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What works?
National and regional initiatives to build health worker improvement competencies
Lesley Anne Smith @LAS_QI Quality Improvement Programme Director, NHS Education for Scotland
Tana Wuliji @TanaWulijiSenior Improvement Advisor, US Agency for International Development Applying Science to Strengthen and
Improve Systems Project, University Research Co., LLC (URC), Australia www.usaidassist.org @usaidassist
#I9, #Quality2014 Friday 11th AprilInternational Forum for Quality and Safety in Healthcare, Paris
We have no conflicts of interests to declare
http://bit.ly/1gQu5qD
What works?
National and regional initiatives to build health worker improvement competencies
Challenge
s
How?Chall
enges
How?
What works?Chall
enges
How?
1. Health systems needs2. Utilizing competencies3. Health worker education systems4. Stakeholder engagement
Quality Education for a Healthier Scotland
Building Capacity and Capability for Quality Improvement
A National Approach
Lesley Anne SmithQuality Improvement Programme Director
NHS Education for Scotland
Quality Education for a Healthier Scotland
Our vision is that by
2020 everyone is able
to live longer healthier
lives at home, or in a
homely setting.
NHS Scotland 20:20 Vision
Quality Education for a Healthier Scotland
“All staff need to be
appropriately trained and have
access to learning and
development to support the
Quality Ambitions and 2020
Vision for Health and Social Care.
2020 Workforce Vision
Quality Education for a Healthier Scotland
NHSScotland Quality Improvement Capacity and Capability Building Plan
Improve the confidence, capacity and capability of
those leading and practicing quality
improvement across NHS
Scotland by 2015
Quality Improvement Education Framework
(What)
Identify Target Audience
(Who)
Quality Improvement Learning Resources Delivery Model
(How)
Infrastructure
Quality Education for a Healthier Scotland
NHSScotland Quality Improvement Education Framework
Quality Education for a Healthier Scotland
NHSScotland Improvement Skills Model
Quality Education for a Healthier Scotland
Quality Improvement Educational Resources
E-learning modules
Formal national programmeso SPSP Fellowshipo Improvement Advisor (IHI)o Improvement Science in Action (IHI)/ Scottish Improvement Skillso Skills for Improvement - Measurement for Improvement
Collaborativeso Scottish Patient Safety Programme (SPSP)o Person Centred Health & Careo Early Years
NHS Board courseso Internal and external
Quality Education for a Healthier Scotland
Quality Education for a Healthier Scotland
NHSScotland e-Learning Modules
Introduction to our Purpose and ValuesIntroduction to Quality and Quality ImprovementIntroduction to Healthcare SystemsIntroduction to Quality Improvement MethodsIntroduction to Measurement for ImprovementLean in HealthcareKnowledge into Practice in HealthcareBuilding a Quality Culture
Leading Quality ImprovementCreativity and Innovation in HealthcareIntroduction to Data AnalysisMeasurement for Improvement – Presenting DataEvaluating Quality ImprovementIntroduction to Statistical Process ControlSkills for Improvement: Measurement Module A – PlanningSkills for Improvement: Measurement Module B – Analysing Data
Quality Education for a Healthier Scotland
Purpose:
• Develop and strengthen clinical leadership capability to support the
SPSP
• Contribute to the development of a long term quality improvement
and patient safety culture
• Establish a learning support network for transformational
leadership
• Strengthen existing collaborations within NHS Scotland
Scottish Patient Safety Fellowship
Quality Education for a Healthier Scotland
To provide participants with:
• An in-depth understanding of core Improvement Science
Concepts
• Ability to apply Improvement Science tools, techniques and
methods to improvement projects
• The skills required to lead or support improvement projects
• The ability to teach and coach individuals and teams in
improvement science
NHSScotland/IHI Improvement Advisor Programme
Quality Education for a Healthier Scotland
NHSScotland Future Lead Level Programmes
Quality Education for a Healthier Scotland
NHSScotland Approach to Practitioner Level Development
???
???
Quality Education for a Healthier Scotland
Lesley Anne Smith
[email protected],nhs.uk
@LAS_QI
NHSScotland QI Hub
www.qihub.scot.nhs.uk
What works?Chall
enges
How?
1. Health systems needs2. Utilizing competencies3. Health worker education systems4. Stakeholder engagement
USAID Applying Science to Strengthen and Improve Systems
Maximize healthcare quality with the health workforce (change agents) we have
The world redrawn according to its share of nurses
USAID Applying Science to Strengthen and Improve Systems
Service delivery
Health workforce
Information
Medical products, vaccines and technology
Financing
Leadership/governance
Weak/dysfunctional health system
Health worker education
Does the education we have set up health workers to succeed in the reality of current health systems?
Every system is perfectly designed to achieve exactly the results it achieves
USAID Applying Science to Strengthen and Improve Systems
+ improvement competencies
Change agents
Service delivery
Health workforce
Information
Medical products, vaccines and technology
Financing
Leadership/governance
Integrating improvement competencies into pre-service education + life long learning: Lifelong change agents
#WHWWeek
USAID Applying Science to Strengthen and Improve Systems
Integrating improvement across the continuum of learning: Key issues and examples from low and middle income countries
22
Pre-service education
Life-long learning
USAID ASSIST/HCI eg: East Africa (partnership with RCQHC), Swaziland (2), Nicaragua (8)
WHO Patient Safety Curriculum Guide: Difficult to change educational culture to be patient centered, faculty capacity to teach improvement, sustainability of teaching resources
East Africa: In-service training is commonplace but doesn’t reach all, training is not competency-based, resources are donor dependent
Push for transformative learning & social accountability = opportunity
USAID Applying Science to Strengthen and Improve Systems
Integrating improvement across the continuum of learning: What stakeholders do we need to engage?
23
Education & training
Profession + Services
Policy + regulatorsFunders
Evaluate impact?Determine value?Inclusion as core competency?Leverage investment?
USAID Applying Science to Strengthen and Improve Systems
Scaling efforts to build a workforce of change agents – we’ll need to work with others
USAID Applying Science to Strengthen and Improve Systems
77%
52%
33%
10%
25
L Miller Franco & L Marquez, BMJ Qual Saf, 2011
27 projects, 12 LMIC countries
• Rapid: 6-13 mo to 80% performance• Real + substantial potential health gains in LMIC
What works?Chall
enges
How?
1. Health systems needs
2. Utilizing competencies
3. Health worker education systems
4. Stakeholder engagement
Panel:Carly Strang, IHI Open School, USAMarie Kehoe O’Sullivan, Health Information and Quality Authority, Ireland Tricia Woodhead, Safer Care South West our Quality Improvement Collaborative, UK
Diana Frymus, US Agency for International Development, Washington DC, USA
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