Det er ikke et sprint løb, men snarere et maratonløb…

st@patientsikkerhed.dk

@simontulloch

(+45) 20 20 43 92

I sikre hænder2013

I sikre hænder

2013

I sikre hænder

2013

I sikre hænder

2013

Forbedringsarbejdet var dejligt, hvad nu?

ELFT Quality Strategy

(2013 – 2020)

ELFT Driver diagram

AIM:

To provide the highest quality mental health

and community care in England

by 2020

Build the will

Build improvement

capability

Alignment

QI Projects

(clinical bundles)

1. Newsletters (paper and electronic)2. Stories from QI projects - at Trust Board, newsletters3. Annual conference4. Celebrate successes – support submissions for awards5. Share externally – social media, Open mornings, visits, microsite, engage key

influencers and stakeholders

1. Build and develop central QI team capability2. Online learning options3. Pocket QI for those interested in QI4. Improvement Science in Action waves5. Develop cohort and pipeline of QI coaches6. Bespoke learning, including Board sessions & commissioners

1. Embed local directorate structures & processes to support QI2. Align projects with directorate and Trust-wide priorities3. Support staff to find time and space for QI work4. Support deeper service user and carer involvement5. Support team managers and leaders to champion QI6. Align research, innovation, improvement and operations

Reducing Harm by 30% every year1. Reduce harm from inpatient violence2. Reduce harm from pressure ulcers3. Other harm reduction projects (not priority areas)

Right care, right place, right time1. Improving access to services2. Improving physical health 3. Other right care projects (not priority areas)

ELFT QI Projects

Pressure Ulcers

57,30%

73,10%

92,01%

UCL

LCL

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

28-A

pr-

14

12

-May

-14

26

-May

-14

09-J

un

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23-J

un

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07-J

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21-J

ul-

14

04-A

ug-

14

18-A

ug-

14

01-S

ep-1

4

15-S

ep-1

4

29-S

ep-1

4

13-

Oct

-14

27-

Oct

-14

10-N

ov-

14

24-N

ov-

14

08-D

ec-1

4

22-D

ec-1

4

05-J

an-1

5

19-J

an-1

5

02-F

eb-1

5

16-F

eb-1

5

02-M

ar-1

5

23-M

ar-1

5

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15

20-A

pr-

15

04

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18

-May

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un

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15-J

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-15

29-J

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-15

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15

27-J

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15

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24-A

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15

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5

21-S

ep-1

5

05-

Oct

-15

19-

Oct

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02-N

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16-N

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Co

mp

leti

on

Rat

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%

Waterlow Completion Rate - P Chart

Aim:

Reduce grade 2 pressure ulcers in the EPCT

29%

61%

Grade 2 Pressure Ulcers – C Chart

We aim to provide high quality, continuously

improving care for our service users.

We do this through four types of activity…

ELFT Quality Strategy

(2013 – 2020)

The journey (so far…)

Inspiration & guidance

Inspiration & guidance

Sustaining improvement – a marathon

“Hard-won improvements often ‘backslide’ when the team turns its attention to other priorities.”

… especially when there are too many ‘projects’ to keep up with.

Sustaining improvement – a marathon

A framework which focuses on:

• The daily work of frontline staff

• Supported by a quality management system

• Clear definitions of ‘standard tasks’ and

‘responsibilities’ at all levels of the organizations

Sustaining improvement – a marathon

QualityPlanning

QualityImprovement

QualityControl

Quality Management

System

Manage the work

Improve the work

Design and manage systems

capable of delivering

quality

The Relationship of Quality Improvement and Quality Control

• QC and QI as interlocking loops of activity.

• Quality Control involves standard tasks, monitoring quality, and making routine adjustments and local improvements.

• When problems arise, the problem is escalated to a higher-level QI initiative to redesign the process, or to Quality Planning functions to fundamentally revise the production system.

The Relationship of Quality Improvement and Quality Control

• QC and QI as interlocking loops of activity.

• Quality Control involves standard tasks, monitoring quality, and making routine adjustments and local improvements.

• When problems arise, the problem is escalated to a higher-level QI initiative to redesign the process, or to Quality Planning functions to fundamentally revise the production system.

Pressure Ulcers

57,30%

73,10%

92,01%

UCL

LCL

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

28-

Ap

r-14

05-

May

-14

12-

May

-14

19-

May

-14

26-

May

-14

02-

Jun-

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09-

Jun-

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16-

Jun-

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23-

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30-

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07-

Jul-

14

14-

Jul-

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21-

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14

28-

Jul-

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04-

Au

g-1

4

11-

Au

g-1

4

18-

Au

g-1

4

25-

Au

g-1

4

01-

Sep

-14

08-

Sep

-14

15-

Sep

-14

22-

Sep

-14

29-

Sep

-14

06-

Oct

-14

13-

Oct

-14

20-

Oct

-14

27-

Oct

-14

03-N

ov-

14

10-N

ov-

14

17-N

ov-

14

24-N

ov-

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01-D

ec-1

4

08-D

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4

15-D

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4

22-D

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4

29-D

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05-

Jan-

15

12-

Jan-

15

19-

Jan-

15

26-

Jan-

15

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eb-1

5

09-F

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5

16-F

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5

23-F

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02-M

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23-M

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30-M

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r-15

13-

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r-15

20-

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r-15

27-

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r-15

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g-1

5

07-

Sep

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11-

Jan-

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Waterlow Completion Rate - P Chart

The Relationship of Quality Improvement and Quality Control

• QC and QI as interlocking loops of activity.

