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Building Capacity & Capability for Innovation & Improvement
Carrie Marr Director Tayside Centre for Organisational Effectiveness
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Building Capacity & Capability for Innovation & Improvement
Carrie Marr Director Tayside Centre for Organisational Effectiveness
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Our Journey So Far….. Scaling Up Movement Redesign Process Thinking
Public Service Working with Communities Mobilising and deploying shared resources Movement Triple Aim System Infrastructure - TCOE Creating Breakthrough and Leverage Redesign Improvement as a Systems Property Steps to Better Healthcare Triple Aim Process Thinking Lean and Rapid Improvement work Real time data and measurement for improvement Education Learning from Qulturum and IHI Patient Safety Officer training Improvement experts and practitioners training Board Effectiveness Development Programme Awareness Safer Patient Initiative Change & Innovation Plan Beyond Source: System thinking and spreading knowledge, Bojestic M., Henriks, G., Provost L. IHI European Forum, Prague 2006
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Creating the Conditions
Formal programmes of QI education Embed QI into all development work e.g. leadership and management development Build Infrastructure & Capacity Shaping the Culture: Will and commitment Quality reinforced at every level by behaviour, action and communication. The patient and the family are the focus of attention at all times “Data is our vision - we must learn from it” Realtime measurement and Information systems Enabling people to lead improvement in their daily work processes Tools, techniques, support Ref: Staines 2009
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Building Local Capacity & Capability
Improvement Academy eLearning Portal Tools and Techniques Leadership and Management Development Virtual learning environment Building Capacity & Capability Shaping the Culture Permission and space Evidence based approach Facing the Future – shared ethical responsibility Board Effectiveness Programme User and community voice Real time information and measurement systems Sharing evidence of improvement Staff engagement Data for discussion not judgement Clearing the way!! Experiences of care, compassion and respect Mobilising & deploying expert support “through the line” – 2 step challenge
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Continuum of PI Knowledge and Skills
What Skills Do We Need? Many People Few People Everyone Staff Change Agents (Middle Managers, project leads) Senior Leaders & Boards Experts Lisa Staff and everyone – RIM, define problem, identify solution and measures, test is it better? Implement. Front line and change agents get skills during improvement work (collaboratives, study circles and action learnining sessions) Executives and experts – may get some of their deeper training as part of full day or “mini fellowships” but they also use these skills as part of their work with the collaboratives Teams Source: Kaiser Permanente, 2008 Shared Knowledge Deep Knowledge Continuum of PI Knowledge and Skills
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Patient / Practitioner Level
What data do we need? Board ET EMT Directorate / CHP Ward / Team Level Patient / Practitioner Level ASSURANCE Validated Data for 6 domains: Access, Efficiency, Infection & Prevention, Quality & Patient Experience, Patient Safety and Data Quality Assurance PERFORMANCE Validated and un-validated data across 6 domains: Clinical Excellence, Finance & Activity, Valuing Staff, Capacity & Activity Planning, Patient Experience and Patient Safety Data and Measurement for Performance IMPROVEMENT Un-validated data provided in real time through Unified Patient Tracking, Clinical Portal and operational dashboard with metrics covering Patient Flow, Inpatient Activity, Out Patients, Waiting Times, Patient Safety, Infection Control, Clinical Outcomes Improvement “focusing on information and data to provide assurance on improvement and quality to deliver better services”.
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a culture of improvement
What Knowledge Do We Need? The Shift to “All Learn : All Teach” as a Movement Workplace VLE Communities of Practice Developing a culture of improvement Developing local improvement stories Widening our improvement conversations and networks Improvement Evidence Real time tests of change Profound Knowledge & Evidence of Standards Adopt & Adapt Improvement Tools and Technology Sharing experiences and embedding the improvement culture Harvest and share and enable new ideas Measuring the effectiveness of improvement activities Microsystem frontline Mesosystem Middle mgrs Macrosystem Policy Individual
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Steps to Better Care Mental Health Older People Planned Care Workforce
Integrated care communities Child health Optimisation of Health Facilities across Tayside Prescribing and Medicines Other Labs Maternity Scenario Planning, Financial Baselines, Benefits Tracking, Business Cases Finance Support Workforce Support Workforce Modelling, Engagement & Communications with staff Comms Support Communications with public and staff OE Support Improvement & Development Support
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Organisational Effectiveness
Tayside Centre for Organisational Effectiveness Real time information and measurement resources to support quality improvement of clinical services. Enhance spread and share of good practice through use of technology e.g. Clinical Portal, Clinical Dashboards. Mobilisation of trained experts in quality improvement organisational development and leadership to support improvement work. The focus of this expertise will be mobilised to support front line staff and clinicians to build capability in improvement methodology and support key improvement programmes Technology Enabling Health Improvement & Development Support Research & Development Knowledge Management Improvement Academy A dynamic approach to knowledge transfer which supports our “All teach: All learn” philosophy in support of quality improvement. Develop an innovative education and training resource to build further out capacity and capability in improvement science.
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Table Top Discussion Where should our focus be to create the necessary capacity and capability required to support our improvement and innovation ambitions?
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