NHS – Enabling Change Improving processes and adding value 5th February 2015 Ian Quinnell Associate Director for Programme Management and Service Improvement

NHS – Enabling ChangeImproving processes and adding value

5th February 2015

Ian QuinnellAssociate Director for Programme Management and Service Improvement

Join the discussion at www.triaster.co.uk/connectorCall us on +44 (0)870 402 1234

Challenging Times

“The next 5 years are

going to be extremely

challenging for the

NHS”

NHS England, 2014

“We have an innovative

group of health care

professionals who

are up for change”

NHS England, 2014

“We’re in quality improvement

for the long haul,

but real success will be when

Quality Improvement is

business as usual”

The Health Foundation


Gloucestershire NHS Foundation Trust - GHNHSFT

• One of the largest hospital trusts in the UK

• Provides care for 612,000 people

• Split over two sites – Cheltenham General and

Gloucestershire Royal

• Employs over 7500 staff


Trust challenges

• Increase in demand for all services, limited resources

• Need to align services across the 2 sites

• Growing population – in 10 years the Trust will need to provide care for

850,000

• An ageing population – Gloucestershire has a greater than the national

average rise in those aged over 65

• Chronic disease increase – over the next 20 years those with diabetes

and strokes are projected to increase by over

30% and coronary heart disease by 50%


Trust challenges: Productivity and Efficiency

• NHS is expected to deliver savings of £20bn by 2015

• Every Trust has Cost Improvement Plans (CIPs) in place

• GHNHSFT needs to save in the region of £24m p.a


Trust challenges: Cost Improvement Plan

The Cost Improvement Plan (CIP) includes reducing costs and generating additional income.

There are a combination of initiatives and projects running to achieve this:

Trust initiatives - technology systems, getting the basics right, process improvements

Local Improvement Events – within the local area, joint ventures

with other NHS partner organisations

Community wide projects – across counties and regional

networks


Time for Transformation

Transformational change is required now


Time for transformation: Trust projects

Vision for Healthcare Technology for GHNHSFT

Current situation:

• End of life patient administrative system (PAS) & other aging systems

• Individual clinical systems with no integration

• Government directive for an Electronic Patient Record (EPR)


Time for transformation: Trust projects

SmartCare solution:

• Fully integrated clinical system

• Patient centric electronic record

• Provision of Order Comms and ePrescribing

• Real time data entry providing up to date information

Harnessing the benefits of information technology to improve the quality of care


Enabling the Change

What are we doing now?

• Needed to know what current processes we had in the trust to support change management for SmartCare

• Visited the ‘hands on’ operational staff, from Porters to Intensive Care, covering various activities

• Mapped using Microsoft Visio, using swimlanes to identify the person/group responsible for the task


Enabling the Change

Managing the cultural change

• Identified over 300 key processes that needed to be mapped

• Lack of actual process in some areas but the visit was used as an information session and staff engagement

• Useful exercise for identifying inconsistent working practices across sites

• Obtained sign off and ownership from general managers or senior supervisors


Mapping in action: Rapid Improvement Event


Process Map in Visio

Swimlanes used to identify the person or

group of people responsible for the

task

Subject Matter Expert and the

date the process was collected

Person responsible for

sign off / process map

owner

Colour & a code used to identify

the system currently used

File reference

and version


Quite complex processes

Quote Goes here

Some maps are too large to fit on one page and

therefore cannot be displayed end to end


Making things simpler

• Visio maps were quite hard to read and required Visio to view/edit them

• To encourage alignment in working processes needed to be made more transparent and accessible

• Lack of version control for processes and supporting documentation

• Data was captured but could not be searched or retrieved to use effectively

• Information needed to be easy to get to and

• All in one place


Introducing a central source of Truth

Quote Goes here Quote Goes here


Triaster Process Mapping


Use of a Keyword to

speed up the search for

appropriatemap/s

Accessed using a web browser, so it can be viewed by everyone

Gateway to the sub

specialties and all the maps related to a

division


Triaster Process Mapping



Local Improvement Event – clear concise mapping style

Quote Goes here Quote Goes hereLinks to supporting

information e.g. forms, procedure notes etc


Supporting the system transformation


• Staff can access the GHNHSFT Process Library from the hospital intranet

• All SmartCare training materials will only be placed on the Process Library

• Staff will be required to use the Process Library and processes to support the implementation of SmartCare

• Process Mapping is also supporting lots of local & community wide Improvement Projects

• The Process Library drives the management and continuous improvement of processes


The Future


• The Process Library will be the One Stop Shop for all information

• GHNHSFT will utilise SmartCare as the enabler to introduce Triaster to the organisation


Sources of funding


We have £1.5m available for up to 20 teams to test and develop innovative ideas and approaches to improving health care delivery in the UK.

A Regional innovation Fund (RIF) of £5million was launched by NHS England in November 2013, to support and promote the adoption of innovation and the spread of best practice across the NHS.

In collaboration with NHS England Innovation Exchange is the central point for anyone interested in innovation in healthcare in the NHS.


Thank you

Any Questions?

Documents

NHS – Enabling Change Improving processes and adding value 5th February 2015 Ian Quinnell Associate Director for Programme Management and Service Improvement