1. Spotlight Session 4 #nhss4

2. NHS Tayside: Dundee Community Rehabilitation and Enablement Service

3. Enablement Service
Community Rehab Team
Social Work Occupational Therapy

4. Baseline (May 2015) 3 separate teams No common vision/goals
2 separate IT systems
No common vision/goals
Limited therapy input in Enablement
Duplication in (OT) provision

5. The story of Ms O. 90+ year old Lives alone
Housebound for the last couple of years
Cognitive decline
Falls risk
No service input

6. Transformational change (1 year on)
Integrated OT service
Dedicated therapist input in Enablement
Single shared IT system
Joint decision-making across the 3 teams

7. Lessons learnt – 1 Staff and user consultations – bottom-up process
100+ staff and users consulted
Co-production approach in 1 Dundee ward

8. Lessons learnt - 2 Collection, collation and analysis of data
Dispelling myths and agreeing on facts
Analysis of client pathways (to identify improvement areas)

9. Lessons learnt - 3 Governance and integration ‘infrastructure’
Senior management champions (NHS & Council)
Establishment of a joint decision-making forum
Agreeing Standard Operating Procedures
Agreeing an exit strategy
Importance of investing in infrastructure: organic, bottom-up process works to an extent. Also need the infrastructure to carry on.

10. The team
Operational team: Stuart Fordyce, Karen Lesslie and Tracy Oram (Dundee City Council); Jean Driscoll, Janice McNee and David Johnston (NHS Tayside); Christina Cooper (Dundee Voluntary Action)
Strategic Board: Matthew Kendall and Wendy Reid (NHS Tayside); Alexis Chappell and Denise Morton (Dundee City Council)

11. Any questions? Contact details: Joke Delvaux (project manager)
Telephone:

12. Healthcare Improvement Scotland: Testing a Framework for the Measurement and Monitoring of Safety

13. Measuring and monitoring safety
Many of you will be new to this report – and part of today is to understand what the authors and the HF have created and how it might help us here in Scotland – a broader approach to understanding safety in our health ( and care) systems
#THFSMP #nhsscot16 #NHSS4

14. Number of downloads of the report
34,000
Number of downloads of the report
#THFSMP #nhsscot16 #NHSS4

15. #THFSMP #nhsscot16 #NHSS4
proactive approach that the framework encourages us to take. Not just looking at past harm and being reactive – but looking to the future. Moving from assurance to inquiry and using the questions in the framework to help us with that. Moving from lagging to leading indicators. 
Proactive (versus traditional reactive)
Assurance to inquiry
New perspective
Framework allows us to shift our mind-set and challenge our traditional perspectives on safety
Understanding current measurement in addition to new strategies to measure safety
#THFSMP #nhsscot16 #NHSS4

16. #THFSMP #nhsscot16 #NHSS4
It encourages us to ask a series of questions ...
#THFSMP #nhsscot16 #NHSS4

17. UK-wide testing #THFSMP #nhsscot16 #NHSS4 Test sites
The range of health settings testing the framework include:
Mental health services – outpatient and inpatient high security
Critical organ wards such as Cardiology and Renal/Gastro
Pathways such as Sepsis and Frailty
Ambulance Trust
#THFSMP #nhsscot16 #NHSS4
Image

18. NHS Borders Daily Monthly Weekly #THFSMP #nhsscot16 #NHSS4
At an organisational level looking at the framework as daily, weekly, monthly
Using a script at the daily hospital huddles based on the framework
Recording this with video – to see changes in conversation over time
Developing a dashboard for use a weekly senior team meetings – each measure has an SPC chart / run chart behind it
Ward safety briefs
Ward safety information
Hospital safety brief
Weekly operational forums
Monthly board and decision making groups
#THFSMP #nhsscot16 #NHSS4

19. NHS Tayside #THFSMP #nhsscot16 #NHSS4
MDT communication
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Safety Planning
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Safer Medicines
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Started with MDT comms, then drilled down to
Safety planning and safer medicines (based on SPSP MH priorities)
Safer medicines then drilled down to medicines administration and meds rec
As a result – have redesigned their medicines administration process and consequently:
Saved time (did take 2 hours now can take 20 minutes)
More time to spend with patients
Freed up a room for other uses
Patients have time to discuss concerns
Cleaners are able to clean that corridor!
Medication errors
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
Past Harm
Reliability
Sensitivity to Operations
Anticipation and Preparedness
Integration and learning
#THFSMP #nhsscot16 #NHSS4
Source: Vincent C, Burnett S, Carthey J. The measurement and monitoring of safety. The Health Foundation, 2013

20. Want to find out more? e: JoThomson@nhs.net @JoThomsonQIe:
@juliajcs40 t: e: t:
#THFSMP #nhsscot16 #NHSS4

21. Health and Social Care Alliance Scotland: Transforming Self-Management in Scotland

22. “Our vision is for a Scotland where people who are disabled or living with long term conditions and unpaid carers have a strong voice and enjoy their right to live well.”

23. 2020 Route Map to the 2020 Vision for Health and Social Care
The ALLIANCE projects
2020 Route Map to the 2020 Vision for Health and Social Care

24. Transforming Self Management in Scotland
Self Management Strategy
Funding
Activities
Awareness Raising
Sharing Learning
Influencing change

25. Gaun Yersel!

26. Self Management Fund

27. Self Management Projects

28. Self Management Campaign

29. Self Management Network

30. Thank you
@kevingeddes7
#SelfManagement