Workstream breakouts

Dundee City

Format for Workstreams sessions• Introductions at your table• Improvement Bootcamp overview and other

improvement journeys• Components of a learning system – how does our

work stack up?• Workstream presentations – 30 mins each including

Q&A• Table top reflection on own learning and application

of improvement methodology

The Bootcamp Experience : from this…..

The Bootcamp Experience : to this……

Components of a Learning System

1. System level measures2. Explicit theory or rationale for system changes3. Segmentation of the population4. Learn by testing changes sequentially5. Use informative cases: “Act for the individual learn for the

population” 6. Learning during scale-up and spread with a production plan

to go to scale7. Periodic review8. People to manage and oversee the learning system

From Tom Nolan PhD, IHI

Kerstin Jorna & Marie Dailly

Dundee: How to engage with a growing and changing population

Dundee

Growing Population of over 147,000Over 9,000 children aged 0-5 Sunniest City in Scotland but …

Dundee – Changing for the Future

EYC logo

But how???

Tests of change?Workstreams?

Driver diagrams?

EYC

?

Dundee adult literacy – Hotspot areas

Dundee adult literacy – Hotspot areas

Testing a new way of workingTo test out a new way of working, taking data which indicated the likelihood of potential literacies needs down to a street level and offering everyone in those areas, with a child aged 0-3 years old, the chance to take part

What did we want to achieve?• Whole family approach to learning

• Putting the parents/carers at the heart of early literacy development

• Increasing confidence in their abilities as the primary educator

• Children developing the early foundation of literacies.

What do we know?

• 198 children 0-4 in identified streets• Limited engagement with speech and

language therapists and Health Visitors• Lack of facilities for families pre nursery

Engaging with Families• Addressing barriers• Building on assets• Getting to people “hard to reach”• Testing a strategy for engagement.

Key Wins – Engagement by many methods

• Initial contact with community• Follow ups face to face and telephone• Getting people to sign up for the “real”

learning afterwards• Facebook• Texting

www.facebook.com/yourchildisamazing

Key Wins – from outreach to outcomes

• Increased participation• Community building (bring a

friend)• From introductory fun sessions to

“serious” learning• Observing improvement/parents

feed back

Video playing here….

Key Lessons Learned • Time has to be invested in engaging with parents and the community they

live in• The same approach may not work in all communities• The effort is really worth it when target families enjoy and learn• The whole family benefits, not just the children in target age group

Key Wins in the Area of Measurement

Data collection by “experts” was excellent anyway (pre EYC)

Allowed easy mapping to EYC formatThis could be fed back to staffmeasurement now done by “non experts”

Texting will improve attendance

1st Attempt

• Theory detail: 7pm on the previous night• Prediction: 8 families will attend

Texting will improve attendance

1st Attempt

• Theory detail: 7pm on the previous night• Prediction: 8 families will attend• Result: 10 families attended

Texting will improve attendance

2nd Attempt

• Theory detail: 3pm previous afternoon• Prediction: 8 families will attend

Texting will improve attendance

2nd Attempt

• Theory detail: 3pm previous afternoon• Prediction: 8 families will attend• Result: 7 families attended

Texting will improve attendance

3rd Attempt

• Theory detail: 1 hour before start of group• Prediction: 8 families will attend

Texting will improve attendance

3rd Attempt

• Theory detail: 1 hour before group• Prediction: 8 families will attend• Result: 3 families attended

Texting will improve attendance

4th Attempt

• Theory detail: 7pm on the previous night• Prediction: 8 families will attend

Texting will improve attendance

3rd Attempt

• Theory detail: 7pm on the previous night• Prediction: 8 families will attend• Result: 8 families attended

Lessons Learned in the Area of Measurement

• Acknowledgement of existing measures• Simple Paperwork• Linking measures to outcomes • Dialogue between subject expert and data

expert

Key Wins in the Area of Testing

and so forth…. and so on…. different times for texting

different media for reminders

different titles of activities

different methods of initial engagement

Lessons Learned regarding testing

• Method works well once format simplified• Need several tests for each PDSA• Many tests are transferable to other projects• Each test has to be tried again in new

environments/ communities/ context

Plans for next 3-6 months

• Continue to engage with further families• Progress from initial to intensive stage• Continue to encourage families to then take part in

intensive literacy support work • Develop parent volunteer• Test outcomes linked to stretch aims

TABLE DISCUSSION• Who are individuals and/or teams currently

working on/in this area? Are they currently using Quality Improvement methods/PDSA cycles to guide their learning?

• Reflecting on the emerging knowledge within this area, and today’s plenary session on scaling up your work, what are some considerations you need to plan for to get to scale for your project?