1. www.hee.nhs.uk Welcome to the zoo

2. Innovation & Improvement in the NHS & learning from you Orlando Hampton Innovation Development Manager Health Education East Midlands orlando_hampton orlando.hampton@nhs.net

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4. Aims Brush up on service improvement in the NHS Share our experiences in small groups Feedback to the room Learn at least one new thing Squeeze that all into 35 minutes

5. www.hee.nhs.uk Definitions: Innovation: The process by which an idea or invention is implemented in practice, resulting in a change or improvement. Quality: Refers to the inherent or distinctive characteristics of properties of an object, process or other thing which may set apart a person or thing from other persons or things, or may denote some degree of achievement or excellence. In terms of quality improvement in healthcare, quality is about learning what you are doing and doing it better.

6. www.hee.nhs.uk Definitions cont. Lean: A management philosophy centred on preserving value with less work, by reducing waste to improve overall customer satisfaction. Plan-Do-Study-Act (PDSA) Cycle: Another name for a cycle designed to test a change. The PDSA cycle includes four phases: Plan, Do, Study and Act. PDSA Cycles are small scale, reflective tests used to try out ideas for improvement.

7. www.hee.nhs.uk Basics of Lean The term Lean is used to describe a set of principles and tools used to support organisations to pursue continuous improvement of their systems and processes. Lean focuses on adding value and eliminating waste and, importantly, always striving to improve. This focus can be on a process or a system.

8. www.hee.nhs.uk Originates from research in the late 1980s in Toyota High quality products at a lower cost by focussing on some key principles. How the workplace was organised and managed. Based on management thinkers of 20th century ie Edward Deming “Plan-do-study-act”. The origins of Lean

9. www.hee.nhs.uk improve services for the customer supporting a positive work environment for staff running an effective, high performing organisation adopted and adapted by healthcare organisations to support continuous improvement The origins of Lean cont.

10. www.hee.nhs.uk What do we mean by “add value” Value: Noun – The regard that something is held to deserve, the importance or preciousness of something: “your support is of great value”. Verb – Estimate the monetry worth of (something): “her house is worth £100,000”.

11. www.hee.nhs.uk The Productive Ward: Releasing time to care The Productive Series Innovation in the NHS

12. www.hee.nhs.uk NHS Change model

13. www.hee.nhs.uk Balancing Lean in the NHS: 2013 NHS Scotland QI Hub, 2013, 2011

14. www.hee.nhs.uk 2011 1.Reduce variation 2.Better metrics and information 3.Systematic delivery mechanisms 4.Incentives and investments 5.Procurement for quality & value 6.Develop our people 7.Leadership in innovation 8.Mandate the adoption

15. www.hee.nhs.uk How will this happen? IHW, 2011 Derby Hospitals Prototype, testing and manufacture with commercial provider DH Flyer BBC article Expo (London) The Improvement Network

16. www.hee.nhs.uk Barriers to innovation in the NHS IHW, 2011

17. www.hee.nhs.uk What makes “diffusion” happen? IHW, 2011

18. www.hee.nhs.uk Models as a timeline

19. www.hee.nhs.uk Models as a timeline InnovateAdoptDiffuse Top downHorizontalBottom upBrainstormingSix hatsFresh eyes

20. www.hee.nhs.uk Models as a timeline LEAN: Add value and eliminate waste InnovateAdoptDiffuse Top downHorizontalBottom upBrainstormingSix hatsFresh eyes IMPACT: Any outcome to service or participants

21. www.hee.nhs.uk Table exercise 1 1.Nominate a scribe 2.Nominate a time keeper 3. In one minute describe one service improvement cycle you have done/been part of / witnessed 4. Scribe notes it in one sentence 5. Choose one, answer questions on next slide

22. www.hee.nhs.uk Table exercise 2: Choosing one example, answer: 1.Did it add value? 2.Did it eliminate waste? 3. Identify barriers encountered and if/ how they were overcome. 4. How was it shared?

23. www.hee.nhs.uk Table exercise 3 Group share back with the room All examples will be written up and shared with permission Would you like to put your email to your one liner?

24. www.hee.nhs.uk Feedback Name Animal Type Improvement project in a sentence Add value? Eliminate waste? Barriers? Shared?

25. www.hee.nhs.uk Zoo Review

26. www.hee.nhs.uk Resources and references NHS Scotland Quality Improvement Hub: www.qihub.scot.nhs.ukwww.qihub.scot.nhs.uk The Lean Enterprise Academy: www.leanuk.org/healthwww.leanuk.org/health The (former) Institute: http://www.institute.nhs.uk/innovation/innovation/introduction.html http://www.institute.nhs.uk/innovation/innovation/introduction.html “It’s a zoo around here” Nigel Risner, 2005 The Improvement Network (for now): http://www.tin.nhs.uk/innovation-nhs-east-midlands http://www.tin.nhs.uk/innovation-nhs-east-midlands

27. www.hee.nhs.uk ‘Heavier than air flying machines are impossible’ Lord Kelvin, president, Royal Society, 1895

28. www.hee.nhs.uk The Zoo – Workshop Resources

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33. Lion Single-minded Visionary Straight forward Purposeful Persevering

34. www.hee.nhs.uk Elephant Cautious Meticulous Deliberate Sceptical Formal

35. www.hee.nhs.uk Monkey Playful Energetic Extrovert Lively Persuasive

36. www.hee.nhs.uk Dolphin Caring Nurturing Supportive Patient Relaxed