Local Improvement following National Clinical Audit

1. Local Improvement following National Clinical Audit Linda Chadburn, Governance Manager, Mersey Care NHS Trust July 2012

2. Me

3. Context • Experiences of the Trust • Using national audit results • Practical steps taken to make change happen

4. Case Studies • National Audit of Falls and Bone Health (Round Three) • National Audit of Schizophrenia (Round One) • 2 NCAs = 2 models

5. Model one • NCA: Falls and bone health • Stakeholders involved: Senior Physiotherapist and me • College Liaison: me • Data collection: Senior Physiotherapist • Considered results: together • Identified issues: together • Developed action plan: together

6. Lone working • Owned the action plan • Senior Physiotherapist • Implemented action plan • Senior Physiotherapist • Develop policy, changes in process, introduce new assessments, and…. • Senior Physiotherapist • Report progress to me: • Senior Physiotherapist

7. Experiences • Using NCA results to make improvements: • Isolated • No-one knows you’re doing it at all • Ineffective • Lessons learnt • Time to test out another model

8. Model two • NCA: Schizophrenia • Increased number of stakeholders: consultants, service users, carers, audit team and me • Pilot: service users, carers, PALS, RCPSYCH, audit team and me • Three aspects of main audit: • Service user: own survey form • Carer: own survey form • Consultants: own audit tool • Audit team: upload consultant data

9. The continuum • Lots of activity • Wait for report • Risk of inertia • Options

10. Sit and wait for the report Plan strategically Just go for it Analysing the options Risk: Inertia Benefit: Real results Benefit: Maintain momentum Risk: Low risk Risk: Break the rules Benefit: Make best-fit

11. The strategic option

12. Framework Step One Step Two Step Three Step Four Step Five Step Six Strategy: Shared aims & objectives Ownership Champions Work group Barriers: Conflicting priorities Power struggles Accepting responsibility Methodology: Sharing event Gain perspectives of stakeholders Identify areas for improvement Develop action plan Momentum: Maintain enthusiasm Maintain stakeholder involvement Share successes Benefits: Making use of national audit data Improves patient care Provide high quality service Coalition: Stakeholder discussion Knowledge base Influence and power

13. The session Aim To understand the audit results and engage in discussion, giving own perspective; encouraging the identification of areas for improvement and consideration of ‘CLEVER’ actions.

14. Involvement & engagement • Encourage participation • Issues identified in writing • Discussed as a group • Recommendations for improvement identified • Recommendations turned into actions • Actions tested

15. Are the actions CLEVER? C what costs are predicted to implement theaction? L who will lead the action? E what evidence will confirm implementation ofthe action? V will the action add value to the service? E what is the predicted end date? R are sufficient resources in place to implement the action?

16. Template action plan

17. Resistance

18. Ownership • Identify champions • Maintain momentum and engagement • Engagement = motivation • NAS Champion Group formed • Monitor action plan • Call upon resources

19. Model of achievement Maintain involvement Share successes