FLOW

FLOW

Dot to Dot –

Improving the patients’ journey through

care pathways

Rules

Best of 3

Winner then plays another winner

Loser follows their champion and supports vocally

Until we have a FLOW eRPS Champion

Paper > Rock

Scissors > Paper

Rock > Scissors

Improving Flow at MCA Expo ’16

RPS Champion 2016

6th June 2016

Nick Miller

Tom Downes

FLOW

Welcome and Introduction to

Improving Flow

Nick Miller Improving Flow Manager

MCA Improving Flow

Two Types of Knowledge

Subject Matter

Knowledge

Improvement

Science

&

Coaching

Improvement Science

& Coaching

Subject Matter

Knowledge

Discovering

great

care

Flow improvement -

The structure

Diagnosis -

Change

Ideas

Treatment

- PDSA

SDSA

‘Standardise’

Value

inVolve

Vision

Values

Visualisation

Assessment

How it happens

•12 care pathways, 24 coaches

•Clinical & Flow Coach

•BIG Room meetings

The Big Room

Global

Aim

Themes

‘Post-it

Frenzy’

Build a Big

Room

Specific aim

Change

Ideas

Brainstorming

Change Concepts

Benchmarking and

visits

Process/Value

Stream Map

Fishbone

Spaghetti

Diagrams

Selection criteria &

Multivoting

Change

idea

Standardise

A P

S D Define

measures

Pre-

Phase

A P

S D

Coached weekly

meetings

Patient

stories

System

data

Reflective

learning

A P

S D

Improving Flow:

Roadmap

The future

Cohort 2 October 2016

3 hospitals

Cohort 1 coaches become faculty

FLOW

Welcome to the Coaches

Portia Chikwanha

Amanda Turner

Claire Powell

Nick Lee & Lee Alexander

Acute Paediatric Pathway

Amanda Turner and Latha Rengaraju

Introducing FLOW

“BIG ROOM”

“BIG ROOM”

Flow Programme – Acute Paediatric Pathway Progress – May 2016

PRIMARY DRIVERS SECONDARY DRIVERS

WARD BASED MEDICINE DISPENSING

REDUCE LENGTH OF DISCHARGE PROCESS EARLY DISCHARGE DECISION

PRIORITISE PAEDIATRIC TTOS IN PHARMACY

EARLY COMPLETION OF DISCHARGE PAPERWORK

REVIEW INFECTION PREVENTION POLICIES

REDUCE A&E WAIT TIMES

REVIEW TERMINAL CLEAN PROCESS

STREAMLINE PATIENT JOURNEY / 3PM WARD ROUND BY HOTWEEK CONSULTANT

REDUCE LENGTH OF STAY EARLY SENIOR DECISION MAKING

REVIEW BY SENIOR BEFORE HANDOVER

Aim

- Pharmacist available on ward for dispensing @10 am

- Additional items being added to ward dispensing list

- 7am ward round/discharge by Registrar

- Paediatrics now being prioritised

- Compiling list of prescribing errors that commonly cause delay to share amongst junior doctors

- Discharge paperwork being completed on night shift by SHO

- Infection prevention to attend meeting on 12th

May

- Val Quelch (Hotel Services) attending meeting on 27th

May

- To be discussed and agreed at next Consultant Meeting

- To be discussed and agreed at next Consultant Meeting

CHALLENGES

•TIME

•BIG ROOM

•MANAGING EXPECTATION

•COMMUNICATION

•ROBUST DATA

•TRANSFERRING OWNERSHIP

WHAT’S GONE WELL

•INVESTMENT

•ENTHUSIASM

•ENGAGEMENT

•SMALL CHANGES

•POSITIVE FEEDBACK

FLOW