KQUiPHome dialysis National ProgrammeA proposal for a improvement project for home dialysis

Richard FluckDate 30th September 2016

Antrim

Belfast

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West NI

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D&Gall

DundeeEdinb

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Inverns

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Clwyd

Swanse

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Home therapy (all) % rate by centre Home Nations

2010 2011 2012 2013 2014

The proposal: translating vision into action

A national project facilitated by KQuiP

Focused on home dialysis – PD and Home HD

Improving outcomes – uptake, patient experience and measures

Defining success – also at regional level

Designed and led at a local level

Regional groupings – centres working together

Your role at this meeting

Starting the design process

Starting that regional collaboration

The offer from KQuiP

Core metrics• Defined in collaboration • Collected and presented via UKRRDevelopment of teams• Leadership • QI skillsProject and network support

Communications

Possible project resources

Regions: how?

Regional networks of providers – cf Transplant First

Common purpose

Delivering local solutions

Who is in the team – region and provider?

Patients, MDT, commissioners, managerial (finance)

Data

Define additional local data

The ‘dashboard’

Three phases to project

Principles

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Bristol

Dorset

Exeter

GloucKent

Oxford

Plymth

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Truro0.0

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30.0

Home therapy (all) % rate by centre South

2010 2011 2012 2013 2014

Phase 1 Discovery

Define current pathways, collect data, consider the barriers

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Home therapy (all) % rate by centre London

2010 2011 2012 2013 2014

900.00.0000Kidney Quality Improvement Partnership | Title | Author

Initial survey data

Phase 2: ideas

Develop ideas and potential solutions

Share ideas

Bring ideas together

Develop the change package

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45.0 Home therapy (all) % rate by centre Midlands

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Education

Unplanned starts

MDT review of all starters

Shared decision making

MDT review of exits from home therapies

Data presentation

00.00.0000Kidney Quality Improvement Partnership | Title | Author

The change package

SDM Collaborative NICE action plan

1. Leadership and culture change2. Local leadership3. Education and training4. Shared decision making tools5. Guidance development and evidence reviews6. Measurements of successful shared decision making7. Research.

Phase 3: Test

Agree testing period

Put into action

Measure effect via agreed dashboard

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Salford

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Wirral

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10.0

15.0

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35.0

Home therapy (all) % rate by centre North

2010 2011 2012 2013 2014

1300.00.0000Kidney Quality Improvement Partnership | Title | Author

Step wedges and peer assist

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The KQuIP offer

The shared purpose

Communications support and advice - mobilise

Education – methodology and tools

Measurement – collection and presentation support

Networks – linkage within and between networks, influencing, spread and adoption

Projects - project support – rigorous delivery – PROJECT MANAGEMENT

Leadership – supporting the design and championing of the project, co design

Peer assist model as part of step wedge

00.00.0000Kidney Quality Improvement Partnership | Title | Author

The ask of you

Advocate for the project

Form your regional groups – you have started that!

Be inclusive – think about the entire process, coproduction

Think about what and how of your project – you have started

Explore barriers and solutions – the survey is a start

Indicate you want to be part of this

Understand the detail is yet to be defined.

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The end (?)

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