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Transforming Urgent and Emergency Care Day Two

Transforming Urgent and Emergency Care Day Two. What we learnt yesterday. Objectives. Have increased understanding of the evidence to support urgent and emergency care transformation Understand the clinical systems improvement approach and associated tools

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Transforming Urgent and Emergency Care Day Two

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  1. Transforming Urgent and Emergency Care Day Two

  2. What we learnt yesterday

  3. Objectives • Have increased understanding of the evidence to support urgent and emergency care transformation • Understand the clinical systems improvement approach and associated tools • Understand how systems thinking can support system transformation • Have knowledge of data and evidence sources to aid commissioning, and how best to utilise these when leading transformational change • Recognise transformational opportunities, and know how to challenge their own behaviour and approach, and that of others • Understand the potential and the limitations of existing components of the Urgent and Emergency care system

  4. Francis Enquiry

  5. Garry Swann What is the role of the Emergency department?

  6. In the next hour: Challenge: Measuring Success and Monitoring performance Group work: What you measure Challenge: Measuring for improvement Challenge: What I would measure 10.00 Measurement

  7. What is the purpose of our present measurement system? Challenge: Measuring Success and Monitoring performance

  8. Attendances by age

  9. Which month they attend

  10. What time they arrived

  11. What day they come

  12. What day and time they attend

  13. Disposal

  14. Arrival time

  15. Assaults

  16. When they leave

  17. And have you fallen in to the usual trap?

  18. Data without knowledge and observation is ignorance

  19. How do you decide where to get your care?

  20. Failure to have balanced measures

  21. Goodhart • Any observed statistical regularity will tend to collapse once pressure is placed upon it for control purposes

  22. Why has four hours failed? • The regulatory system. • Commissioners • Organisations • Clinicians • Individuals • Commentators (including the media)

  23. Cooke 1 • Quality indicators should be based on accurate data combined with knowledge and observation of the underlying processes and then create constructive debate, discussion and healthy competition amongst the individuals who can directly influence the quality, who are striving to deliver the best care possible

  24. Cooke 2 • A good system should openly and accurately demonstrate its quality (including outcomes, safety and experience) across the whole range of patients and should be more concerned with their own improvement than with their relative “scores” (e.g. league tables) or performance against an arbitrary level.

  25. Cooke 3 • The attitudes, behaviours and culture across the whole system (from policy makers and regulators to individuals on the front line) should all promote a patient focussed approach to global Improvement in clinical outcomes and service experience.

  26. Group work: What you measure now

  27. How do others use measures? Challenge: Measuring for improvement

  28. Challenge: What I would measure • Outcomes • Experience • Timeliness • Bring together in • Narrative • Validatted by • Peer review • Population based • Network audited • Publically available

  29. Failure to have balanced measures

  30. Group work: What you will measure in the future

  31. 11.30 after coffee Challenge the experts Badges 1-49 The modern ambulance service: Mr Barry Thurston Badges 50-99 Lessons from NHS Intensive Support Team: Mr Russell Emeny Rotate at 12.15 Lunch at 13.00 11.00 Coffee

  32. 1.45 Building consensus • 100 experts are a strong voice • 100 experts agreeing can create change • 100 experts spreading a common message can change the NHS

  33. AgneloFernandes 2.00 Leessons from a Commissioner

  34. 2.45 Building consensus • 100 experts are a strong voice • 100 experts agreeing can create change • 100 experts spreading a common message can change the NHS

  35. 3.00 TeaReturn at 3.15

  36. Future application of learning Convincing others Engaging clinicians 3.15 Facilitated Group Discussion

  37. 3.45 Unresolved issues

  38. Action Cards Final Challenge Feedback Forms Next Steps 4.15

  39. Warwick Medical School is the first UK medical school to receive an Athena SWAN Bronze award for its school-wide work supporting the Charter for Women in Science. Thank you

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