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An Associated University Hospital of
Brighton and Sussex Medical School
Trust Board summary
October 2018 v1.1
Overview of KPO
• Our aim is to pursue perfection, putting our patients at the
forefront of everything we do, improving safety and quality
by reducing variation and waste in every process. Our
SASH+ work supports an accelerated transformation in
quality by providing us with a structured approach to
continue our improvement journey taking us from a good to
an outstanding organisation.
• Our kaizen promotion office (KPO) team lead the
transformation programme; they provide the structure,
methods and rigour behind the successful implementation
of the SASH+ improvement methodology, alongside
training and developing others to lead using the new
methods.
Strategy alignment
Organisational goals and
SASH+ links
VS updates
VS1 – Cardiology
Improvement work currently paused as team embed improvements agreed at
previous RPIWs. Progress against this is being monitored monthly via
performance reviews
VS2 – Outpatients: ophthalmology
Baseline for revised high level metrics for this value stream are currently being
collated
Second RPIW for ophthalmology being planned which will focus on booking of
follow up appointments following a clinic consultation
VS3 – Management of diarrhoea
Improvement phase is now complete after 6 RPIWs. Now moved to
implementation phase which will include roll out of 25 improvements identified in
RPIWs. A heat map of all of improvements and all wards will be used to monitor
implementation
VS updates
VS4 – Sepsis
3rd RPIW currently being planned for focussing on how staff receive
education and training around sepsis when they join the Trust
VS5 – Discharge
Launch event complete with more than 40 staff and patient
representatives involved. Current state high level value stream validated
and future state value stream agreed. Baseline of high level metrics data
currently being collected. 1st RPIW focussing on setting estimated date
of discharge was held in September 2018 and lead time reduced from
23½ hours to 29 minutes
VS6 – Diagnostic imaging
A value stream sponsorship team has been established and Dr Ed Cetti
is the executive sponsor. The scope of this value stream will be from
request for outpatient CT scan to report being available. Observation and
data collection is underway and the launch is planned for 21 November
and the first RPIW is scheduled for January 2019.
Education and training – roll out plan
Planned for
17/18
Planned for
18/19
Planned for
19/20
Induction All new starters (1101) All new starters
(1100 anticipated)
All new starters
(1100 anticipated)
5S and waste taster
sessions – for all new
and current band 1 – 4s
6 sessions per year -
bi monthly
20 – 30 staff per
session
6 sessions per year -
bi monthly
20 – 30 staff per
session
6 sessions per year -
bi monthly
20 – 30 staff per
session
One day introduction –
for all new starters,
junior doctors and staff
on FTC > band 4
6 sessions per year -
bi monthly
20 – 30 staff per
session
6 sessions per year -
bi monthly
20 – 30 staff per
session
6 sessions per year -
bi monthly
20 – 30 staff per
session
KSS junior doctors
introduction day (HEE)
N/A Monthly sessions for
20 – 30 staff planned
to commence
October 2019
Monthly sessions for
20 – 30 staff planned
Mistake proofing 1 session delivered for
25 staff in March 18
2 sessions per year
planned for up to 60
staff
2 sessions per year
planned for up to 60
staff
Promoting innovation 1 session delivered for
31 staff in January 18
2 sessions per year
planned for up to 60
staff
2 sessions per year
planned for up to 60
staff
Education and training – roll out plan
Planned for
17/18
Planned for
18/19
Planned for
19/20
L4L 4 cohorts of 25 - 30
staff planned to
commence each year
4 cohorts of 25 - 30
staff planned to
commence each
year
4 cohorts of 25 - 30
staff planned to
commence each
year
0%
5%
10%
15%
20%
25%
30%
35%
0
10
20
30
40
50
60
70
80
Cohorts 1 & 2Jun 16 to Jun
17
Cohorts 3 & 4Feb 17 to Mar
18
Cohorts 5 & 6Sep 17 to Oct
18
Cohorts 7 & 8Jan 18 to Dec
18
Cohorts 9 &10
Jul 17 to May19
Commenced
Graduated
Cumulative L4L total
Cohort target
Attrition
Education and training – roll out plan
Planned for
17/18
Planned for
18/19
Planned for
19/20
ALT 2 cohorts of 10 staff
planned to commence
1 cohorts of 5 staff
planned to
commence each
year
1 cohorts of 5 staff
planned to
commence each
year
0
2
4
6
8
10
12
ALT originalcontract
SJ, AH, HG,KM
ALT cohort 1ZP, SC, PT,
SR
ALT cohort 2Feb 18 toMay 18
BP
ALT cohort 3Jun 18 toSep 18JF, LW
ALT cohort 42019
ALT cohort 52020
Commenced
Certified
Target
RPIW cert
Cumulative RPIW cert
Cultural Assessment Tool Results
2018
Presentation title
3534 people within SASH were invited to take part in the survey. 1243 people
completed the questionnaire. This represents 35.2% of those invited to
participate.
