1. Leading Improvement in Safety and Quality A training and coaching programme to support general practice in improving safety, quality and satisfaction for patients and staff  NEXT 

2. Objectives This programme will develop your ability to lead effective and sustainable service improvement with less effort and resistance. Using a variety of skills and tools, you will be equipped to address any aspect of improving safety and quality – in a way that will inspire and engage the whole team Intended for GPs, lead practice nurses, practice managers CCG & federation quality improvement leads  NEXT 

3. Benefits Improve quality safety without just working harder. Make best use of the new NHS Change Model. Enthuse, engage and empower staff to continually improve. Involve patients as partners in improvement. Build your personal change leadership skills.  NEXT 

4. The programme Practical, challenging and fun. We blend workshop learning with personal reflection, action learning, practical project work and guided reading. The programme can be adapted to meet your own situation and priorities, including basing it around a specific theme or challenge. A typical programme involves 6 one day workshops over 6-9 months, with 8 coaching webinars in between workshops. Inputs can be tailored according to participants’ prior experience, as well as particular learning needs. Contact Dr Robert Varnam, Clinical Lead for Primary Care, to discuss your needs and begin planning your programme (robert.varnam@institute.nhs.uk).  NEXT 

5. The impact 98% of GPs attending our workshops would recommend them to anyone 100% change how they think about improving care 98% of GPs attending our workshops would recommend them to anyone 100% change how they think about improving care “A lightbulb moment in every session” “Inspiring” “Why didn’t someone show me this years ago?” “We’re finally turning good ideas into actual benefits for patients”  NEXT  “Very, very impressive” “Even my difficult colleagues are coming on board” “The best use of time for our GPs and managers since I don’t know when” “The whole team have a sense that we can finally do this”

6. Building a culture of continual learning & improvement Topics covered Diagnose Plan, learn & implement Work smarterShare itDefine Leading people in transition The case for change Linking quality, safety, productivity & happiness Linking quality, safety, productivity & happiness 360 degree practice appraisal 360 degree practice appraisal Quality & safety culture Quality & safety culture Understanding variation Understanding variation Design better solutions Design better solutions Plan & communicate strategy Plan & communicate strategy The Model for Improvement The Model for Improvement Measuring improvement Measuring improvement Understand processes Understand processes Improve reliability Improve reliability Engage patients Spread innovation Spread innovation Sustain improvement Sustain improvement This map is clickable

7. The case for change  Understand and reflect on the evidence about our current situation: patient safety quality of care patient experience staff satisfaction productivity rising demand & complexity Reflection & discussion Knowing How We Are Doing

8. Linking quality, safety, productivity & happiness  Understand the links between quality, safety, productivity and satisfaction for patients and staff  Develop your case for change, based on the evidence for improving value in care Making the case for change The Transition model (Bridges) Gathering data & stories

9. 360 degree practice appraisal  Get the full picture about safety & quality  Focus on solvable problems  Stop misusing information  Include everyone’s perspective  Be more proactive  Find easier opportunities to improve  Include patients in improvement Staff & patient safety reporting Safety Walkrounds Trigger tools

10. Quality & safety culture  Understand the contribution of organisational culture to patient safety and quality  Evaluate your own safety and quality culture  Develop a plan to broaden and bolster team engagement in improvement, addressing specific cultural challenges Understanding culture Manchester Patient Safety Framework Improving culture for quality

11. Why is excellence hard?  Understand human and system performance  Reduce the likelihood of error  Identify the reasons for rule violations  Make it easier to do the right thing Understanding human error Understanding rule violation Systems thinking

12. Understand variation  Learn techniques for measuring and exploring variation in performance, between teams and individuals, and over time  Develop plans for effective recording and analysis of data about variation  Apply the 360 Degree Appraisal model to use information for improvement rather than judgement Detecting & measuring variation Understanding variation Discussing variation with colleagues

13. Design better solutions  Reduce error-producing conditions  Improve teamwork and communication  Improve processes and tasks  Eliminate obstacles to effective working The London Protocol Human factors engineering SBAR communication

14. Plan & communicate strategy  Review your current approaches to strategic planning & implementation  Brainstorm more effectively using creative tools  Use driver diagrams to avoid “silver bullet” thinking  Show staff where their contribution fits  Make programmes easier to track and evaluate Driver diagrams Making a case for change Creating a compelling vision

15. The Model for Improvement  Understand why traditional change strategies are hard work and inefficient  Appreciate the principles of small step change  Practice using the PDSA methodology to test and refine change ideas Reflection & discussion Kaizen principles The Model for Improvement

16. Measuring improvement  Understand the different strategies required for research, judging care and improving care  Learn how to measure in real time using statistical process control  Choose indicators to provide knowledge, not just data  Understand and track variation in real time  Avoid acting on impulse  Select the right strategies for investigating variation  Measure and understand demand, workload and patient flow Run charts & Statistical process control Understanding variation

17. Understand processes  Develop methods and skills for mapping processes as they actually are  Identify the parts of your system that serve patients best, using value stream mapping  Pinpoint the changes necessary to maximise the benefit of your hard work  Create the ideal future processes for your patients Task-oriented process mapping Value stream mapping The power of observation

18. Improve reliability  Understand the impact of poor reliability in your practice’s processes  Use simple methods to develop more standardised approaches to common and high risk processes  Prioritise the areas to improve, using FMEA  Redesign processes to improve reliability  Achieve almost total reliability with barriers, mitigations and redundancies  Select the right indicators to measure improvements and unintended consequences Design for reliability Failure Mode & Effects Analysis Choosing metrics

19. Engage patients  Use new methods to engage patients and carers in highlighting improvement opportunities  Apply the evidence about what patients want to your practice  Use experienced based design principles to get better results  Help patients to improve patient safety  Improve concordance and satisfaction with shared decision making  Plan new evidence based programmes to improve self care and community care Experience Based Design 360 Degree Patient Safety Appraisal The new Engagement Cycle

20. Spread innovation  Appreciate why innovations often spread slowly  Assess your local readiness to share learning and collaborate for improvement  Plan new structures and processes to spread innovation within and between practices  Take a lead on improving care within your locality The NHS Institute Spread Tool Stakeholder analysis Peer support

21. Sustain improvement  Understand the reasons why improvements and innovations are often not sustained  Embed sustainability principles in your plans are sustainable from the outset  Apply specific strategies to improve sustainability Sustainability Model Reflection & discussion

22. Building a culture of continual improvement  Understand & measure your safety & quality culture  Choosing & changing priorities  Being proactive  Engaging the right people  Empowering every member of staff to be a change agent  Building sustainable change programmes Innovation culture evaluation Innovation culture planning tool Understanding drive (Pink)

23. Leading people in transition  Lead people as effectively as you lead change  Developing your leadership style  Diagnosing the causes of apathy and opposition to change  Using tools to support people through transition  Understanding differences in people’s motivation  Using different influencing styles to build motivation and commitment  Planning changes in people The Transition Model (Bridges) Strength Deployment Inventory Reflection & discussion