• Quality Control involves standard tasks, monitoring quality, and making routine adjustments and local improvements.

• When problems arise, the problem is escalated to a higher-level QI initiative to redesign the process, or to Quality Planning functions to fundamentally revise the production system.

Pressure Ulcers

57,30%

73,10%

92,01%

UCL

LCL

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

28-

Ap

r-14

05-

May

-14

12-

May

-14

19-

May

-14

26-

May

-14

02-

Jun-

14

09-

Jun-

14

16-

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30-

Jun-

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07-

Jul-

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14-

Jul-

14

21-

Jul-

14

28-

Jul-

14

04-

Au

g-1

4

11-

Au

g-1

4

18-

Au

g-1

4

25-

Au

g-1

4

01-

Sep

-14

08-

Sep

-14

15-

Sep

-14

22-

Sep

-14

29-

Sep

-14

06-

Oct

-14

13-

Oct

-14

20-

Oct

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27-

Oct

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03-N

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14

10-N

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17-N

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22-D

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29-D

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05-

Jan-

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12-

Jan-

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Jan-

15

26-

Jan-

15

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5

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5

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g-1

5

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Au

g-1

5

17-

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g-1

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24-

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g-1

5

31-

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g-1

5

07-

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14-

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Sep

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02-N

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09-N

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15

16-N

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15

11-

Jan-

16

Co

mp

leti

on

Rat

e /

%

Waterlow Completion Rate - P Chart

The Relationship of Quality Improvement and Quality Control

• QC and QI as interlocking loops of activity.

• Quality Control involves standard tasks, monitoring quality, and making routine adjustments and local improvements.

• When problems arise, the problem is escalated to a higher-level QI initiative to redesign the process, or to Quality Planning functions to fundamentally revise the production system.

Pressure Ulcers

57,30%

73,10%

92,01%

UCL

LCL

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

28-

Ap

r-14

05-

May

-14

12-

May

-14

19-

May

-14

26-

May

-14

02-

Jun-

14

09-

Jun-

14

16-

Jun-

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23-

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14

30-

Jun-

14

07-

Jul-

14

14-

Jul-

14

21-

Jul-

14

28-

Jul-

14

04-

Au

g-1

4

11-

Au

g-1

4

18-

Au

g-1

4

25-

Au

g-1

4

01-

Sep

-14

08-

Sep

-14

15-

Sep

-14

22-

Sep

-14

29-

Sep

-14

06-

Oct

-14

13-

Oct

-14

20-

Oct

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27-

Oct

-14

03-N

ov-

14

10-N

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14

17-N

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4

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4

22-D

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4

29-D

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4

05-

Jan-

15

12-

Jan-

15

19-

Jan-

15

26-

Jan-

15

02-F

eb-1

5

09-F

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5

16-F

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5

23-F

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02-M

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Ap

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13-

Ap

r-15

20-

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r-15

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Au

g-1

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g-1

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g-1

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5

07-

Sep

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Sep

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28-

Sep

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02-N

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15

09-N

ov-

15

16-N

ov-

15

11-

Jan-

16

Co

mp

leti

on

Rat

e /

%

Waterlow Completion Rate - P Chart

The Relationship of Quality Improvement and Quality Control

• QC and QI as interlocking loops of activity.

• Quality Control involves standard tasks, monitoring quality, and making routine adjustments and local improvements.

• When problems arise, the problem is escalated to a higher-level QI initiative to redesign the process, or to Quality Planning functions to fundamentally revise the production system.

The Relationship of Quality Improvement and Quality Control

• QC and QI as interlocking loops of activity.

• Quality Control involves standard tasks, monitoring quality, and making routine adjustments and local improvements.

• When problems arise, the problem is escalated to a higher-level QI initiative to redesign the process, or to Quality Planning functions to fundamentally revise the production system.

The Relationship of Quality Improvement and Quality Control

• QC and QI as interlocking loops of activity.

• Quality Control involves standard tasks, monitoring quality, and making routine adjustments and local improvements.

• When problems arise, the problem is escalated to a higher-level QI initiative to redesign the process, or to Quality Planning functions to fundamentally revise the production system.

Daily catheter care (KAD packet elements are met)

Bente Øllgaard – Thisted Kommune

Median; 100,00

Mål; 95

92

93

94

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96

97

98

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feb

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apri

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sep

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Alt-eller-intetAndel situationer i forbindelse med daglig kateterpleje, hvor KAD-pakkens elementer

er opfyldt

Median Mål Alt eller intet

Quality Improvement or

Quality Control?

Medicinpakken

Tove Hagen – Lolland Kommune

Quality Improvement or

Quality Control?

Sustaining improvement is…

…essential (but bloody difficult!)

Sustaining improvement requires…

…the development of more robust systems to ensure sustained improvements in outcomes.

Incorporating the different elements of improvement, control & planning.

Forbedringsarbejdet er dejligt, og det er

den måde, vi arbejder på.

I SIKRE HÆNDER MARATON 2013 - ?

Tusind tak!