NHSScotland's Quality Improvement Hub

1. NHSScotland's Quality Improvement Hub

2. Context

3. NHSScotland’s Improvement Journey Strategic Lean Scottish Patient Safety Programme Mental Health Collaborative 18 Weeks Service Redesign and Transformation Programme Long Term Conditions Collaborative Planned Care Improvement Programme Unscheduled Care Collaborative Diagnostics Collaborative Primary Care Collaborative

4. JANE MURKINAssociate Director of Improvement, Healthcare Improvement Scotland

5. Background Develop the Quality Improvement Hub, reflectinga new partnership for improvementbetween NHS National Services Scotland (NSS), Healthcare Improvement Scotland, NHS Heath Scotland, NHS National Education for Scotland (NES), and the Scottish Government Health Directorates Quality and Efficiency Support Team (QuEST).

6. Our Aim: • The Quality Improvement Hub aimsto bring improvement science into the everyday work and language of NHS staff and to support demonstrable improvement in patient care through quality improvement activity • Building national and local Quality Improvement capacity and capability

7. Adoption of InnovationE Rogers – Diffusion of Innovation 1995

8. We are not alone:

9. Shaping the Hub • The NHSScotland Quality Improvement Hub shaped and developed by NHS boards. • Providing : • Implementation support which is flexible and responsive • Education and learning about QI which is accessible and relevant • Measurement of QI which is meaningful • Facilitating QI networks for NHS staff

10. Implementation Support which is flexible and responsive: Local • Each board has an infrastructure • Emerging local hubs National • Supporting NHS boards with the design, testing and implementation • Think Glucose – testing and spread across other boards • Building capacity and capability for improvement in the senior charge nurse team • Mortality reduction improvement plan • Brokering improvement and topic expertise support between boards for the benefit of NHSScotland • Brokering of design students

13. Creative Space • A creative and innovative space that enables users to work in an environment conducive to quality improvement • The space is flexible, adaptable, accessible and supportive to make it easy for people to think differently to identify creative and innovative solutions

14. The Improvement Journey

15. Questions • In your role: • what opportunities do you have to improve services locally? • what challenges do you face in using quality improvement methodologies and tools? • what do you need to support you to use continuous quality improvement and creativity and innovation?

16. SHONA COWANEducation Programme Manager, NHS Education for Scotland

17. EDUCATION AND LEARNING: QUALITY IMPROVEMENT EDUCATION FRAMEWORK • Focus on four key staff groups – Foundation, Practitioner, Lead and Board Members • Identifies knowledge and skills required to be able to undertake improvement work and links to KSF • Designed for use by individuals, organisations and education providers • Quality Improvement Learner Journey will be key - targeted learning resources will be mapped, where available, and new learning developed to meet gaps • Opportunity to integrate improvement learning with existing activity • Spread expertise on improvement developing into new service areas eg public health

18. EDUCATION AND LEARNING: CAPACITY BUILDING IN MEASUREMENT FOR IMPROVEMENT • Development of skills framework for measurement • Identified learning requirement for four groups • Commissioning learning resources to meet identified needs • Pilots in quality improvement for organisational development leads and information managers in quality improvement

19. ROGER BLACKHead of Improvement Programmes, Information Services Division, NSS

20. MEASUREMENT: INTEGRATING MEASUREMENT INTO IMPROVEMENT • NHS Orkney • How to interpret and use the Hospital Standardised Mortality Rate (HSMR) • Mortality reduction improvement plan • Blood Transfusion Service • League table approach • From measurement for judgement to measurement for improvement

21. MEASUREMENT:BUILDING CAPACITY AND INFRASTRUCTURE • Building capacity in measurement for improvement in information staff (NES, ISD, HIS) • Leadership in statistical methodology (ISD) • Quality improvement data repository to support national improvement programmes (ISD)

22. An NHS Boards Perspective CARRIE MARRAssociate Director of Change and Innovation, Centre for Organisational Effectiveness, NHS Tayside

23. Full Scale • Public Sector Infrastructure to support improvement • Working with Communities A History of Quality as a Business Strategy in Tayside • Movement • Triple Aim • System Infrastructure - TCOE • Creating breakthrough • 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 2006 2007 2008 2009 2010 2011 Beyond Source: System thinking and spreading knowledge, Bojestic M., Henriks, G., Provost L. IHI European Forum, Prague 2006

24. Engaging with the National Quality Hub as part of our QI Strategy • Building capacity and capability locally, nationally and internationally – TCOE, National Quality Hub, IHI • Knowledge transfer and shared learning • Joint mobilisation of national and local expertise to support improvement priorities e.g. population health measurement

25. Engaging with the National Quality Hub as part of our QI Strategy • National network for Improvement Advisers to learn and stretch • Access to the Patient Safety Fellows and Improvement Advisers to influence and inform our improvement work locally • Hub access to commission the expertise of NHST Improvement Advisers to support Hub improvement work • Access to educational resources in support of our local Improvement Academy

26. Embedding a Culture of Continuous Quality Improvement • Winning the hearts and minds of the staff • Develop testing and innovation • what to test…..how to test • Leadership and culture • Integration – making it daily work • Creating the infrastructure • Creating capacity and capability • Measurement that has meaning

27. Upcoming Events • 8th September 2011 • Quality Improvement and Organisational Development Summit • 27th October 2011 • Embedding a Culture of Continuous Quality Improvement – Next Steps

28. Question and Answer Session