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Improving Quality Together in NHS Wales

Improving Quality Together in NHS Wales. Population 3.1 million 7 integrated Health Boards 3 NHS Trusts Approx 70,000 staff. National Quality improvement journey. 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013. +. Safer Patients Initiative. =. IHI 100,000 Lives Campaign.

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Improving Quality Together in NHS Wales

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  1. Improving Quality Together in NHS Wales

  2. Population 3.1 million 7 integrated Health Boards 3 NHS Trusts Approx 70,000 staff

  3. National Quality improvementjourney 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013... + Safer Patients Initiative = IHI 100,000 Lives Campaign 1000 Lives patient safety Campaign 1000 Lives Plus – national programme in NHS Wales Where we are in Wales

  4. Current National policy context We must achieve a common and consistent language and approach to improvement across Wales 1000 Lives Plus will be the core NHS improvement programme 25% of the workforce to be trained in Quality improvement by 2014

  5. Berwick Report... • Recognise with clarity and courage the needed for wide systemic change – all improvement begins with recognition of the need to improve. • Reassert the primacy of working with patients and carers to set and achieve quality goals. • Use quantitative targets with caution. • Recognise that transparency and open communication is essential. • Give the people of the NHS – top to bottom – career long help to learn and apply modern QI/QA methods. • Make sure pride and joy in work, not fear, infuse the NHS

  6. Improvement and change:What NHS staff said... NHS Wales staff survey (22.5k respondents)

  7. IQT Framework • 3 levels of development: • Bronze • Silver • Gold • Complemented by Board level development.

  8. Bronze Aims: • To build awareness of QI • To introduce the Model for Improvement and its application at a basic level Delivered via an online training package or face-to-face

  9. Aims Three fundamental questions for improvement Measurement Ideas, hunches,other people etc. The Model for Improvement How to make change happen Langley et al (1996) – cited 1000 Lives plus (2012)

  10. Silver Builds on Bronze level and covers • Identifying what needs improving • Organising measures • Presenting data – run charts • Special and common cause variation • Human factors • Sustainability and spread • Core training materials developed nationally for local use can be integrated with existing programmes. • Individuals are supported to complete their own improvement project. • The course is nationally accredited.

  11. Progress towards the training target

  12. Board • Support leading system-wide quality improvement and assurance • Create a culture where everyone feels engaged and accountable for their two jobs: • To do their job • To improve their job

  13. Assurance External ‘In Boardroom’ Pro-active Improvement Internal ‘Out of Boardroom’ Reactive Particular challenges for Boards

  14. Incremental improvement Brent James: Intermountain Healthcare Presentation to IHI Forum 2012

  15. Breakthrough improvement Brent James: Intermountain Healthcare Presentation to IHI Forum 2012

  16. A mature quality system Brent James: Intermountain Healthcare Presentation to IHI Forum 2012

  17. Gold Aims • To develop expertise to coach and support Silver and Board levels in integrating quality improvement into routine practice. • To develop a national network of improvement experts. The national role in this is an emergent process and needs to complement and support organisation-level work to change improvement practice and culture at system-level.

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