Organisation Score – overview
The following table shows the mean scores across the organisation for all of
the cultural dimensions measured by the CAT
Cultural Assessment Tool Results 2018
SASH
Presentation title
The following table shows the comparison of mean scores for all the cultural
dimensions by Knowledge or experience of VMI Partnership
NB: In the mean data tables significantly different scores are shown in red or green. Figures shown in red indicate that we can be 95% certain that the score is significantly
lower than the overall mean score (p<0.05). Figures shown in green indicate that we can be 95% certain that the score is
Significantly higher than the overall mean score (p<0.05).
SASH results indicate that in 2 of 9 dimensions measured, SASH score higher than average where staff have participated
in activity relating to the NHS Partnership with VMI ‘SASH+’
CAT score comparisons
2016 2018 Difference
Values 3.98 4.14 +0.16
Vision 3.66 3.80 +0.14
Objectives 3.98 4.02 +0.04
Feedback 3.49 3.72 +0.23
Support 3.56 3.73 +0.17
Compassion 3.93 4.04 +0.11
Learning, Quality &
Innovation
3.56 3.76 +0.20
Team Working 3.93 3.95 +0.02
Collective
Leadership
3.69 3.82 +0.13
SASH+ staff knowledge comparison from CAT
survey
Heard about
SASH+
Not heard about
SASH+
Taken part in
briefing or
learning
2016 2018 2016 2018 2016 2018
Values 3.95 4.12 3.88 4.11 3.96 4.20
Vision 3.55 3.81 3.30 3.57 3.68 3.90
Objectives 3.86 3.96 3.88 3.92 4.03 4.21
Feedback 3.43 3.72 3.31 3.60 3.45 3.85
Support 3.46 3.74 3.21 3.61 3.56 3.76
Compassion 3.88 4.01 3.70 3.85 4.00 4.09
Learning 3.50 3.75 3.33 3.62 3.46 3.87
Team
Working
3.84 3.91 3.77 3.84 3.92 4.13
Leadership 3.60 3.80 3.43 3.66 3.71 3.90
Trust headlines • Trust level
- Announced CQC inspection due 16/17 October
- The BBC’s team from The One Show has completed filming of SASH+ work for an item they are
planning to feature wc 15.10.18
- Continued attendance at and really positive feedback from quarterly Kaizen open days which
continue to be offered for regional and national stakeholders and health and social care
colleagues
• Safety - Implementation plan for management of diarrhoea value stream improvements now underway
- “App” developed to support the daily checking of key anaesthetic equipment in theatres which
demonstrates compliance and provides assurance that all relevant checks have been completed
- Sepsis value stream launched and third RPIW being planned for
• Access and flow - Discharge value stream now launched and planning for first RPIW
- VSST for 6th value stream now established – diagnostic imaging
- Real time updated clinical operations boards helping to support flow of hospital and capture bed
hours lost per day
Trust headlines cont.
• Value - Impact assessments being completed by all L4L and ALT graduates. This focuses on value in its
broadest sense including patient experience, staff experience, set up reduction, 5S
improvements, mistake proofing, quality defects, increased activity/productivity and reduced
costs. It also asks candidates to consider the spread and sustainability opportunities of any
improvements that have been made
- Lowest reference costs for any acute trust in the country
- Contributed to NHS providers national report of productivity and efficiency
- “Rooming in” process for fracture clinic patients has improved ability of consultant to see 24
rather than 8 patients per clinic
- Virtual clinic has reduced demand for low acuity new patient attendances by 4 – 5 patients for
every 20 patient clinic
- Top 20% scores for national staff survey results
• Culture - 9 people completed ALT including medical director
- 48 more commenced on L4L
- First NED has completed 6 taught modules of L4L
- Improvements on CAT scores across the board compared to 2016
- Secured contract with HEE to train all junior doctors across Kent, Sussex and Surrey in SASH+