1. Welcome to the Building on the Best ECHO Session
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2. Agenda for ECHO Session 9 May 2018:
Agenda item
Duration
Welcome and introductions
10 minutes
Update on the Building on the Best Evaluation – Anita Hayes
Preparation for 27 June Event and Elevator Pitches/Posters – Toby Scott and BOTB Team volunteers
30 minutes
Where next for the ECHO Curriculum? (Potential topics and discussion points) – Anita Hayes, Claire Henry and BOTB Teams
Next Steps & Any other business
20/11/2018

3. Evaluating Building on the best
Where are we now?

4. Aims of the evaluation Understand the Value of the Botb Programme
There is national interest in what you are doing!
Collect & Share Learning

5. The evaluation needs to be able to address:
The evaluation questions
The overall programme at a national level
The individual sites at a local level

6. Evaluation Questions
What interventions delivered within the BotB programme have been effective, and in what circumstances?
What impact has the BotB programme had on:
The adoption of these interventions?
The capability and capacity of staff to carry out improvement activity at the front line?
What outcomes have been achieved in its two years of funding, and how might these outcomes be sustained?

7. What information are we collecting?
Local outcome measures Local case studies Relational value surveys Survey of local team members In depth interviews with local team leads

8. Elements of the Evaluation
Overall picture of what each site has been doing (in the form of a case study) including local process & outcome measures; and patient, carer, staff experience
Local Evaluation
Provides validation through peer review on the work of each site
Peer Review
Common headline measures for each topic area across all sites
Headline process measures
Assess the relational value of everyone involved in the programme
Relational value tool
Botb programme delivery team from the perspective of the sites involved across England and Scotland, generating learning for the programme team
Effectiveness of the Botb intervention
The overall impact of the programme
FINAL REPORT
Sites with support from Botb delivery team
External Evaluator
Mapping the interventions
In order to assess the overall way in which interventions were mapped within acute care systems at local level, the interventions identified by each site have been mapped across two dimensions in the ‘heat map’ below.
By programme theme
Where possible, interventions have been tagged with the most relevant programme theme, from those identified for the programme at outset:
Pain and symptom management
Communication on handover
Outpatients
Shared decision making
[examples for each theme]
In many cases, sites worked on a number of themes simultaneously and in this case the individual intervention has been plotted against all the themes that appear to be applicable. Where an intervention does not appear to fit any of the themes, it appears in the side bar of the heat map.

9. Curriculum Development
Acute Hospitals Community of Practice
ECHO Series 2
By point of impact
Interventions have also been assessed by the point of impact in the local care system, ie the relationship(s) which are subject to change as a result of the intervention.
Each intervention has been assessed as having a potential impact on one or more of the following ‘points of change’:
The relationship between end of life care team and the patient/ carer  
Within the end of life care /Palliative care / team
The relationship between the end of life care/palliative care team and one or more clinicians in other specialties
The relationship between the end of life care/palliative care team and the management of the organisation
[examples for each point]
Where an intervention is working on several points of change, it has been plotted against each one separately. Where an intervention does not appear to fit any of the themes, it appears in the side bar of the heat map.
[chart]
Note that the chart provides an overview of the level of activity associated with the programme that can be seen as relevant to each theme and point of change. It does not take account of the size, ambition or impact of any individual intervention.
Heat map - discussion 
[discussion of heat map outputs – hot spots and deserts, any relationship between theme and point of impact]
 Suggest this comes first?
 agree
 Really like this methos of mapping interventions and heat map makes it visual and therefore more easy to assimilate

10. Current situation Series 1 for Building on the best teams
Using ECHO principles
Shared learning
Taught session
Discussion
Opportunity of continuity

11. Where next

12. Potential Discussion areas:
Those driven by national policy or strategy – what do policy changes mean to practice?;
Case based discussion – to support practice?
Your continued quality improvement projects – how can the community of practice help and support?

13. Other potential priorities that were considered for the Building on the best programme:
Bereavement and care after death – practical and clinical considerations
Emergency care: facilitating the best place of care for patients…there is also a link here with the end of life care hospital improvement programme
Sustainability ward and system capability to sustain improvement
ITU and critical care

15. Next steps Formulate curriculum outline Plan timetable
Check technology
Share connection details