Welcome to Releasing Time Care Integration WebEx

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Introduction to Health and Social Care Integration

NHSScotland

24th May 2013 13:00 – 15:00

Fiona Cook, Healthcare Improvement Scotland

Julie Main, NHS Education for Scotland Margot White, Joint Improvement Team.

Content Introduction Getting to know you Integration and expectations Realising the impact and data collection Understanding the Productive Series Work based activities

Introduction Getting to know you and your project

What is Integration? For the purposes of this Programme Integration is defined as:- “A newly integrated team or two or more teams from health and /or social care jointly implementing Productive modules in order to provide a more effective and positive experience for patients .” NHS Institute for Innovation and Improvement

However, teams may be physically integrated, virtually integrated or separate teams trying to work jointly in key areas to improve patient experience.

Background • “The lack of joined-up care is the biggest frustration for patients,

service users and carers.”

• “Conversely, achieving integrated care would be the biggest contribution the health and care services could make to improving and safety.”

• “Patients, service users and carers want continuity of care, smooth transitions between care settings, and services that are responsive to all their needs together” National Voices, October 2011

• “We will have a healthcare system where we have integrated health

and social care, a focus on prevention, anticipation and supported self management.” A Route Map to the 2020 Vision for Health and Social Care, 2013

Complicated easy: uses lots of brain power but nothing else. Simple hard : simple to describe, hard to do, never get it right, just gets

better and better over time. Needs courage and care. We all tend to run away from the simple hard to the complicated easy

Simple hard versus complicated easy

Building relationships to improve outcomes

Planning and transactional contracting

Our Expectations Attendance at workshops and local event

– Western Isles 29th May – Ayrshire and Arran 5th June – Orkney 13th / 19th June – Tayside 24th June

Core baseline measures – Templates – Reflective diaries

Work based activities – Regular team meetings and activities – Milestones for data collection – Productive Series – Community Of Practice – Engage with e- learning opportunity

National support – NHSScotland RTC licence and copyright – Monthly VC events – Optional WebEx sessions available – Network meetings and support

Your expectations From us From each other

– locally – across pilot sites

• waiting time for OT interventions .

• Improved service user experience

• Improved staff experience • Improved use of resources

•Staff Survey • Patient Survey • Steps Saved • Time Saved

• Reduction in number of delayed discharges • Increased number of patients discharged within 24 hours of planned discharge date • Increase in number of patients and carers aware of PDD where appropriate. • Reduction in average length of stay • Reduction in the number of readmissions within 7 days

•Hospital Emergency Admissions and Readmissions • Service user/patient experience • Patient profile, bed occupancy and length of stay • Impact on the Befriending service • Impact on the Enhanced responder service • Increased capacity and capability • Staff experience • Other nationally reported target/measures

Realising the impact – your proposal was:

Measures Agree: Core measures for all pilot sites Specific measures demonstrating impact of key improvement

Patient experience Tools to consider

– Experience questionnaire – Patient Experience diary – Interviews with patients and their relative/carers. These could be

videoed so they may be shared with the integrating teams. – Relevant information about complaints, compliments, patient

surveys – 15 Steps Challenge

Staff experience • Feedback tool • Staff thermometer

What worked well for you?

What could we do more of/ better to improve the

experience?

Understanding The Productive Series

What is Releasing Time to Care? • An evidence-based approach to improve the way we

work. • It can support staff across health and social care to work

more effectively together. • It provides a method to systematically engage and equip

teams to address quality and productivity challenges. • It reduces variation and improves efficiencies by using

LEAN methodology. • It focuses on areas for improvement where we can make

the biggest difference. • It aligns and is complementary to other programmes of

work.

Making our priorities possible

Productive Programmes

The process of Improvement

Prepare Understand what we’re doing now

Agree what you want to implement

Consider what ‘good’ looks like

Test what’s agreed

Assess the impact

Assess

Diagnose

Plan

Treat

Evaluate

What is Lean?

Waste is anything other than the minimum amount of equipment, materials, space, or time which is essential to add value to the service. NHS Institute for Innovation and Improvement.

Removing non value adding steps from our working environment and processes.

A process that guides improvements by understanding customer value and focusing key processes to continuously increase it. The ultimate goal is to provide perfect value to the customer through a perfect value creation process that has zero waste. Lean enterprises

DirectCare Time

Motion Admin Discussion Handovers Information Roles

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me

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. nur

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Total Time

“Everything I need to do my job is

conveniently located”

‘The paperwork is easy to understand

and quick to complete’ I am not interrupted by

people requesting information or looking

for things ‘’Handovers are

concise, timely and provide all the

information I need”

‘It is clear to everyone who is

responsible for what”

‘We have the information we need

to solve our own problems, and find out if we were successful”

Opportunity to increase the time available to

deliver safe, high quality and reliable direct

patient care

Examples in practice

Staff Morale

0%10%20%30%40%50%60%70%80%90%

100%

Base

line

Februa

ry

March

April

May

June

Augu

st

Octobe

r

Decembe

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2009

BrilliantSomewhere inbetweenRotten

http://www.knowledge.scot.nhs.uk/rtccommunity.aspx

AHP Impact examples Radiology - Patient waiting time for appointments 3 weeks to 1 week Podiatry – extra 372 appointment slots gained per year Radiology released 175 hours per year

More examples:

Measuring impact- increasing productivity “We devised work plans at a glance which improved our team communication and helped manage our workload” NHS Lanarkshire “We designated a referral line for hospital staff manned for 2 hours a day. More in-depth referrals. Better time management. ” “We introduced Patient Status at a Glance boards and improved efficiencies in patient journey – reduced complaints; less missed visits; improved patient and staff satisfaction; better communication – Community midwifery team NHS GGC “We introduced grab bags for District Nurses. Reducing risk, time, errors and bag weight. Improving patient experience and staff morale” Various community teams “We implemented WOWE which increased staff morale, reduced waste and reduced cost” NHS Tayside Extracts from national stocktake report April 2013

Work based activities – Hold your first team meeting and plan others for pilot

period. – Link with other RTC facilitators locally and nationally. – Gather baseline measures and complete

measurement plan. – Join Community of Practice

http://www.knowledge.scot.nhs.uk/rtccommunity.aspx – Access optional WebEx sessions. – Obtain RTCC box sets. – Engage in E- learning.

E- learning suite The Productive Foundation Modules 6 underpinning knowledge e-learning modules, with individual auto marked assessments and certificates of completion.

Be on the look out for an email from: TMS Learner Admin [NDR@virtual-college.co.uk] Subject: productive ward e-Learning Registration Details This will contain instructions of how to login an access the training content.

Next session

Teams will: •Have a greater sense of shared values, vision and purpose •A plan on how to work together more effectively •Build on existing relationships between team members •Develop a better understanding of each other’s roles and challenges •Implement RTC principles to achieve local outcomes.

Your expectations From us From each other

– locally – across pilot sites

Any further questions?