1. Using JBI COnNECT to Implement Best Practice across NHSGG&C (Rehabilitation & Assessment Directorate)

2. Elaine Burt and Marie McAloon – NHS GG&C (RAD), GCU

3. Background NHS GG&C(RAD) in conjunction with GCU secured monies from NHSQIS in April 2009 to roll out JBI COnNECT across the Directorate, building on the RAD Community of Practice project undertaken in 2008

4. Directorate Profile RAD aims to achieve an integrated and whole system approach to assessment, rehabilitation & enablement in the care of older people and those with long-term conditions RAD aims to achieve an integrated and whole system approach to assessment, rehabilitation & enablement in the care of older people and those with long-term conditions Manages Acute services which include frail elderly, palliative care, falls, physical disability, stroke and AHP services, as well as a range of community services including Care Homes. Manages Acute services which include frail elderly, palliative care, falls, physical disability, stroke and AHP services, as well as a range of community services including Care Homes.

5. Directorate Sites WEST Blawarthill, Drumchapel, Western and Gartnavel General Hospital Blawarthill, Drumchapel, Western and Gartnavel General Hospital NORTH EAST Stobhill, GRI & Lightburn Stobhill, GRI & LightburnSOUTH Mansionhouse Unit, Mearnskirk House & Southern General (Langlands & PDRU) Mansionhouse Unit, Mearnskirk House & Southern General (Langlands & PDRU)CLYDE RAH, Johnstone, Inverclyde and Vale of Leven RAH, Johnstone, Inverclyde and Vale of Leven

6. Ageing Population The number of people aged over 75 years is projected to rise by nearly 81% by 2031. Leading to an increasing number of frail older people needing hospitalisation for multiple episodes of care (SG 2007). The number of people aged over 75 years is projected to rise by nearly 81% by 2031. Leading to an increasing number of frail older people needing hospitalisation for multiple episodes of care (SG 2007). Over 15 million people in the UK currently have a long term condition, and as the number of older people is projected to increase significantly so the number will increase as will the demand for health care. Over 15 million people in the UK currently have a long term condition, and as the number of older people is projected to increase significantly so the number will increase as will the demand for health care.

7. Nursing Practice Development Today the more dynamic areas of nursing practice are to be found within care of the elderly and disability settings. – Nursing older people is core business and the use of JBI will enable evidence based care to be implemented consistently Today the more dynamic areas of nursing practice are to be found within care of the elderly and disability settings. – Nursing older people is core business and the use of JBI will enable evidence based care to be implemented consistently

8. Why the NHS needs JBI NOW ! Early figures on the knowledge and skills of SCN’S indicate (Senior Charge Nurse Review) Out of 3 cohorts (120 SCN’S) across NHS GG&C, only 27% have a first degree Out of 3 cohorts (120 SCN’S) across NHS GG&C, only 27% have a first degree Coupled with a mature workforce within the RAD Directorate could assume there has been limited formal research training Coupled with a mature workforce within the RAD Directorate could assume there has been limited formal research training Huge Directorate – 1000 trained staff - geographically dispersed --- Huge Directorate – 1000 trained staff - geographically dispersed ---

9. Subsequently; RAD wished to explore effective mechanisms to ensure best practice is currently implemented and support SCN’s and trained staff…..rather than wait for 3-5 years for some to complete their first degree/research training. RAD wished to explore effective mechanisms to ensure best practice is currently implemented and support SCN’s and trained staff…..rather than wait for 3-5 years for some to complete their first degree/research training. Build on the earlier project RAD – Community of Practice) which offered ’bite-sized’ chunks on the notion of evidence-based practice Build on the earlier project RAD – Community of Practice) which offered ’bite-sized’ chunks on the notion of evidence-based practice

10. Also, need a resource that is SMART that can complement and enable the implementation of other healthcare policy initiatives – for example, Better Health, Better Care (SG 2007), which is where JBI comes into play

11. One of the first CQI’s to be implemented across all Health Boards in Scotland is the falls statement. Timely, as the statement refers to NHSQIS (BPS) and JBI as resources.

12. Way Forward for NHSGG&C (RAD Directorate) As part of the Implementation Group (JBI) the intention is to use JBI resources to enhance the Practice Development Journey (PD), in this instance building on RAD CoP project. Caledonian Development Model (Tolson et al 2008)

13. To achieve this end and begin the PD journey the project has 2 strands. 1. Look at ‘bigger picture’ Benchmark audit - (n=1000) trained staff across RAD to determine degree status and current knowledge on JBI (NHS has had JBI licence for almost 2years)

14. Based on findings from benchmark audit – develop a 5 point action plan to cascade and utilise JBI resources across RAD. Use the knowledge and skills of CoP members, facilitators, link nurses and the PEF’s to share info through mentors- staff- students, face2face and using CoP Re-audit – similarities to PDSA cycles Based on findings from benchmark audit – develop a 5 point action plan to cascade and utilise JBI resources across RAD. Use the knowledge and skills of CoP members, facilitators, link nurses and the PEF’s to share info through mentors- staff- students, face2face and using CoP Re-audit – similarities to PDSA cycles

15. 2. To address the perceived lack of first degree status Re-package work based learning modules for Nursing the Older Adult (part of BSc. Professional Development programme) using JBI resources as one educational strategy Values/Dignity based framework underpins all module content. Finally, and….. 2. To address the perceived lack of first degree status Re-package work based learning modules for Nursing the Older Adult (part of BSc. Professional Development programme) using JBI resources as one educational strategy Values/Dignity based framework underpins all module content. Finally, and…..

16. most important of all! As a Directorate, be able to move forward with confidence that we are providing ‘best practice’ to patients across RAD.

17. References Scottish Government (2007), Better Health, Better Care Action Plan, Scottish Government Health Directorate. Tolson D et al (2008) Achieving evidence- based practice: impact of the Caledonian Development Model, 16:682-692.

18. For further information and your JBI COnNECT password please contact elaine.burt@ggc.scot.nhs.uk marie.mcaloon@ggc.scot.nhs.uk