Transforming Participation in CKD - peer review - 10 May 2016

Valuing Individuals – Transforming Participation in Chronic Kidney Disease

Peer Review Event

10 May 2016

Welcome and Housekeeping

Richard FluckNephrologist, Derby and Co-Chair of TP-CKD

Programme

Welcome and Housekeeping

Transforming Participation in CKD Programme Peer Review Event 10th May 2016 | 3

Programme for the Day

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09:30 Registration opens and tea/coffee and snack available10:00 Welcome and housekeeping10:05 Programme Update and Purpose of Day10:25 Renal Unit Mixed Group Peer Support Session 11:25 Tea & Coffee 11:35 Renal Unit Group Work12:05 Feedback from Group Work12:55 Lunch Break13:30 Programme Updates

- Data Feedback - PV and SONAR Update - Intervention Workstream update - Q&A Session

14:40 Specialist patient / professional session15:20 Tea / Coffee break15:30 What advice would we give to Cohort 216:00 Close

Transforming Participation in CKD Programme Peer Review Event 10th May 2016

Programme Update &Purpose of Day

Rachel GairPerson Centred Care Facilitator,

UK Renal Registry

The Passive Patient

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Healthcare can be profoundly disempowering

But most patients want to be treated as active participants – as co-producers of health.

To a person centred approach…


Co-producing health


What are the questions the TP – CKD programme is asking?


Can: Patient Activation Measure (PAM)Patient Reported Outcome Measure (PROM)Patient Reported Experience Measure (PREM)Clinical Support – Patient Activation Measure (CS-PAM)be collected routinely within renal units?

Is the PAM related to PROM/PREM/Clinical Measure results?

Can we introduce interventions that will increase a patient’s and teams activation?Co-production as a core value

Measurement Workstream Update


Patient Activation Measure – PAMAssesses an individual’s knowledge, skill, and confidence for managing one’s health and healthcare.People who measure high on this assessment typically understand the importance of taking a pro-active role in managing their health and have the skills and confidence to do so.

Patient Reported Outcome Measure - PROMTwo validated PROM’s chosen:CKD specific: Looking at different symptoms known to be found in patients with CKDA generic survey looking at the overall health of the individual and the impact CKD has on this

Measurement Workstream Update


Patient Reported Experience Measure - PREMA patient's experience provides valuable insight. Understanding a patient's experience when he or she receives health care is integral to improving patient-centred care.

As a suitable validated tool for this could not be found it was decided to design a new one which encompassed all aspects that patients wanted measuring. For this reason the new Renal PREM has been designed by the Measurement Workstream but in collaboration with the BKPA and NKF so that it was designed predominantly by patients.

As this is will be used annually by all Renal Units it is hoped that it will soon become a validated tool.

Intervention Workstream Update


The Interventions Development Team- A working party of patients and health professionals set up to source and create a toolkit comprising Intervention Programmes to improve the skills, knowledge and confidence of patients with kidney disease (Stage 3b or higher) Objectives- The group was tasked with identifying interventions helpful for health professionals as well as patients- Likelihood of achieving full involvement of patients in their own care is dependent on both their own level of activation and the level of activation of their health care teamWork to date- Team sourced an outline of interventions- Narrowed these down to a specific group- Prepared a draft Intervention toolkit

Communications Sub Group – Update and Strategy

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Vision

To develop an inclusive and practical communication strategy to deliver awareness of, and support to, the programme team and everyone involved.

Definition of stakeholders and the targeted audience TP-CKD branding optionsCommunication methods

- Social media- External /internal involvement- Patient and staff information


Communications Sub Group – Update and Strategy

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What we have achieved

•Stakeholder analysis•Brand identity•Website under the umbrella of Think Kidneys •Patient information leaflets/ posters•Staff information / renal unit guidance•Monthly newsletter•Monthly teleconferences/meetings•Patient stories•Blogs •Communications support to workstreams•Media planning


Commissioning Workstream - Update


• To establish ways to embed the learning from the Programme into commissioning plans.

