Upload
jemimah-griffith
View
217
Download
0
Embed Size (px)
Citation preview
© NHS Institute for Innovation and Improvement, 2010
Improving End of Life Care
Dr. Sakthi Karunanithi, Locum Consultant in Public HealthMr. Mike Leaf, Director of Public Health (Acting)
Acknowledgements: Dr. Mark Spencer and Dr. Gillian Au
The Quality Challenge People are not receiving the best possible
end of life care Gap between scientific know how and reality Unwanted clinical variation Avoidable costs National and Local priority
Aim: Improve the percentage of people dying in their preferred place of care by 10% in one year
Patient & Carer
Care Homes
GP
HospiceHospital
Community Services
NWASPCT
People and Changes Being Introduced
Education
Pathways
Team mobilisation
Funding
Gold Standards Framework
McMillan GP
Paradigm Shift: Moving beyond a QI project to a large scale change
Run chart of number and percent of deaths occuring at homeJan 2009- present: North Lancashire resident population
0%
10%
20%
30%
40%
50%
60%
2009 2010 2011
No.
dea
ths
% of Home Deaths
Baseline - 2009 Median – 37%
Impact so far
Impact of Vanguard on us
Insight into various dimensions of large scale change
Enhanced understanding of methods to match the large scale change
Ability to mobilise the right people with narratives Mindset to blend QI with organisational development
and social mobilisation Already applying the learning into other areas of
work!
Spread so far and next steps From one practice in Fleetwood towards a
EoL care programme across the local health economy
Linking with level 3 QIPP priorities
Next steps Link with regional work stream Spread through end of life care network Scope new financial models