1. BREAKOUT 2: TAKING ACTION TO CLOSE THE GAP (11:10 - 12:25)

2. WORKSHOP OBJECTIVES Presenter builds on break out 1, but then takes the gap and describes their action plan to refine their work, expand their projects, and close the gap Using the Closing the Gap Action Planning form, participants are invited to create a plan for closing the gap that they identified in Day One Have fun!

3. SOME IMPORTANT NOTES Our discussions today are about learning, not about performance, so… sharing your challenges and failures can be just as important as sharing your wins and successes.

4. MEETING NORMS REFRESH Suspend judgment as best you can. Respect one another. Seek to understand rather than persuade. Invite and honour diverse opinions. Speak what has personal heart and meaning. Go for honesty without going on and on and on.

5. Site Sharing: Reflecting on Our Work to Date To maximise global development and wellbeing outcomes for children at 27-30 months of age by earlier detection and prevention of areas of concern

6. PROJECT GAPS 95% of children aged 12 -15 months designated by the Health Visitor caseload in the Coatbridge Locality will have a review completed by 31 March 2015 and provided with interventions and anticipatory guidance around areas of concern to meet their needs

7. REVISED DRIVER DIAGRAM

8. Impact of the intervention Process in place for monitoring & improving if necessary: uptake; accuracy & completeness of information; information sharing permission Identify Capacity within Team Review skills of Team and Support for assessment at this age Design an Excel capture tool for data collection First cycle of assessments (20) Review data and learning from first cycle of assessments Revise data capture to gather details of interventions by staff and anticipatory guidance provided

9. Data Very early and provisional data, caution should be used when interpreting data There have been no refusals 69 have been invited and 56 attended, 80%~ uptake All DNAs and cancellations contacted and offered new appointments 56 Reviews carried out from 26 th of July to 22 nd of September 23 Checklists used, 16 (70%) complete and 7 (30%) incomplete 21 Parental Review Questionnaires received, 100% positive feedback, answered Yes to all questions

10. Our Gaps - What did we test, what did we learn, what did we change? What did we test? Saturday clinic with 45 minute appointments (6 appointments). What did we learn? Feedback from parents via telephone conversations was that Saturday was a good time for them to attend. Particularly to allow dads to be involved. Reflections of HV’s was that more dads attended the assessments, which was a good opportunity to assess family interaction. Reflection of HV’s was that the assessment took less than 45 minutes given the age of the child. HV’s felt it was important to capture the parents feedback for quality purposes, planning future improvement and patient centred care. What did we change? Appointment length was changed to 30mins which allowed for 8 appointments to be allocated (implemented 9 th August). A simple and anonymous evaluation tool was created to record parents feedback. (implemented 16 th August).

11. Our Gaps - What did we test, what did we learn, what did we change? What did we test? We tested attendance on a Saturday of additional families that had been identified as HPI of ‘additional’. What did we learn? Additional families were more likely not to attend on a Saturday. Additional families who did attend on a Saturday did so because their own HV was carrying out the assessment. What did we change? Identified ‘additional ‘ families were assessed at home by their own HV, during the week at a suitable time for the family. (implemented 30th August).

12. Our Gaps - What did we test, what did we learn, what did we change? What did we test? We tested who should make the initial contact with the family, and gathered what information the parents wanted to know about the assessment. 3 grades of staff were tested, 6, 5 and 2. What did we learn? Parents wanted to know WHY ? and WHAT would be happening, would the assessment be invasive etc. Parents were happy to receive information from any grade of staff, as long as the information was correct. What did we change? Training and support given to Band 2 staff, encouraged ownership of the appointment process, part of the team. Liaison with HV if any concerns. (implemented over weeks 23 rd Sept until 11 th October).

13. Our Gaps - What did we test, what did we learn, what did we change? What did we test? How far ahead should appointments be made to ensure maximum attendance, 1 week, 2 weeks, 4 weeks. What did we learn? Parents were more likely to attend if the appointment was made no more than 2 weeks ahead. Parents reported that they liked to have a reminder call a couple of days before the appointment. This meant that those cancelling could be offered another appointment quickly. What did we change? Appointments made no more than 2 weeks in advance (implemented 4th October ). All families were contacted a couple of days before the clinic. Increased possible appointments to 9 per clinic, allowing for a late add on or cancellation. (implemented 18th October).

14. Our Gaps - What did we test, what did we learn, what did we change? What did we test? We tested the data being collected against the work being done in the assessment, particularly anticipatory guidance. What did we learn? To measure the effect of the assessment on the outcomes from the 27-30 month assessment in the future it was felt that the current data collection tool was insufficient to reflect this. What did we change? As an assessment in itself wont reflect change, following a meeting with the Senior Nurse and others involved it was decided to design an additional data collection tool that would reflect what was happening in the assessment. apart from the SOGS2 assessment. This tool was reflective of GIRFEC, using the wellbeing indicators. New data collection tool was implemented 6th September.

15. Our Gaps - What did we test, what did we learn, what did we change? What did we test? We tested the new data collection tool. What did we learn? HV’s feedback was that this tool was helpful. HV’s reported that they felt the tool was helpful to reflect their input at around anticipatory guidance at assessment as preventive service. Admin support were easily able to input new data. What did we change? We added more data to the new tool e.g. maternal mood. We added to the resources given to parents e.g. ‘Good Egg’ safety guide, Speech and Language ‘Talking Tips’. Speech and Language advice line telephone number. The above changes were implemented 13th September.

16. Table Reflection and Discussion part one Using the action planning form – sketch out milestones, next actions, and structural things they need to do to move their dots and close their gap – 20 minutes Action planning questions on next slide

17. Table Reflection and Discussion 1.What's the next action or task for each to move them forward. 2.What assets can we draw upon within our partners or the community to move this work forward? 3.Who needs to be involved? 4.What do you need for others? 5.What are predicted barriers and what are your ideas for overcoming them?

18. Discussing as a table, participants are invited to share their action plans What were common theses about your next actions to move things forward? What can you do in the next 2 weeks to move existing projects forward and start new ones? Where do you need help or support? Table Reflection and Discussion part two – 20 minutes

19. What did you discover in your action planning? What surprised you? What ideas are you taking home from your table discussions? REPORT OUT

20. PLEASE INSERT HERE (DURING SESSION): – Top 5 emerging themes based upon facilitator themes from tables. THEMES FROM THE ROOM

21. Parting Thoughts Today was about closing the gap Take your plans to CPP action planning, to close the gap you’ve identified Head into the action period with clarity about what you need to do!

22. Thanks for a great session!