• Commissioning should encourage the adoption of evidence based medicine and best practice

• Think Kidneys

• Improving experience

• Improving outcome

• How do we incentivise or mandate behaviour change?

• Contract terms and conditions• CQUINs• Service Specifications• Quality Standards• Outcome measures / Dashboards• The work stream will develop contract “products” that reflect the learning and draw directly from

patient and carer views and involvement

Survey Returns


Unit PAM Returns

CS-PAM Returns

Birmingham Heartlands Hospital (Heart of England NHS Foundation Trust) 37 28St Luke’s Hospital (Bradford Teaching Hospitals NHS Foundation Trust) 180 (HD) 61Coventry (University Hospitals Coventry & Warwickshire NHS Trust) 22 (HD) 14Derby (Derby Teaching Hospitals NHS Foundation Trust) 96 (OPD/PD) 76Hammersmith Hospital (Imperial College Hospital NHS Trust) 61 (HD) 6King’s London (King’s College Hospital NHS Trust) 6 (HD) 31Freeman Hospital (Newcastle Upon Tyne Hospitals NHS Foundation Trust) 0 19City Hospital ( Nottingham University Hospitals NHS Trust) 18 (OPD) 16Derriford Hospital ( Plymouth Hospitals NHS Trust) 8 (OPD) 54Northern General Hospital (Sheffield Teaching Hospitals NHS Foundation Trust) 39 (HD) 19TOTALS 467 324

Purpose of the Day


• This going to be hard work!

• To share experiences

• Ask questions – find out what works

• Challenge beliefs and practices

• Inform and change practice on return to units

• Develop partnership working even further – co-production

• Inform cohort 2

• Capture learning

What next…


• Data feedback – start changing the conversation

• Launch Interventions

• Cohort 2

• Continue to share learning with other LTC + NHS England

• Commissioning + Contracting for Person Centred Care

• Health Economics

Renal Unit Mixed Group Peer Support Session

10:25 – 11:25

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Peer Support Session – Instructions


PURPOSE: Build on the concept of ‘buddy units’ and gain as much learning and sharing of experiences from across all teams by mixing them up. A facilitator will be allocated to each table

Ice – breaker: . This will involve each person in turn in the team asking the person next to them ‘I bet you have never’ and then recount something revealing that they as an individual have done. The aim of this is to move beyond the value judgements that we sometimes make without thinking and start the day as equals bringing different qualities to the event.

In the first half of the session the facilitator will encourage sharing and engagement of all individuals involved making sure that there is full interaction and all voices heard. This will be unstructured and about engagement and confidence building. This section will last about 20 minutes including the ice breaker.

Post it notes will be available on tables to encourage note taking on points to take back to unit teams.

The second part of the session will be more focused on challenges and solutions that have been experienced by the teams.•Did you feel involved in the process of measurement after attending the event in November – how were you involved ( group meetings, emails etc)•Have there been any barriers to starting surveys or spreading surveys to wider population in unit•What have been responses of fellow patients and colleagues to the programme – has there been good support?•What are views on Renal Unit Package and timings (posters, leaflets, RUG etc) and are there any changes you would suggest

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Peer Support Session – Groups


Renal Unit Team

11:35 – 12:05 Group Work12:05 – 12:55 Feedback

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Renal Unit Group Work – Instructions


11:35 – 12:05 Renal Unit Group WorkIndividual teams to use ‘pre-work’ as a resource for discussion.Individuals to bring back to the team any learning that may have been gleaned from previous sessions – any solutions or offers of help. Returning to your own Renal Teams we would like you to bring together the ‘Pre Work’ (as per below) and your learning from the previous Mixed Group session to draw out the key points and set some next steps that your unit teams can take away with you. •The 5 challenges + 5 successes we have had in implementing the Health Surveys•The 2 pieces of overwhelming advice we would offer to team in cohort 2 ( feedback in last session)•The impact co-production has had and how we feel we are doing things differently •How we think this will change outcomes for patients Please use the template provided to capture your learning and next steps in preparation for feedback. A facilitator will be available to support and guide this session.

