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Service Redesign. A Team Effort ! CPPC Study Day September 2009 Irene Pullar. The Team ?. or. The Continence Team (In no particular order!). Continence Nurses/advisors
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Service Redesign A Team Effort ! CPPC Study Day September 2009 Irene Pullar
The Team ? or
The Continence Team(In no particular order!) • Continence Nurses/advisors • Continence Physiotherapists • GP’s • Urologists • Urogynaecologists • District Nurses • Midwives • Colorectal Surgeons • Physiologists • Carers • Any appropriately trained health care professional • Managers/Budget holders • And last but not least ››››››
Service Redesign • Service Design is the activity of planning and organizing people, infrastructure, communication and material components of a service , in order to improve its quality, the interaction between the NHS as service provider and patients and the patient's experience
Service Redesign • How do we know our service need changed? • Think and ask anyone in the ‘Team’ and remember to include Yourself!
Why does it need changed? • New guidelines -Local or National • Departmental changes • Patient choices • You
Why does it need changed? • Waiting lists • DNA rates • National Government ‘Drives’ -18 weeks pathway
What needs changed? • Clinic times ? • Patient information ? • Waiting times? • DNA rates? • Staffing ? • Training ? • Attitudes ?
Have the same changes been done elsewhere? • Ask other areas • Google it • iCSP • Clinical Governance Dept • Modernisation team • Don’t reinvent the wheel
How do we change it? • Ask the ‘Team’ • Get evidence – Local /National Guidelines • Get help – Colleagues ,Clinical Interest groups • Modernisation Team • Audit department • Clinical Governance (local or national)
Clinical Governancehttp://www.clinicalgovernance.scot.nhs.uk
PDSA Cycle • Plan • Do • Study • Act • Small pilot • Review • Any further changes • Then implement • Review ……
PDSA Improvement Model What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in an improvement? Cycle 1 Cycle 2 Cycle 3
Does it need funding? • Small changes may not need funding • Local NHS Intranet – source local or national initiatives. Fit your project to their project • Modernisation Teams
Funding? • Drug companies. • Local University/Medical school-lists of bursaries/awards. • ACPWH/CSP- Lists of bursaries/awards • Local charities
How do we know that our change is an improvement? • Audit it but Get Help and use your trust’s audit/clinical governance department. Simple patient/Staff questionnaire QOL scores Validated outcome tools. Touch screen waiting room Questionnaires
Go for it! • Think positive • Jot down ideas • Go for small projects first • Try to fit your ideas to any ‘directives’
Go for it If you don’t ask you don’t get! Don’t give up at the first hurdle. Persevere , if you don’t succeed try again or somewhere else Use the NHS Clinical governance/audit departments
Useful websites • http://member.goodpractice.net/ContinuousImprovementToolkit/resources/core-improvement-tools/overview-to-core-improvement-tools.gp • www.scottishcf.org/grantsforwomen • http://www.show.scot.nhs.uk/CSO/index.htm) • Your NHS Intranet • http://www.nice.org.uk/usingguidance/commissioningguides/uiwomen/UrinaryContinenceService.jsp • http://www.institute.nhs.uk/index.php?option=com_quality_and_service_improvement_tools&Itemid=551.html
Useful websites • http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Tools/Plan-Do-Study-Act+(PDSA)+Worksheet.htm • http://www.csp.org.uk/director/members/research.cfm • http://www.18weeks.nhs.uk • http://www.clinicalgovernance.scot.nhs.uk/section2/pdsa.asp • http://www.healthdesign.org/ • http://www.google.com
Any Questions? Or Have I confused you enough!