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Productive General Practice. Aim. Introduce the Lean context for Productive General Practice and describe PGP’s structure and content Explain how it will support you in Delivering Quality in Primary Care
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Aim • Introduce the Lean context for Productive General Practice and describe PGP’s structure and content • Explain how it will support you in Delivering Quality in Primary Care • Describe how it’s being used and some examples of the benefits it offers from the Walmer Practice
Productive General Practice uses Lean Principles • Specify what does & does not add value – from the patient’s perspective. • Identify steps necessary to design, order and produce across the whole value stream. • Make those actions flow without interruption, detours, waiting or rework. • Only make what is pulled by the patient. • Strive for perfection by continually improving & removing wastes as they are uncovered.
Why is it relevant? • Lean is a systematic approach to reducing waste through a process of continuous improvement • Waste is anything other than the minimum amount of Practice equipment, materials, space and time which are essential to add value to the patient or service. • A Lean ‘Goal’ is to supply a product or service to the patient’s demand with 100% quality • Making the right thing easier to do – for every person, every time
The benefits it offers…Stanley Medical Group, County Durham • Reviewed their recall system for patients needing routine drug monitoring • Applied lean principles to understand the current process and design an improved process • Existing system lead to inconsistencies, waste and patient safety risk • Results: • Patient Safety (faster lead time and higher degree of accuracy) • Time (35 hours/month to 0.53 hours/week) • Patient experience (increased HCA patient facing time) • Money (£4150/year) Stanley Medical Group, County Durham “Streamlining this process has saved us time but the real benefit has been that we have improved patient safety and the patient experience, as we are now able to offer more appropriate appointments” Sue Elsbury, Practice Manager Source: Iain Smith, Corporate Improvement Team, North East Transformation System
The benefits it offers.. William Brown Centre, Peterlee • Practice nurse team applied 5S, a fundamental lean tool to their working environment • Impact • Reduction in inventory • Reduction in interruptions to consultations • Improved efficiency (e.g. staff walking distances reduced from 174 steps/ patient cycle to 18 steps/ patient cycle “By using simple tools to make simple changes you can made a lot of difference and I would recommend it to anyone thinking of using this approach” Dr Russell, GP Source: Iain Smith, Corporate Improvement Team, North East Transformation System
Focus on improving both quality and efficiency Invest to release time for Delivering Quality in Primary Care Working in partnership Scottish Government Institute for Innovation and Improvement RCGP Scotland Quality Improvement Hub Primary Care Leads The background to PGP in Scotland
Productive General Practice in Scotland • UK launch in November • Grampian, Tayside and Glasgow developing, or testing modules • Early Adopters in Grampian and Tayside starting August • www.evidenceintopractice.scot.nhs.uk
Support being tested Two whole day sessions Online forum - LinkedIn group Website – Scottish and Institute Advisers – Quality and Efficiency Support Team, RCGP Feedback on use and benefits
Where’s the link to patient safety? • Patient safety is 1 of 4 dimensions of quality in Knowing How We’re Doing Module • Helps identify opportunities for patient safety improvement • Signposts
Design Modules • Improving Today’s Practice – The Way Through Modules • Shaping Our Future Practice – Major Structural Change
Process Modules • Prescriptions – variation in rates, process, common principles • Referrals – variation in rates, common principles • Consultation – appropriate clinician, supported • Back Office – efficient and accurate functions • Planning and Scheduling – planning and appointment processes • Front of House – patient experience
The Crescent Practice’s story • Time out to discuss and share vision for Partners and Manager • Business Planning for Practice • Almost 97% return on Patient survey • Concentrated data Collection week • Staff involved and feel included • Staff champions identified for modules
Cons • Time pressure of Beta test site • Data Collection – Typical week? • Arranging Meetings • Sharing vision – IT issues whole practice meeting?
Launch and delivery UK launch end of yeat Discussion ongoing re phase delivery, or spread Productive General Practice across Scotland
Support already designed Two whole day sessions Detailed manuals Online forum - LinkedIn group Website – Scottish and Institute Advisers – Quality and Efficiency Support Team, RCGP Feedback on use and benefits