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Renal Unit Group Work – Instructions


12:05 – 12:55 – Feedback

You will have 5 minutes to feedback to everyone your teams’ next steps and key learning points. Nominate one person from your team to - a roving mic will go around the tables giving each unit an opportunity to share.

LUNCH

12:55 – 13:30

Programme Updates and Data- Data Feedback

- PV and SONAR Update- Intervention Workstream Update

13:30 – 14:40

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Data Feedback


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Intervention Workstream Update


UK Renal Registry have worked in setting up a group consortium to develop a programme – Transforming Participation in CKD.

The Interventions Development Team•A working party of patients and health professionals set up to source and create a toolkit comprising Intervention Programmes to improve the skills, knowledge and confidence of patients with kidney disease (Stage 3b or higher) Objectives•The group was tasked with identifying interventions helpful for health professionals as well as patients•Likelihood of achieving full involvement of patients in their own care is dependent on both their own level of activation and the level of activation of their health care teamWork to date•Team sourced an outline of interventions•Narrowed these down to a specific group•Prepared a draft Intervention toolkit

Lower time and cost

Higher cost and more time

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• Any questions?

Q&A Session


Specialist Patient / Professional Session

14:40 – 15:20

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Patients and clinical teams will break away into separate rooms. The purpose of this session is not to be divisive but to enable free discussion and networking amongst relevant groups. Although this will be an informal session some structure is required. The facilitator will encourage the use of post it notes to share ideas and will also take notes on themes on a flip chart to ensure all information is captured.

Specialist patient / Professional Session Instructions


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Patient Team


Networking - chatting

Sharing specific ideas on –

• What has gone well as a patient and do they feel they could or would want to be more involved

• Have they felt involved in the programme as team approach – co-production

• Have they done surveys – what has been their experience of this

• Have they been a patient volunteer and do they think there is more that can be done in this role

• Sharing of experiences to take back to units and also programme.

• Sharing of experiences to inform cohort 2

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Health Care Team


• What has been experience regarding engagement across the whole MDT – is there a disparity in engagement from each discipline ( nursing staff, medical staff, dieticians etc)

• How have teams managed and organised themselves without additional resource to implement PAM/PROM? ( get examples)

• What are experiences of patient volunteering

• What are thoughts on further spread – what will be required to embed this?

What advice would we give Cohort 2?

Richard Fluck & Jonathon Hope

15:30 – 16:00

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This session is an open mic session and we will be asking each Renal Unit team to offer 1 or 2 pieces of advice that they would give to Cohort 2.

Please use the templates provided. A roving mic will go around the room and feedback will be captured and taken back as part of the TP-CKD Programme Learning to give to Cohort 2

What advice would we give Cohort 2 - Instructions


Richard FluckNephrologist, Derby and Co-Chair of TP-CKD [email protected]

Jonathon HopeTP-CKD Patient [email protected]

Patricia MuramatsuSenior Strategic AdvisorPerson Centred Care Team, NHS [email protected]

How to find out more

Karen ThomasHead of ProgrammesUK Renal [email protected]

Sarah EvansTP-CKD Programme CoordinatorUK Renal [email protected]

Rachel GairPerson Centred Care FacilitatorUK Renal [email protected]

Ron CullenCEOUK Renal [email protected]

Contact Think Kidneys

www.linkedin.com/company/think-kidneyswww.twitter.com/ThinkKidneyswww.facebook.com/thinkkidneyswww.youtube.com/user/thinkkidneyswww.slideshare.net/ThinkKidneyswww.thinkkidneys.nhs.uk/CKD


Transforming Participation in CKD - peer review - 10 May 2016

Health & Medicine

Transcript of Transforming Participation in CKD - peer review - 10 May 2016