of England NHS Foundation Trust. All rights reserved

31. Circle of Conce rn Restructur e A last minute presentation Paedophiles 4 hour breaches Traffic Hopes & Fears of implementing MK Quality Improvement Model NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 31 © Heart of England NHS Foundation Trust. All rights reserved

32. Circle of Conce rn Restructur e A last minute presentation Paedophiles 4 hour breaches Traffic MK Quality Model NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 32 © Heart of England NHS Foundation Trust. All rights reserved Foundation For Change  Managing Change  The Change Curve  Transactional Analysis  Sphere of Influence  Rapport Building

33. Circle of Conce rn A last minute presentation Paedophiles 4 hour breaches Traffic MK Quality Model NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 33 © Heart of England NHS Foundation Trust. All rights reserved Investigation  4N’s  7 Forms of waste using waste walks  Clarifying Value – patient, staff  Supporting evidence  Value stream mapping  Spaghetti diagrams  Hand off charts

34. Circle of Conce rn A last minute presentation Paedophiles 4 hour breaches Traffic MK Quality Model NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 34 © Heart of England NHS Foundation Trust. All rights reserved Prepare and deliver plan  Understanding variation  Batching  Root cause analysis  Project Management  Rapid Improvement Events  A3 Reports

35. Circle of Conce rn A last minute presentation Paedophiles 4 hour breaches Traffic MK Quality Model NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 35 © Heart of England NHS Foundation Trust. All rights reserved Check & Adjust  Communication strategy  Plan Do Check Act  Sustainability  Case Study development

36. Circle of Conce rn Restructur e A last minute presentation Paedophiles 4 hour breaches Traffic Next Steps NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 36 © Heart of England NHS Foundation Trust. All rights reserved

37. Restructur e A last minute presentation Paedophiles Goodbye, Good Luck and Thank You! NHS MILTON KEYNES QUALITY IMPROVEMENT MODEL 37 © Heart of England NHS Foundation Trust. All rights reserved